世界银行-巴基斯坦-气候和健康脆弱性评估（英）-2024-78页_6mb

CLIMATE AND HEALTH VULNERABILITY ASSESSMENT: PAKISTAN

Summary

Introduction
Pakistan, a climate-vulnerable country with diverse geography and heavy dependence on agriculture, faces rising climate-related health risks. This assessment evaluates current and future climate exposures, examines health risks (e.g., heat stress, vector-borne diseases, waterborne illnesses, and nutritional deficiencies), and assesses the health system's adaptive capacity to develop recommendations for building resilience.

Observed and Projected Climate Change

• Temperature: Pakistan has warmed by ~0.5°C over the past century, with warming accelerating in winter and post-monsoon months. By mid-century, average temperatures could rise by 1.3–1.9°C, leading to more extreme heat events (e.g., daily max temperatures exceeding 47°C).
• Precipitation: Rainfall has increased slightly but varies regionally. Floods and droughts are becoming more frequent and intense, with sea-level rise threatening coastal areas, particularly in Sindh.

Climate-Related Health Risks

1. Heat-Related Risks:

   • Extreme heat is a major risk, with Lahore and Karachi facing the highest exposure.
   • Heatwaves exacerbate mortality (e.g., the 2015 event killed ~1,200 people) and reduce labor productivity.

2. Vector-Borne Diseases (VBDs):

   • Dengue cases surged 800-fold between 1995–2004 and 2019, affecting ~62 million people.
   • Climate may expand dengue and malaria transmission, though Pakistan’s cold winters limit year-round spread.

3. Waterborne Diseases (WBDs):

   • Climate-driven flooding increases risks of cholera and diarrhea. Poor sanitation and limited WASH infrastructure exacerbate vulnerability.

4. Nutrition Risks:

   • Climate shocks (e.g., droughts) threaten food production, particularly wheat and rice, worsening malnutrition in Balochistan and Sindh.

Health System Adaptive Capacity

The health system faces significant gaps:

• Leadership and Governance: Limited coordination mechanisms between climate and health sectors.
• Health Workforce: Shortages and uneven distribution, especially in rural areas; lack of training on climate risks.
• Health Information: Insufficient integration of climate data into surveillance systems.
• Financing: Low public health expenditure leads to high out-of-pocket costs, reducing resilience.

Recommendations

• Strengthen climate-health policy integration, establish national coordination mechanisms, and mainstream climate adaptation into health programs.
• Enhance health workforce training, surveillance systems, and early warning systems.
• Invest in climate-resilient health infrastructure and financial mechanisms to protect vulnerable populations, including risk-pooling tools.
• Promote intersectoral collaboration (e.g., with agriculture and disaster management) to address climate vulnerabilities holistically.

Poli
cy actions are urgent to mitigate climate-related health risks and build long-term resilience.