8.6.4 Health implications of adaptation strategies, policies and measures

Because adaptation strategies, policies and measures can have inadvertent short- and long-term negative health consequences, potential risks should be evaluated before implementation. For example, a microdam and irrigation programme in Ethiopia developed to increase resilience to famine increased local malaria mortality by 7.3-fold (Ghebreyesus et al., 1999). Increased ambient temperatures due to climate change could further exacerbate the problem. In another example, air-conditioning of private and public spaces is a primary measure used in the USA to reduce heat-related morbidity and mortality (Davis et al., 2003); however, depending on the energy source used to generate electricity, an increased use of air conditioning can increase greenhouse gas emissions, air pollution and the urban heat island.

Measures to combat water scarcity, such as the re-use of wastewater for irrigation, have implications for human health (see Chapter 3). Irrigation is currently an important determinant of the spread of infectious diseases such as malaria and schistosomiasis (Sutherst, 2004). Strict water-quality guidelines for wastewater irrigation are designed to prevent health risks from pathogenic organisms and to guarantee crop quality (Steenvoorden and Endreny, 2004). However, in rural and peri-urban areas of most low-income countries, the use of sewage and wastewater for irrigation, a common practice, is a source of faecal–oral disease transmission. The use of wastewater for irrigation is likely to increase with climate change, and the treatment of wastewater remains unaffordable for low-income populations (Buechler and Scott, 2000)