Climate change poses a major challenge for all nations before the increasing alteration of the natural dynamics of the planet by human activities, since it has a social, economic and health impact on the population. It has been scientifically proven that climate change may originate and even make worse many diseases and health problems, this situation has led to take actions and implement public policies to address the issue in Mexico. This document presents a review of the legal and regulatory frameworks implemented by the Government of Mexico, focusing on the health care system to deal with the effects of climate change. This situation reveals the need to carry out more research on the subject, due to the wide variety of repercussions for the population’s health. To broaden the knowledge and the generation of scientific evidence, allows a better design of laws, strategies and programs before implementing policies in the country.
Keywords: Climate Change, Health, Health Regulation, Mexico
The elements that determine the health of populations are very diverse and interact in a complex way, so it is a priority to deepen the knowledge of their impact and the vulnerability of the population to them, particularly with regard to the people’s health.1
Today, there is solid scientific evidence that clearly show that the Earth's climate is changing at a high speed, mainly due to human activity.2 The new global climate scenario has consequences not only on developing countries, but also on developed nations.3 It is also clear that in the absence of changes in man's behavior in relation to nature, the catastrophe would not only be imminent, but also potentially irreversible.4
Increases in temperature and sea level, changes in the distribution of precipitation and extreme events are expected to increase a variety of health risks, ranging from the direct effects of heat waves, floods and storms, to more favorable conditions for the transmission of major infectious diseases, and repercussions on the natural systems and socio-economic sectors that ultimately support human health. However, much of the possible impact of climate change on health can be avoided by combining the strengthening of key functions of the health care system and a better management of risks leading to a changing climate.5
Establishing the link between the current and potential impacts and the consequences of global climate change on the health of the population is a matter of great urgency, in order to identify, among other aspects, the degree of vulnerability of society to climate change, and with that to make or adapt plans and strategies of mitigation and/or adaptation. 6 In 1997, the World Health Organization (WHO) adheres to the global climate change agenda and, officially in Mexico until 2009, when the Ministry of Health joins the Inter-Ministry Commission for Climate Change.7 The objective of this document is to present a review of the legal and regulatory frameworks implemented by the Government of Mexico, with an emphasis on the health care system to deal with the effects caused by climate change.
Climate Change is understood as the global variation of the planet's climate, caused by natural causes and by man's actions that occur at various timescales and over all climatic parameters: temperature, precipitation, cloudiness, etc.1 It is considered the greatest threat of life as we know it because it raises the average temperature of the planet. No matter how small the temperature variation can be, it affects the water cycle, alters the frequency of normal weather phenomena, and causes more catastrophic natural disasters. This also damages communities, crops and ecosystems by breaking the ecological balance on which present life on Earth is based on.8
Data show that the most serious detrimental effects tend to affect the poorest and most vulnerable populations. In addition, the negative impact of climate on health is worsened by rapid and unplanned urbanization, air and water pollution, and other consequences of environmentally unsustainable development.9 There is a wide variety of health effects due to climate change that are currently present and will be presented over time.10 Climate change is a significant emerging public health threat that modifies the way we should consider protecting vulnerable populations.10
It can affect human health through a number of mechanisms, including the relatively direct effects of phenomena such as heat waves, floods and storms, and by means of more complex pathways such as changes in the behavior of infectious diseases, alterations in agricultural and other types of ecosystems, and possible population displacements and conflicts caused by the depletion of resources such as water, fertile soils and fishing.11 Climate change threatens to slow down, disrupt or reverse the advances that were achieved in public health or in the fight against major epidemics. It is anticipated that the effects will be more severe in elderly people and people previously affected by some health problem. However, most of the burden of additional morbidity and mortality will fall on children and the poorest, especially women. Health problems sensitive to climate change are more serious in children living in poverty.12,13
Measuring the health effects of climate change can only be done in an approximate way. However, in an evaluation carried out by WHO that takes into account only some of the possible health impacts, and which assumes economic growth and continued health progress, it was concluded that, according to forecasts, climate change will cause around 250,000 additional annual deaths between 2030 and 2050; 38,000 for exposure of elderly people to heat; 48,000 for diarrhea; 60,000 for malaria; and 95,000 for child malnutrition.14
The health effects caused by climate change need new strategies to mitigate them, with a multidisciplinary and intersectoral approach, where health prevention and promotion are essential to tackle this issue.15
In Mexico, population’s health in terms of the effects of environmental pollutants and in particular of climate change is protected through the Constitution of the United Mexican States, which establishes the health guarantee for all Mexicans.16
The General Health Law regulates the right to health protection that every person has, it establishes the bases and modalities to access health care services and the concurrence of the Federation and the States in matters of general health; in addition, this provision mandates the Health Care System to implement actions aimed at counteracting the effects of climate change.17
The General Law on Climate Change came into force in October, 2012 and it clearly defines the scope and content of the national climate change policy; it defines the obligations of State authorities and the powers of the three levels of government, besides it establishes the necessary institutional mechanisms to face this challenge. According to the law, the federation is responsible for formulating and conducting the national climate change policy in accordance with clearly defined principles, among which social co-responsibility stands out in a relevant way. The National Strategy for Climate Change, Vision 10 - 20 - 40, is the instrument that guides actions as a nation, to combat the phenomenon for 40 years. It is based on scientific principles, proposes viable goals. It outlines a long-term route to improve the health and life quality of the population, besides making Mexico a society with greater resilience. It is the result of the joint participation of citizens, companies and academics with the Government of the Republic.18,19
The 2014-2018 Special Climate Change Program is the country's main public policy instrument for tackling climate change. Its objective is to regulate, promote and enable the implementation of the national climate change policy. It incorporates adaptation and mitigation actions with a long-term, systematic, decentralized, active and integral approach.20
Mexico has the National System of Climate Change aimed at promoting synergies to jointly tackle the vulnerability and risks of the country and establish priority actions for mitigation and adaptation to climate change.21 The system is integrated by the Inter-Ministry Commission on Climate Change, National Institute of Ecology and Climate Change, Climate Change Council, Federal States, Associations of municipal authorities and the Congress. In accordance with article 47 of the General Law on Climate Change, the Inter-Ministry Commission on Climate Change will promote the coordination of actions between agencies and entities of the Federal Public Administration (FPA) in the field of Climate Change. The functions of the Ministry of Health within the Commission include: Conduct the national policy on social assistance, medical services and general health, and coordinate the health care service programs of the FPA. Besides, it administers the assets and funds that the Federal Government allocates to provide health care services. To ensure the right to health protection, it regulates, coordinates and evaluates the National Health Care System, in addition to promote the adequate participation of agencies and public entities, as well as social and private sectors.22
The topics on the environmental health agenda have varied during these years, as well as the incorporation of different perspectives.7 There is a need for further development in climate and health science because of the importance of having an assessment of the health impacts attributable to climate change, both acute and chronic-degenerative infectious diseases, without ignoring the synergistic impact on human health and social instability in a context of epidemiological transition. This is a serious obstacle to change health policy based on concrete data.23
Although there is significant progress in Mexico, information on climate impacts on human health remains scarce, and there are few studies that take into account the effects of climate change as one of the factors influencing the transmission of pathogens.24
In Mexico, policies related to environmental health are not confined to the health and environment sectors alone. In general, the conciliation of the content and scope of these sectorial policies is limited and inefficient depending on the national needs for further progress towards a sustainable development. Also, the different interventions and programs, both for environmental health promotion, and the ones to reduce and mitigate risks, are incomplete and fragmented, and tend to be more reactive than proactive, in a context where coordination deficiencies persist between federal, local and municipal governments. It is also important to note that the interaction between the public bodies and the various academic and productive groups of civil society, is more conjunctural than strategic.7 Only through extensive processes of dialogue, debate and consensus-building between the various sectors of society will these mitigation measures be more productive and efficient.25
Climate change is a problem of global transcendence. The health care system is one of the most affected by climate implications in diseases and vulnerable populations. The review of the regulatory framework in Mexico regarding climate change and health reveals that it is relatively new, plans and strategies have been developed focused on present and future repercussions of the effects of climate change on the population’s health. Although it is true that for the implementation of public policies, the government conducts a prior review, it is important to expand the existing knowledge in order for these implementations to be the most appropriate to the situation occurring in the country, prioritizing the most vulnerable population. Therefore, it is necessary to review and update existing policies and, if necessary, to create new ones, as well as to respond to the objectives set in them, redefining the scope and responsibilities not only in a single institution.
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[a] School of Health Sciences, Universidad Autónoma del Estado de Hidalgo. Ex hacienda la concepción s/n; Carretera: Pachuca-Actopan. Camino a Tilcuautla. Pachuca de Soto Hidalgo, México.
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