Poverty: The Real Threat to Health

Friday, May 15, 2009

By Philip Stevens

A prestigious report by doctors says climate change is the biggest threat to the health of the poor around the world. But isn’t poverty the biggest threat and prosperity the best solution ? 

A major new report from doctors at University College, London, and medical journal The Lancet claims that climate change “is the biggest global health threat of the 21st century.” Their solution means permanent recession, more famine and more disease.

Killer heatwaves, insect-borne "tropical" diseases, flooding and hurricanes will affect billions over the next 100 years as global temperatures soar, they say. With this report published on 14 May, doctors are adding their powerful voice to calls for deep cuts in carbon emissions to stabilise global temperatures. But if their aim is actually to improve health–particularly in poor countries–they could hardly be more wrong.

For starters, the relationship between climate and disease is weaker than claimed. The Lancet report details at length how warmer temperatures will lead to so-called tropical diseases such as malaria moving northwards and to higher altitudes. But this ignores the vast range of human and ecological factors that surround disease.

According to Professor Paul Reiter, an expert on insect-borne diseases and contributor to the UN’s Intergovernmental Panel on Climate Change (IPCC), “there is no evidence that climate has played any role” in malaria. Reiter points out that malaria was endemic in Britain until the second half of the 19th century, when improved agricultural practices, drainage and housing caused a spontaneous decline of the disease because mosquitoes had fewer opportunities to bite people–while records show temperatures rising.

The report also claims global warming will lead to more deaths from heatwaves as the sick and elderly struggle with high temperatures. But Professor Bill Keatinge, an expert on human physiology at London University, has shown that deaths do increase in the first few days of a heatwave but most of the victims were likely to die shortly anyway. The data show that average mortality actually decreases during the later stages of heatwaves.

Moreover, humans have developed a range of ways coping with high temperatures, from adaptation to siestas to air conditioning. Ask the Tuareg.

In fact, cold weather is far more harmful because of the increased risk of respiratory infections, heart attacks and strokes. Britain, for example, with a temperate climate, has only 1,000 heat-related deaths every year, compared with 20,000 cold-related.

The report also claims that millions will die as a result of “extreme weather events” such as hurricanes. But such deaths have actually decreased by 95 per cent since the 1920s, according to calculations by Indur Goklany, who has represented the USA on the IPCC, largely due to better early warning systems, building standards and weather forecasts.

Cutting greenhouse gas emissions, however, would be very bad for human health.

According to calculations by Lombard Street Research in the UK, any global treaty that would stabilise the climate at today’s temperatures would cost a total of £8 trillion–45% of the world’s current annual economic output, causing permanent economic depression.

Economic growth is an absolute pre-requisite for improved health. One study has shown that if economic growth in the developing world had been a mere 1.5% higher in the 1980s, at least 500,000 child deaths could have been prevented.

This is because much of the disease burden in developing countries is a direct result of poverty. Diarrhoea, chest infections from burning wood and dung indoors, water-borne infections and malnutrition are the biggest killers of children, killing millions regardless of any changes in the climate.

Britain eliminated malaria as a side-effect of increasing prosperity: glass windows, separate barns for cattle and better land management, depriving the mosquito of feeding and breeding opportunities. It is no coincidence that malaria is currently confined to the poorest parts of the world, because they are the least able to afford such improvements.

The doctors’ call for cutting carbon emissions would be a betrayal of the sick in the world’s poorest regions, because it would undermine the one mechanism–economic growth–which allows people to move beyond the primitive living conditions that encourage disease.

Prosperity also removes the doctors’ apocalyptic vision of social turmoil and mass migration as millions flee flood or drought: growth allows adaptation and protection.

If doctors are concerned about the effect of climate on health, they should not advocate hobbling the global economy and preventing the poor from getting richer.

Philip Stevens is director of policy at International Policy Network, a development think-tank based in London.