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Vulnerable flanks

Indicator maps the impact of climatic changes on public health in all the states

Rare are the countries in the world, including those on the list of the more developed ones, that have occupied themselves with mapping how vulnerable they are to global climate changes, although many are signatories of international conventions that recommend this kind of survey. Brazil was no exception to the rule. It produced isolated studies on the impact of changes in the climate, for example, on certain agricultural crops and on marine and terrestrial ecosystems. But a group of researchers from the Oswaldo Cruz Foundation (Fiocruz), sponsored by the Ministry of Science and Technology (MCT), is going to present, next month, an important contribution in this field. This is a methodology that may serve as a basis for any nation to evaluate the threats of warming to a crucial flank, public health. The result was the creation of an indicator, the General Vulnerability Index IVG in the Portuguese acronym ), made up by weighting the data on the incidence of some diseases, the living conditions of the population and the swings in the climate, that sets out to point out how much a certain region is sensitive to damage from the climatic transformation.

Coordinated by epidemiologist Ulisses Confalonieri, a professor from Fiocruz’s National Public Health School, the methodology took three years to be concluded and applied in all the Brazilian states. The main conclusion is that the region of the Northeast, thanks to a combination of poverty, exposure to ailments and the cyclical phenomenon of drought, is the one that shows the least capacity for supporting the effects of warming. The negative highlight is the state of Alagoas. On the scale from 0 to 1, Alagoas showed an IVG of 0.64, the highest in the country. Next, the states of Bahia (0.46) and Pernambuco (0.44) appear. At the other extreme arose the states of Rio Grande do Sul (0.13), Mato Grosso do Sul (0.14), Federal District (0.17), Paraná (0.18), Santa Catarina (0.19) and Goiás (0.20). “They revealed themselves as being less susceptible to the changes and/or more capable of facing up to them” says Confalonieri, who is taking part, as the coordinator of the health committee, of the Intergovernmental national Panel on Climate Change (IPCC), a group of scientists connected with the United Nations that is evaluating the existing knowledge about climate change.

The equation developed by Fiocruz is inspired on the methodology of the Human Development Index (HDI), created by the United Nations Program for Development, with the objective of comparing the situation of the countries using indicators for education, longevity and income. The IVG is calculated from the arithmetic average of three other indicators, also conceived by Confalonieri’s team. The first is the Socioeconomic Vulnerability Index (IVSE  in the Portuguese acronym ), which combines 11 indicators, each one with a specific weight, relating to demography, degree of urbanization, income, education, sanitation and health. In this question, São Paulo and Santa Catarina revealed the lowest indices, of 0.10 and 0.15, respectively, on the scale from 0 to 1. At the other end, Alagoas (0.76), Maranhão (0.75) and Piauí (0.73) emerged as the most vulnerable.

A second category of data makes up the Epidemiological Vulnerability Index (IVE), which takes into account the current occurrence of diseases like dengue, malaria, cholera, leishmaniasis, and leptospirosis and the hantaviruses, endemics that are prevalent in Brazil and sensitive to climatic variation. The classic case is leptospirosis, whose outbreaks take place in flooded areas. Likewise, the extremes of precipitation also influence the biological cycle of mosquitoes transmitting malaria and dengue. The most susceptible states were Bahia (0.30) and Pará (0.31). In the case of Bahia, the rates for dengue, cholera, leptospirosis and leishmaniasis (four of the six diseases) proved to be particularly high. With regard to Pará, there are high rates of incidence of dengue and malaria.

The third category of information forms the Climatological Vulnerability Index (IVC), which classified the units of the federation according to the incidence of drastic swings in precipitation, such as droughts and floods, in the last 42 years. Alagoas, with an index of 1 – on the scale from 0 to 1 – showed the highest number of extreme events, followed by Sergipe, Ceará and Maranhão, with an index of 0.55. But the states of Acre (index 0), Amazonas (0.01) and Pará (0.01), even in the months in which their levels of rainfall are high, did not show any abrupt swings. “The future scenarios associated with global warming include, as a hypothesis, a greater instability in the phenomena connected with climatic variations” says Confalonieri. “This instability enhances vulnerability, because it is difficult to foresee their occurrence and to protect the population” he explains.

Alagoas is the most vulnerable state, because it has suffered more extreme events of precipitation, shows a high demographic density, the highest poverty rate, one of the lowest rates for sanitation services, the lowest life expectancy at birth, and the highest Brazilian infant mortality rate. It was also the unit of the federation with the highest incidence of cholera.

The average temperature of the planet has risen by 0.6 to 0.7 degrees Celsius in the last hundred years, according to research published in international magazines. The hottest five years since modern climatic records started, in 1890, occurred in the last decade, according to NASA’s Goddard Institute for Space Studies. The enormous majority of researchers in the climatic system believe that the cause of the warming are the emissions of greenhouse  effect produced by industry, automobiles and slash and burn of the forest. The IPCC is working with various climatic scenarios for the next hundred years, of two main types: with stabilization, or with an increase in the emission of gases. In both, increases in temperature of from 1 to 6 degrees Celsius are forecast. The effects can be disastrous, from the rise in the level of the sea to the destabilization of ecosystems, but there are no reliable models that make it possible to glimpse the size of the damage.

“From the point of view of the formulation of public policies, the vulnerability studies are fundamental for governments to be clear about the problems and to be able to take hard decisions, like making changes in the energy matrices” says astrogeophysicist Luiz Gylvan de Meira Filho, from the Advanced Studies Institute (IEA) of the University of São Paulo (USP).

The creation of the IVG is a step towards mapping these impacts on the area of health. “This work is the first with a focus on health and climate change, and it will help to create policies that act in the direction of improving the control over diseases” observes Haroldo Machado Filho, from the MCT’s Coordination of Climate Changes, the body that commissioned the study from Fiocruz. However, the author of the research himself points to some limits to his methodology. The main one of them, says Confalonieri, was the delimitation of the universe being evaluated. “We analyzed the impact linked to diseases, but there are other factors linked to health, such as the supply of water and food, which equally need to be mapped to give a more complete sense to vulnerability” he explains.

At the beginning, the MCT gave priority to one kind of survey, the inventory of the emissions of carbon dioxide in the country. The incentive for researches into vulnerability began to arise recently. Besides Confalonieri’s study, researches aimed at other specific themes have been financed, such as the impact of climate changes on the death of coral reefs.

Another limitation was the use of one simple meteorological datum – the levels of precipitation of the last 42 years – when it is known that climatic events are tremendously complex. The current state of knowledge certainly does not make it possible to establish regional scenarios for climate changes with any great accuracy, but there are mathematical models that make it possible to simulate, with an increasingly greater degree of confidence, the future effects of the change of the climate.  “Today, I would try to make this analysis in a more comprehensive way” says Confalonieri.

The methodology does not cover an important phenomenon: the capacity of populations to adapt to the effects of climate changes. According to Confalonieri, this has weight in a situation of vulnerability. He gives an example: in the northeastern states, in spite of the high susceptibility, a capacity for adaptation has been developed over the centuries of drought. The tendency is for the laborer to abandon his land, for not having anything to eat, and to go to the city. The strategies for reducing the exodus are well-known, such as the work fronts that guarantee some income for the laborers.

In the Amazonian region, though, where extreme climatic events are rare, the capacity to adapt is smaller. The calamity caused by the 2005 drought showed this. As the rivers dried up, the riverside populations lost their mobility and a source of food, the fish. “They know how to adapt to the excess of rainfall, but, faced by drought, they were impotent” Confalonieri says.

This gap should be filled by two surveys that Fiocruz is getting ready to carry out. One of them, with Confalonieri in charge, intends to gather data about the potential for adaptation at the municipal level in the Central Amazon, in the environs of the municipality of Santarém, in Pará. The second is also going to analyze the regional capacity for adaptation, in an effort sponsored by an English nongovernmental organization, which will also finance studies in other developing countries.

The preparation of an integrated map of nationwide vulnerability was one of the main recommendations of a panel of 27 specialists that met in Brasilia two years ago at the invitation of the Strategic Management and Studies Center (CGEE), linked to the Strategic Affairs Nucleus (NAE) of the Presidency of the Republic. The encounter updated the scientific knowledge about the threats. One example: in the field of agriculture, the increase in the concentration of carbon in the atmosphere will have the gift of increasing agricultural productivity, but the excess of rainfall may accentuate the erosion of fragile soils. One major consensus united the specialists: the diagnosis of vulnerability depends a lot on investment in new researches into agriculture, the coastal zone, ecosystems and energy, with the objective of identifying the populations and the areas of greater risk. The government is concerned with making good this deficiency. The MCT has now begun to sponsor a new crop of researches, some of them in the areas proposed by the specialists.