柳叶刀气候变化与健康倒计时

TheLancetCountdownonHealth and Climate Change& Médecins Sans Frontières 2024 Every climate action counts: The ripple effect ofeach failure on health care in humanitarian settings At the time of writing, many people around the worldare feeling the pain, disruption, and devastatinghealth consequences driven by climate change. Theworld has been shocked by the widespread flooding inEurope and the consecutive catastrophic hurricanesin North America. Yet far less attention is given to theimpacts of climate change in places where MédecinsSans Frontières (MSF) works, such as Central AfricanRepublic, Chad, Côte d’Ivoire, Democratic Republic ofCongo, Myanmar, Niger, Nigeria, and South Sudan. In2024, these populations have likewise been affectedby devastating floods, many of them not for the firsttime. Angumu, Ituri Province, DR congo. Pamoth is located on theshores of Lake Albert. The camp regularly floods, forcing alreadydisplaced people to move again, inland. (Photo: Solen Mourlon) Although immediate impacts like injury, displacement,and limited access to healthcare may be similarworldwide, the compounding crises that follow andthe capacity to recover from these vary significantly.Individuals in low-resource and humanitarian settingsface significant health threats while contributing theleast to global emissions. These regions are oftenvulnerable to climate hazards and possess lowadaptive capacity, increasing people’s susceptibilityto the negative impacts of climate change. In this brief, drawing on evidence from indicatorsin the 2024 report of theLancetCountdown onHealth and Climate Change,1MSF teams presentexamples of how climate change and environmentaldegradation are making provision of assistance moredifficult by amplifying health and humanitarian needsand by further complicating interventions.2It alsohighlights activities that respond to the climatecrisis using a three-pillar approach:mitigatingMSF’s environmental footprint,adaptinghealthcaredelivery and emergency response to the current andfuture realities of climate change, andadvocatingforthose impacted. The complexity of climate change and environmentaldegradation, coupled with highly politicised and siloedglobal response efforts often make it insufficientlyclear to health and humanitarian implementingpartners that every issue is part of a continuousprocess, where each component informs the others.In this brief, MSF staff outline six focus areas whereteams are engaged in developing environmentally-informed health and humanitarian interventions,emphasising their interdependence, and how failureto act on one issue not only impedes progress onthat specific component but also affects the entiresequence of subsequent actions. Aerial view of flooding in Didangali district, N’Djamena, Chad.Didangali district is on the southern outskirts of the capital.Three men are using a boat to try to reach their home to retrieveblankets and some utensils. Most of the displaced people wereunable to take many things with them. Much of their possessionseither washed away in the flood or were abandoned to facilitateevacuation. (Photo: Fausto Podavini) Integrating mitigation: Not a simple swap, a systemicoverhaul Expanding its definition of the medical andhumanitarian ‘Do No Harm’ principle to integrateenvironmental degradation, MSF set an ambitiouscourse in 2021 by committing to reduce greenhousegas (GHG) emissions by 50% by 2030. To achievethis, mitigation priorities must be as integral toMSF’s mission as any medical protocol, ensuring theorganisation is not contributing to the future harmof people and planet. Efforts should focus on high-impact areas, guided by empirical data that highlightswhere the biggest difference can be made. Indeed, agreat deal of actions that mitigate climate change alsohelp adapt to its effects, offering multiple, interrelatedbenefits including increased resiliency to shocks andreduced reliance on fossil fuel supply chains. In anoperational setting, temperature-controlled medicalwarehouses are a simple, effective, often overlookedexample – both reducing dependance on fossil fuelsand adapting health structures to external weatherconditions. to disposal, to truly gauge their environmental tolland prioritise mitigation action. One of the mainchallenges identified is the lack of sustainablealternatives on the market, and when available,implementing reusable alternatives in systems lackingproper infrastructure, like industrial laundry andsterilisation.Sustainability in medical products isnot a simple swap—it’s a systemic overhaul, whichwill require investment in infrastructures, effectiveimplementation of sustainable medical practices, andadvocacy towards a regulatory shift in the medicalproducts market. In low-resource settings, the obstacles are evensteeper. Reliable data on pollution exposure isscarce, and inadequate waste management, lack ofresources, and the slow uptake of technology makesustainable practices hard to implement.5Accordingto