Climate, Environmental Change and the Public - eurobrisa

First EUROBRISA Workshop: 1717-19 March,
March, ParatiParati-RJ, 2008
Climate, Environmental Change and the
Public Health in Brazil: Scenarios,
Opportunities and Uncertainties for
Improved Seasonal Forescasting
Antonio Miguel V. Monteiro, INPE
Trevor Bailey, Exeter University
{ [email protected] }
Health, Environment and Climate Change Studies:
A Collective
Climate, Environment and Health
Multi-institutional Group
Christovam Barcellos, Marilia Sá Carvalho - CICT,ENSP/Fiocruz
A. Miguel, Virginia Ragoni e Helen Gurgel - DPI,CPTEC/INPE
Wayner de Souza, José Constantino - CPqAM-Recife/Fiocruz
Cáudia Codeço, Aline Nobre, Taynãna , Oswaldo Cruz – PROCC/Fiocruz
The SAUDAVEL Network
Paulo Justiniano – LEG/UFPR
Partially sponsored by: SVS-MS
About this Presentation
Based on slides prepared by Christovam Barcellos
Aquecimento global e sua relação com as
doenças infecciosas no Brasil
Uma verdade inconveniente
O dia depois de amanhã
Katrina, 2005
Relatório IPCC, 2007
Ártico, 2006
Jaboatão- PE, 2005
Ciclone Catarina, RS e SC, 2004
Evolution of the Publications on Global Warming in
Scientific Magazines
8000
Relatório IPCC 2007
trabalhos publicados
7000
citações
6000
5000
4000
BROECKER WS (1975) CLIMATIC CHANGE - ARE
WE ON BRINK
3000OF A PRONOUNCED GLOBAL
WARMING? SCIENCE 189 (4201): 460-463.
Criação do IPCC
2000
1000
0
1975
1980
1985
1990
1995
2000
2005
O Impacto na mídia
Jornal do Brasil, fev./2007
Climate and Health: The Official View
First driven by the Global Warming and
Climate Change (Global) Agenda
Institutionalised by the Health Ministry as a
Public Health issue:
Setting up of Comissions
Technical&Scientific WS
Health Surveillance Office
Climate and Health: The Official View
In its first steps it is looking into the long
run: mitigation and adaptation on the
center of the stage
But, it still have a lot of space for
improvements and changes in orientation
Climate and Health: The (Un)official View
The Collective was invited by the SVS-MS to write down a workingpaper to support the
discussions at the Climate Change and Health Workshop at the 7ª ExpoEpi, the most
important event of the Health Surveillance Office in Brazil. [November, Brasilia 2007]
Climate, Environmental Changes and Infectious
Diseases: Scenarios and Uncertainties for the
Brazilian Health Surveillance
Christovam Barcellos et al., 2007
Climate and Health: The (Un)official View
A very good opportunity for Seasonal
Forecasting !
It can be fundamental for Alert Systems,
Systems the
new generation for the Environmental and
Epidemiological Health Surveillance in the
21st Centrury.
Climate and Health: The (Un)official View
But, Is Seasonal Forecasting
Technology and Science ready for
the challenge ??
Infectious Diseases and Endemies:
Travelling around in Brazil
700.000
600.000
Malária
500.000
400.000
300.000
200.000
100.000
0
Casos
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
169.871 197.149 221.939 297.687 378.257 399.462 443.627 508.864 559.535 577.520 560.396 541.927 572.993 483.367 555.135 564.570 444.049 405.051 471.894 637.474
600.000 cases/year
schistosomiasis
50.000 cases/year
leptospirosis
3000 cases
300 deaths/year
6.000
5.000
4.000
3.000
2.000
1.000
0
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Casos
1.852
1.924
1.594
3.077
2.508
2.409
3.014
2.094
1.728
2.893
4.293
5.579
3.298
3.449
2.433
3.487
3.638
2.620
2.952
3.033
2.698
Óbitos
265
235
330
404
278
290
301
289
215
325
313
368
280
439
310
351
430
320
349
385
301
Dengue
500.000 cases
40 deaths/year
900.000
800.000
700.000
600.000
500.000
400.000
300.000
200.000
100.000
0
Casos
1980
1981
1982
1983
1984
1985
0
0
11.000
0
0
0
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005*
46.309 88.412 1.900 5.367 39.391 104.40 1.823 7.389 57.152 137.07 184.10 249.20 505.02 183.08 228.12 464.31 813.10 403.64 123875241796
Climate e endemies
Esquistossomose
Isoterma de
Dengue
22oC
Leptospirose
Baixa amplitude de
temperatura
Chuvas constantes
Chuvas no verão
Baixas temperaturas
Arroz
leptospirosis
in Curitiba
Association with:
• Poverty
• Housing
• Flooding
De Paula, 2005. Leptospirose Humana: uma análise climato-geográfica de
sua manifestação no Brasil, Paraná e Curitiba
Risk Assessment
Risk = Danger * Vulnerability
•
•
•
•
Nature
Environment
Amplitude of Events
Temporal&Spatial Resolution
•
•
•
•
Society
Degree of Adaptation
Social Territorial Inequalities
Space Heterogeneity
Sanitation – The Scale Problem
Landscape
Cities
Manual de Saneamento (Funasa, 2004)
Household
The Hierarchical Structures of Dependency
Water Basin
Household
Individual
Comunity
Water Services
City
Connection-Delegation
Individual
Household
Comunity
Water Services
City
Water Basin
Individual
Nutritional Condition
Diseases
Cultural Habits/Behaviour
Household
Sanitary Instalations
Income (Investment capacity)
Comunity
Political Organisation
Identity
Localisation
Water Services
Water Source
Distribution and Quality
City
Sanitation Public Policies
Environmental Enforcement Laws and Regulations
Water Basin
Rain Regimes
Vegetation
Climate
System of Dependencies Collapses
Individual
Household
Comunity
Water Services
City
Water Basin
Angra dos Reis, RJ, 2007
Water Crisis
Santos, 1875
Rio de Janeiro, 1850
Mortality Rate by diarrhoea in Children for Municipalities
with and without proper water
10
c om trat
s em trat
8
6
4
2
0
menos de 40
40 a 80
mais de 80
Fonte de dados: SIM/MS, PNSB/IBGE e Censo 2000/IBGE
leptospirosis incidence rates Rio de Janeiro after the 1996 Floodings
around 1500 cases
Data Colection
DT_ATEN
18/03/96
28/02/96
15/03/96
11/03/96
07/03/96
01/03/96
11/03/96
08/03/96
08/03/96
11/03/96
13/03/96
07/03/96
01/03/96
05/03/96
INICIAIS BAIRRO
ENDERECO
AJO
148 TRAV. 8 C/05
AJR
148 TRAVESSA CAMERA 26
DRL
148 R. DEJI LAUDRA 175
IDO
148 RUA NOVA JESUS S/N.
IMO
148 R. NOVA JESSY S/N
JVS
148 ESTR. SANTA EUGENIA, 552
LRA
148 R. MONTE NOPOLIS QD. 90 LT.5
LSS
148 R. IBIRACEMA 13
LSS
148 R. IBIRAREMA 13
PPO
148 RUA DA PAZ, 64
VLS
148 ESTR. SAO GOMARIO R. G 34
ACC
149 R. M. C/09 CONJ. MUCIMO DA SILVA
AFR
149 RUA UM N.71 C.2
ALS
149 R. AURISTELA 15 CASA 59
PONTO DE REFERÊNCIA
ANTARES
TRES PONTES
ASSOCIACAO DE MORADORES
VENDA DE VARENDA
VENDA DE VARANDA
Notification for
leptospirosis
(SES-RJ)
Georeferencing the data –Putting
the Data into the Space
Integration
Census Tract
(IBGE)
Identificação de áreas de risco
Leptospirosis case residence
Flood risk area
&
Buffers around risk area
more than 5000 m
1000 to 5000 m
500 to 1000 m
250 to 500 m
Waste accumulation site
0
2.5
5
km
Barcellos e Sabroza, 2002
Garbage Production
Estimated
Expected Concentration of
leptospira before the
flooding
Expected Concentration of
leptospira after the
flooding
Distance
New Cases Observed
Seroprevalence expected
before the flooding
Seroprevalence expected
after the flooding
Distance
The Lessons from the Flooding
The variability is inherent
but we need prediction
better and early
of the system,
tools to know
The technical systems have large coverage
but are more vulnerable to extreme
events
The Lessons from the Flooding
The Social Systems have Vulnerabilities.
The Vulnerability is bigger amongst the poor and social
excluded groups (usually excluded from the technical
systems)
However, the richest ones are not out-of-risk, on the
contrary, their response capacity is immunological
and socially lower than the other group.
Dengue: The SAUDAVEL Project
SAUDAVEL: Bridging the Gap between
Research and Services in Public Health
Operational
Programs
by
MultiInstitutional Networking Development
and Use of Spatial Information
Technology Innovative Tools
SAUDAVEL 1.0 ALPHA:
From Entomological Surveillance to Epidemiological Surveillance
A Surveillance System for Alert,
Control and Intervention for Dengue
Fever Epidemics Based on Eggtraps
for Aedes spp at the Intra-urban scale.
Engenho do Meio
Slides: MNT e Animação 3D - Produzido
pelos Projetos SAUDAVEL , Defesa Civil
/Recife e Depto Cartografia UFPE
Resp. José Constatino e José Luis Potugal
SAUDAVEL 1.0 ALPHA:
Advancing the Surveillance System for Alarm and Prediction:
More Data and Integrated Models
INMET
Parceria Clima
Estação Simples- Leitura Diária
Por Sítio
Predictive Model
Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 103(1): 50-59, February 2008
Developing new approaches for detecting and preventing Aedes aegypti
population outbreaks: basis for surveillance, alert and control system
Regis at al.
Média de Ovos por Recuperação
de Ovitrampas
Brasília Teimosa
2600
275
2400
2200
250
2000
1800
200
225
1600
1400
175
1200
125
1000
800
100
150
75
600
400
50
25
200
0
0
1
3
5
7
9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51
Semana da Recuperação
Média de Ovos
Precipitação (mm)
Distribuição espacial do vetor, em Brasília Teimosa
Brasília Teimosa
Engenho do Meio
Abril 2004
Abril 2005
Spatial Distribution of Aedes aegypti in Engenho do Meio
This is SAUDAVEL
Entomologists , Engineers, Sanitarists, Matemathicians, Statistics,
Computer
Scientists, Local Health Authorities, Grad Students (PhD and MsC), Epidemiologists, General
Practioneers, Archictects & Planners and Environmental Scientists together to think Recife
and its pieces!!
Back to the Seasonal Forecasting
Looking back nto the problems
presented, the scale they need to be dealt
with, is there a chance of having
Seasonal Forecasting playing a role at
this stage of its development ??
Back to the Seasonal Forecasting
I would like to think that the answer
is Yes!
But I don’t really know how it can
be done.
Anyone can help???
Obrigado!