Wen-Ta Chiu, Taiwan’s Minister of Health and Welfare, warned the World Health Assembly (WHA) this morning (5/21) in Geneva, Switzerland, that climate change already poses a serious threat to human health. If we continue not to respond actively, outbreaks of a number of diseases will occur. The elderly and children are not the only ones in danger, adults with stronger resistance will also struggle to escape. 

The WHA sets a theme each year. This year’s theme is the impact of climate change on health. Among the 194 member countries, 105 have registered to speak. Taiwan was scheduled to take the stage on the morning of the 21st as the first of the observing members. Wen-Ta Chiu used a phrase published in the internationally renowned medical journal The Lancet to remind the world that “climate change is the biggest global health threat of the 21st century.” 

Taiwan is located within the subtropics. With the impact of global warming and climate change, Taiwan cannot stay out of the discussion. Between 1909 and 2008, air temperatures rose by approximately 0.8o C. The rate of increase was 0.14o C every 10 years. This has accelerated over the past 30 years. Over the past 44 years, heavy rainfall across Taiwan has doubled, while the number of days with light rain, which is associated with irrigation and water conservation, dropped significantly. In addition, Taiwan lies on the Western Pacific typhoon belt. In the 10 years between 2000 and 2009, 11 typhoons with heavy rainfall struck Taiwan, resulting in serious flooding. The number of typhoons nearly tripled in comparison to the previous 10 years, during which only 4 typhoons occurred. 

Wen-Ta Chiu stated that climate change influences three factors of health: infections, emergencies, and the challenges of environmental change. In regard to infections, extreme weather intensifies disasters, thereby influencing the occurrence of a variety of infectious diseases. Empirical data from Taiwan’s National Health Insurance Database indicate that four types of infectious diseases are associated with climate change: dengue, melioidosis, leptospirosis, and scrub typhus. 

Of these diseases, an outbreak of dengue in 2002 resulted in 5336 cases. In the 6 years between 2007 and 2013, the intermittent outbreaks of the past became a persistent outbreak. However, thanks to close monitoring, reporting, and intervention, the number of cases has been limited to less than 2000 each year. Nevertheless, the number of imported cases is clearly showing increasing trends. Over the past 10 years, 3 outbreaks of melioidosis have occurred, infecting a total of 86 people. These all occurred within 1 to 3 weeks following the strong rains of typhoons. An outbreak of leptospirosis also occurred following Typhoon Morakot in 2009, infecting a total of 130 people. The occurrence of scrub typhus increased from 1.4 per 100,000 people in 2000 to 3.0 per 100,000 people in 2013. 

In regard to emergencies, typhoons and floods have tripled in Taiwan over the past ten years. Deaths and injuries have also seen corresponding increases. According to analysis of 2000 to 2013 statistics from Taiwan’s National Health Insurance Database, the prevalence of post-traumatic stress disorder increased from 50.1 cases per 100,000 people in 2000 to 60 cases per 100,000 people in 2013. 

Facing these challenges, Taiwan has established a systematic and thorough Central Emergency Operations Center that can respond to 22 types of disasters. A total of 501 hospitals throughout the country have also established emergency response mechanisms. Hospital accreditation ensures the quality of these mechanisms. Hundreds of special space and night exercises are conducted every year. 

In regard to environmental changes, high temperatures and humidity have the most significant impact on mortality. According to research in Taiwan, the heat index temperatures at which mortality rates may increase substantially are 35o C to 38 oC. As these index temperatures are surpassed and humidity increases, mortality rates also grow. The mortality rates of the elderly are even higher than those of the general population are. 

In view of this, the Taiwanese government established the “Program for Caring for the Disadvantaged During Times of Ultra-Low and Ultra-High Temperature” long ago. This program provides direct care and protection for elderly people living alone, vulnerable people, and homeless people during the coldest and hottest weather. For example, during the coldest months of 2012, reports of cardiovascular and stroke emergencies and medical treatment increased by 11%. Promotion and prevention in advance can reduce morbidity and mortality rates. 

Environmental change often leads to increased ultraviolet radiation. Cases of cataracts and skin cancer have gradually increased in Taiwan over the past 10 years, and the cataract patients have been getting younger. Climate change also leads to increased air pollution and allergens. Taiwan’s National Health Insurance Database indicates that allergic diseases have increased from 9.4% to 14.5% over the past 20 years. 

Wen-Ta Chiu emphasized that Taiwan greatly supports the strategies formulated by the World Health Organization (WHO) in response to climate change. Taiwan has created a national inter-ministerial committee to respond to climate change and is adapting and formulating policy frameworks, action plans, and short-, medium-, and long-range plans for climate change. Taiwan is also sparing no effort to promote a variety of measures, including health education, publications, seminars, carbon reduction targets, and strengthening cooperation with non-governmental organizations to support actively the WHO’s strategies for climate change. Taiwan is fulfilling its responsibility as a citizen of the world and joining with global partners to combat the health hazards brought by climate change. 

The Minister of Health of Ghana indicated that climate change will have an even greater impact on a number of sub-Saharan African countries. Ghana frequently uses biofuels. Over the long term, climate change has already resulted in severe consequences for Ghana, such as deforestation, soil changes, and floods. Therefore, in addition to setting a national policy to adopt 50% natural gas by 2025, the Ghanaian government has launched a national campaign asking every child to plant one tree to face the threats of climate change with concrete action. 

The Minister of Health of Poland reminded the assembly that all coastal countries will face rises in the sea level brought by climate change. This will result in major social problems from internal migration. Not only does this threaten the lives of people, but it also presents severe effects and challenges for government agencies.