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Climate and Health Vulnerability Assessment in Tanzania

Core Content

This document presents a Climate and Health Vulnerability Assessment (CHVA) for Tanzania, conducted by the World Bank's Health Climate, Environment and Disaster (HCED) program. The assessment aims to evaluate the impact of climate change on health and to support decision-makers in developing adaptation strategies to address these risks. It covers both mainland Tanzania and Zanzibar, and includes recommendations for strengthening the health system's resilience to climate change.

Main Objectives

• To identify and analyze climate-related health risks and their potential impacts on public health.
• To evaluate Tanzania's adaptive capacity in dealing with these risks.
• To provide recommendations for enhancing the resilience of the health system and related sectors to climate change.

Key Climate Trends and Projections

• Temperature: Mean annual temperatures have increased by 0.56°C over the past 50 years, and are projected to rise by 0.68°C by the 2030s and 1.40°C by the 2050s. The warming is most pronounced in January, June, and September.
• Precipitation: Precipitation in mainland Tanzania has decreased by nearly 50 mm since the 1960s, with significant declines in the Eastern Rift Valley highlands. Future projections suggest a slight increase in rainfall through the 2050s.
• Sea-level Rise: Coastal communities and Zanzibar face a significant threat from rising sea levels, which are projected to range from 16 to 42 cm by 2050, potentially causing USD200 million in annual damages to land and infrastructure.
• Extreme Weather Events: The intensity of heavy rainfall events is expected to increase, leading to more frequent flooding, especially in the southeastern and northwestern regions of mainland Tanzania. This is likely to increase the frequency of dry spells, particularly in regions such as Mbeya, Tabora, Geita, Kigoma, Katavi, Rukwa, Shinyanga, Singida, and Ruvuma.

Climate-Related Health Risks

1. Food Security and Nutrition Risks

• Acute food insecurity affects 56.4% of the population in 2019, with rural areas being more vulnerable than urban ones.
• Climate change impacts on agriculture and population growth are expected to worsen extreme hunger, food insecurity, and malnutrition.

2. Vector-Borne Disease Risks

• Tanzania has one of the highest malaria prevalence rates in Eastern and Southern Africa, with 93% of the population at risk.
• Mosquito suitability is highly sensitive to climate factors, and rain-induced floods are projected to increase malaria transmission and cases.

3. Waterborne Disease Risks

• Waterborne diseases are a leading cause of death among children under five, with 23,900 annual deaths.
• Projected increases in extreme rainfall and flooding are expected to raise drinking water contamination and WBD outbreaks.

4. Heat-Related Morbidity and Mortality Risks

• The Mara region and Dar es Salaam are particularly vulnerable to extreme heat-related injuries and mortality.
• Extreme heat exposure is expected to become more common by the mid-century, with Zanzibar and Dar es Salaam at the greatest risk.

5. Air Quality Related Health Risks

• Indoor air pollution from domestic biomass combustion remains the main driver of poor health.
• Women and children are disproportionately affected due to prolonged exposure.

6. Direct Injuries and Mortality Risks

• Heavy rains cause flash floods, mudslides, and landslides, threatening lives and livelihoods.
• Projected increases in flooding will likely lead to more deaths and injuries.

7. Mental Health and Wellbeing Risks

• Mental health conditions are a growing concern, with neuropsychiatric disorders accounting for 5.3% of the global disease burden.
• Climate change and its socioeconomic impacts are significantly affecting the mental health of low-income populations and creating new vulnerabilities for those with existing mental health and substance use disorders.

Health System Adaptive Capacity

The health system's ability to respond to climate-related health risks is evaluated using the World Health Organization's (WHO) six health system building blocks:

1. Leadership and Governance
2. Health Workforce
3. Health Information Systems (HIS)
4. Essential Medical Products and Technologies
5. Health Service Delivery
6. Health Financing

Key Gaps in Adaptive Capacity

• Limited professional expertise and distribution of the health workforce.
• Lack of awareness among health workers about climate change and its health impacts.
• Health facilities are concentrated in urban areas, making rural populations more vulnerable due to longer travel distances.
• High dependence on foreign donors for health funding, with national investments still below the Abuja Declaration target of 15% of total budgets.

Key Recommendations

To enhance health system resilience to climate change, the report recommends the following 10 components:

1. Leadership and Governance: Integrate climate change into national and local health policies and ensure cross-sectoral coordination.
2. Health Workforce: Improve the distribution and training of health workers to address climate-related health risks.
3. Vulnerability, Capacity, and Adaptation Assessment: Conduct comprehensive assessments to identify and prioritize climate-related health risks.
4. Integrated Risk Monitoring and Early Warning Systems (EWS): Develop and strengthen early warning systems that incorporate weather data and climate projections.
5. Health and Climate Research: Promote research on climate and health interactions to support evidence-based decision-making.
6. Climate-Resilient and Sustainable Technologies and Infrastructure: Invest in climate-resilient health infrastructure and technologies.
7. Management of Environmental Determinants of Health: Address environmental factors that contribute to climate-related health risks.
8. Climate-Informed Health Programs: Design health programs that consider climate change impacts.
9. Emergency Preparedness and Management: Enhance emergency preparedness and response mechanisms for climate-related events.
10. Climate and Health Financing: Increase financing for climate-related health risks, including strategic purchasing that considers climate factors.

Conclusion

Tanzania is highly exposed and vulnerable to the impacts of climate change, which are already affecting health, food security, and livelihoods. The CHVA provides a comprehensive analysis of climate-related health risks and outlines key recommendations for improving the resilience of the health system and related sectors. Strengthening the health system's adaptive capacity is essential for ensuring sustainable development and protecting public health in the face of a changing climate.