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 How Do You Get Pre Approved For A Home Loan - The Malaysian Youth Delegation (MYD) organized a learning session: Dr. Climate change and public health with Khor Swee Kheng - more specifically the political economy of health and health systems strengthening. He shared the connections and complexities between climate change and public health. Inspired by his sharing session, writing this article intends to explore the connections between the two.

The latest report by the Intergovernmental Panel on Climate Change (IPCC) has revealed alarming findings. Substantial evidence reveals human influence on rising temperatures - a 1.5°C increase in climate temperature is now inevitable. This growth will have profound consequences for human civilization, from droughts and rains to rising sea levels.

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Although it is not obvious, the worsening climate crisis directly affects public health in various forms (see figure below). For example, extreme heat due to a changing climate has been reported to increase heat stress in humans (IPCC, 2021).

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In addition to heat stress, climate changes such as increased flooding may also favor disease transmission. In 2014, Kelantan faced its worst floods, and one of its main adverse health effects was the rise of diseases, especially vector-borne malaria.

Diseases affecting public health can be broadly divided into communicable diseases and non-communicable diseases.

Infectious diseases are contagious and can be divided into three categories - water-borne (eg cholera), airborne (eg Covid-19) and vector-borne (eg dengue). Extreme weather events such as El Niño can lead to environmental conditions that facilitate the emergence of vector-borne diseases, thus increasing the risk of large-scale exposure to the community.

Climate change, which influences temperature and rainfall fluctuations, promotes the spread of neglected tropical diseases such as dengue fever (Paul and Tham, 2015). As this phenomenon worsens, environmental changes are expected to accelerate. This increases the likelihood that new viruses will spread throughout the population, where mutation can increase the potency of the virus (Schoop, 1991).

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Non-communicable diseases are chronic diseases developed by factors such as environment, genes and behavior. Such diseases include respiratory diseases, cardiovascular diseases, mental disorders, cancer and diabetes. Because of the indirect nature of their relationship, these diseases are often overlooked in the public health and climate change discourse.

For diabetes, extreme weather events and high temperatures can increase the morbidity of such patients, especially those with existing cardiovascular disease (Zilbermint, 2020). For those without pre-existing conditions, rising temperatures could lead to more people choosing to stay indoors. This discourages a more healthy and active lifestyle, weakening one's immunity and physical health.

There is a strong link between climate change and mental health. This relationship is often seen through climate anxiety or environmental guilt, new terms recently coined to reflect their increasing incidence. A major contributing factor to climate anxiety is the inability to recognize impending danger but to mitigate it. (Ingle and Mikulewicz, 2020). Climate anxiety is particularly prevalent among children and young people - a recent survey of millennials aged 16-25 found that 95% of respondents were concerned about climate change, citing frustration at the lack of government action. In coping with crisis (Thompson, 2021).

Now focusing on Malaysia, local climate-sensitive diseases include: cholera, typhoid, hepatitis A, malaria, dengue and chikungunya. (Alhoot et al., (2016). By reducing short-lived climate pollutants (SLCPs), an estimated 5,900 premature deaths from outdoor air pollution could be prevented by 2030 (Shindel, D., et al., Science, 2012) Storms , floods and droughts Contamination of water and environment and creation of breeding grounds for disease-carrying mosquitoes can lead to emergence and spread of climate-sensitive diseases.

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The Malaysian government has introduced various strategies and roadmaps over the years to reduce public health impacts due to climate change. However, some may argue that these plans were not implemented effectively.

For example, the Ministry of Health (MOH) published the National Environmental Health Action Plan (NEHAP) in 2013, aiming to improve the quality of the environment and public health while maintaining the goal of sustainable development (NEHAP, MOH. Malaysia, December 2013 ). It was introduced in the context of increasing incidence of food, water and vector-borne diseases over time. However, NEHAP 2016-2020 reported that most of the proposed action plan had not been implemented, or there was no concrete plan. The project focused on developing guidelines and research papers under supporting activities and institutional factors for environmental health, but did not formulate any mitigation measures to address the sources of pollution.

As of 2015, one of Malaysia's gaps in its report to the World Health Organization (WHO) was the lack of planned allocations from domestic and international funds to cover the estimated costs of implementing climate-resilient health systems. Development of an integrated disease surveillance and response (IDSR) system for early warning of climate-sensitive health risks and evaluation of health co-benefits of climate change mitigation activities was lacking.

In 2019, Malaysia adopted a national policy on climate change that incorporates health perspectives into its key actions. One is to mobilize financial and technical assistance in the areas of public health and climate change. Although this positive step will contribute to a climate-resilient health system, there has been little progress in fund allocation since the 2015 WHO report.

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However, there may still be hope. The National Climate Change Policy aims to establish and implement a national research and development agenda on climate change in terms of public health services and delivery, as well as integrating measures into policies, plans, programs and projects in public health. In 2019, MOH established 11 Thematic Working Groups (TWG):

TWGs are tasked with identifying threats to the environment and devising strategies to overcome the problem.

While climate mitigation measures offer clear and important disease prevention opportunities in many sectors, including the health sector, these opportunities have not been widely recognized or linked.

We have identified ways in which key measures to address climate change can bring health co-benefits across a range of economic sectors. The health sector should be involved in the development and implementation of relevant mitigation policies. For example, we need health leadership and participation in multi-sectoral and multi-stakeholder decision-making processes related to climate mitigation by engaging key stakeholders in the public and private sectors.

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We must establish and strengthen key public health activities and capacities, including the analysis and communication of health co-benefit opportunities associated with various climate mitigation policies. More importantly, climate mitigation measures should be incorporated into relevant national health system policies and plans in areas where greenhouse gas emissions from health care activities are primary decision-makers for the health sector. It aligns with the National Health Adaptation Strategy to build and modernize climate-resilient healthcare infrastructure, from medical waste management and procurement policies and infrastructure performance standards for healthcare facilities.

Effective engagement with youth groups, civil society organizations and the private sector and providing them with a platform to advocate for climate justice will help raise public awareness of opportunities for climate and health. Climate and Health-Promoting Mitigation Actions in Malaysia (Technical Summary for the WHO Conference on Health and Climate) This will play a transformative role in building public support and creating demand for the implementation of climate and health-promoting actions.

Climate change mitigation policies can prevent significant communicable and non-communicable diseases caused by major economic sectors, thus saving health costs from reduced deaths and illnesses. Harnessing climate action for health benefits plays a transformative role in the climate debate by strengthening the will to action among the public and policymakers, which supports coherent engagement and participation.

Technical summary of the World Health Organization Conference on Health and Climate, 27-29 August, Geneva. Discussion Draft. https://www.who.int/phe/climate/conference_briefing_2_promotinghealth_27aug.pdf?ua=1.Wildfires wreaking havoc in California, Washington State and Oregon, and wildfire smoke affecting air quality in states thousands of miles away, are the most telling of the effects of climate change on our health and well-being. Enter a new reminder.

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As we grapple with the immediate and long-term consequences of the current global health pandemic, it will be challenging to think about climate change with the same level of urgency. But if anything, the pandemic has shown us how unpreparedness for a global health crisis can lead to widespread deaths and bring the global economy to its knees within months. Climate change directly affects our health and well-being now and will become more acute in the future. Devastating wildfires in California, Washington state and Oregon provide the latest reminder.

With the building sector contributing the highest emissions globally each year, now is the time for interdisciplinary collaboration working to impact climate change and health at scale.

As part of our Earth Week 2020 programming, researchers and policymakers from our New York office moderated a virtual panel in April focused on how climate change affects health. The panelists

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