Climate change and vector-borne diseases in Pakistan

Due to poor living conditions, these diseases have affected urban and rural communities alike but have thrived predominantly among the communities with poor living conditions, particularly having lack of access to adequate housing, safe drinking water and sanitation

The earth’s climate has always been changing. The impacts of climate change include biodiversity losses, rise in sea levels, shifts in weather patterns, changes in freshwater supply and an increase in extreme weather events such as floods and droughts as well as glacial melting and various health impacts. Major concerns are the threats to food, water and energy security.
Pakistan is vulnerable to the impacts of climate change. The unprecedented changes in environmental issues, primarily the floods of July 2010 caused by climate change, veritably broke all previous records of loss of life, property, infrastructure and livelihood. The cost of loss and damage has been estimated to the tune of $ 10 billion. In addition, it created 20 million climate refugees in Pakistan in just one incident, which is 10 percent of the total global estimate of 200 million climate refugees by 2050.
The effects of global warming and climate change are relatively more pronounced in the country due to its over-reliance on the environment for basic survival, high population growth rate and density, low capacity to mitigate the negative impacts of climate change and poverty. The poor use natural resources for their livelihoods without paying much attention to seen or unseen consequences, thus limiting their livelihood assets such as employment, health, education and access to water and other basic amenities of life. The Global Climate Risk Index, an annual report prepared by the German non-government organisation Germanwatch, has ranked Pakistan among the three most affected nations worldwide for three consecutive years since 2010. The Islamabad-based think tank, Global Change Impact Studies Centre, has reported that Pakistan is suffering twice the average rate of global warming worldwide.
Various negative effects of climate change are burgeoning every day globally. The rising trend of climate change is shown in recent reports by the United Nations’ Intergovernmental Panel on Climate Change. Nearly half of the world’s population is at risk of vector-borne diseases, which account for more than 17 percent of all infectious diseases and cause more than a million deaths annually.
Climate contributes a significant role in the seasonal pattern or temporal distribution of diseases that are borne and transmitted through vectors. The trends of climate change in various parts of the world help vector animals thrive in particular climate conditions. According to the World Health Organisation (WHO), the most lethal vector-borne disease is malaria, claiming 627,000 lives in 2012 (a vector-borne disease is one carried from one person to another through a third organism, like a blood-sucking bug). However, the world’s fastest growing vector-borne disease is dengue, with a 30-fold increase in disease incidence over the last 50 years.
Vector-borne diseases add to the generous bulk of health-related problems in developing countries. Pakistan has been undergoing a contagious increase of dengue fever since 2005, which has led to many deaths. Since 2010, Pakistan has been going through the scourge of dengue fever, which resulted in 16,580 confirmed cases, 257 deaths in Lahore and approximately 5,000 cases and 60 deaths reported from other parts of the country. It is evident that the whole country is prone to the dengue epidemic in one way or the other through the fluctuating trends of climate.
The current situation of vector-borne diseases in Pakistan is quite alarming. With an estimated burden of 1.5 million cases annually, Pakistan has been pigeonholed by WHO in the ‘group three’ countries of the WHO Eastern Mediterranean Region with Afghanistan, Djibouti and Somalia. The poorest of the poor in vulnerable communities, living in remote rural areas with limited access to health facilities, suffer the most. Improper settlement of the people in slum areas without an adequate system of water and sanitation impacts the other sections of the population within urban and suburban regions. Due to poor living conditions, these diseases have affected urban and rural communities alike but have thrived predominantly among the communities with poor living conditions particularly having lack of access to adequate housing, safe drinking water and sanitation.
According to the World Bank study, rising temperatures and humidity levels are also likely to increase the transmission of vector-borne diseases such as malaria, dengue fever, yellow fever and encephalitis. Studies predict that an increase of three to four degrees celsius in average temperatures may double the reproduction rate of the dengue virus. 
Malaria is greatly influenced by changing climatic patterns and the degree of immunity among the population where it strikes. The major climatic determinants of malaria on transmission are temperature, precipitation and humidity. The temperature range of 20 to 30 degrees celsius is generally optimal for the development and transmission of the malaria vector. In terms of humidity, a level greater than 55 percent is optimal for vector longevity. Mosquitoes breed in standing water and, therefore, rainfall plays an important role in malaria transmission. In Pakistan, malaria usually strikes after the monsoon season. However, in coastal areas and the western borders, it persists throughout the year. The greatest prevalence of disease is found in Balochistan followed by FATA and Khyber Pakhtunkhwa.
Climate change is a global issue impacting the health and lives of a larger portion of the population indicating that the phenomenon is real and is bound to affect the rest of those unaffected by it today. Knowledge of the health impacts associated with climate change will have limited value without effective communication and education strategies to increase public awareness and understanding of the specific risks involved and the complexity of the issues. Communication with particularly vulnerable individuals and populations, as well as with health care professionals and public health officials tasked with protecting communities, is itself deserving of further research to tackle this issue effectively.

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Aaj Kal