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National Programme on Climate Change and Human Health (NPCCHH) is the flagship programme under Ministry of Health and Family Welfare (MoHFW), Government of India to organize health response to impact of climate change on India’s population. The program was initiated in February 2019 at National Centre for Disease Control (NCDC), Delhi, the nodal agency for implementation of ‘Health Mission’ on climate change.

Background

The United Nations Framework Convention on Climate Change (UNFCC) came into force in 1994 wherein 195 countries participated including India with objective of Green House Gas stabilization at level to prevent dangerous impact on health. This was followed by first Conference of Parties (COP) that took place in Berlin. The Kyoto protocol in 1997 refers to the international legal framework for climate change process wherein internationally binding emission reduction targets were set by UNFCC to its Parties. The Cancun Agreement forms the pillar of the largest collective efforts the world has seen to reduce the emission in respect of capturing plans to reduce Green House Gas Emission, and to help developing nations to protect themselves from climate impact and to build their own sustainable futures through Mitigation, Transparency, Technology, Adaptation,  Forest, Capacity building and Finance. The Conference of the Parties (COP) to the Convention meets annually to negotiate and discuss the international climate change agenda and related commitments from countries. India undertook some initiatives in pursuance to the obligation implied by UNFCC like, identification of Ministry of Environment, Forest & Climate Change (MoEFCC) as nodal ministry for matters related to Climate Change; formulation of National Environmental Policy 2006; and formulation of Prime Minister’s Council on Climate Change to advice proactive measures, facilitate inter-ministerial coordination and guide policy in relevant areas. In 2008, the Prime Minister office released a National Action Plan on Climate Change (NAPCC) in June 2008. The plan identified eight national missions:

1. National Mission on Sustainable habitat

2. National Mission for Sustaining the Himalayan Ecosystem

3. National Mission for Sustainable Agriculture

4. National Solar Mission

5. National Mission for Enhanced Energy Efficiency

6. National Water Mission

7. National Mission on Strategic Knowledge for Climate Change

8. National Mission for “Green India”

Executive Committee on Climate Change convened its first meeting on 14th November 2014. The Committee reviewed the progress of eight national missions on Climate Change and suggested formulation of four new missions viz.

1. National Mission on Health

2. National Mission on “Waste to Energy Generation”

3. National Mission on India’s Coastal areas

4. National Wind Mission

In this background, the proposed ‘Mission on Health’ was undertaken by MoHFW under the ‘National Action Plan on Climate Change’. As a follow-up action, MoHFW constituted a National Expert Group on Climate Change & Health (NEGCCH) under the chairmanship of Dr Vishwa Mohan Katoch, Former Secretary (Health Research), Government of India and DG (ICMR) to prepare action plan, recommend strategies for indicators, mitigation, capacity building etc. For the expert group, the National Centre for Diseases Control (NCDC) was the nodal agency with members’ representation from DteGHS, MoHFW, MoEFCC, ICMR, DST, NDMA, CGWB, Min of Agriculture, CPCB, Ministry of Earth Sciences, TERI, NEERI etc to draft the Mission on Health under the National Action Plan on Climate Change.

Climate Change and Health

Climate change is a health emergency. Climate impacts drivers like extreme temperatures, rain and draught, sea level rise and related disasters directly or indirectly affect health of the population. Diseases such as malaria, yellow fever, dengue and cholera are all sensitive to climate change due to effect on the viability and the geographical distribution of the mosquitoes and micro-organisms, which prefer a wetter, warmer world. Deaths from heart diseases and respiratory illness during heat waves and malnutrition from crop failures add to the toll. India being a highly populous country undergoing industrialization, with large scale rural to urban migration resulting in chaotic and unplanned urbanization, depletion of forest cover along and high energy consumption is more vulnerable to impacts of climate change. Until mid-century climate change will act mainly by exacerbating health problems that already exist. However, new conditions may emerge under climate change, and existing diseases (e.g., food-borne infections) may extend their range into areas that are presently unaffected. In addition to their implications for climate change, essentially all the important climate altering pollutants (CAPs) other than carbon dioxide (CO2) have near-term health implications. In 2010, more than 7% of the global burden of disease was due to inhalation of these air pollutants. IPCC report suggests that that reducing emissions of short-lived climate pollutants such as methane and black carbon would not only slow warming, but could avoid 2-2.5 million deaths per year, globally.

Climate change’s health impact are well studied.

India’s Health Vulnerability to Climate Change

India is highly vulnerable to impact of climate change. Climate variability with geographic variation, sociodemographic inequalities, health care access disparities, and political will has contributed to high health vulnerability of the population.

Vision and Goal of NPCCHH

NPCCHH is initiated with the vision to strengthen health of citizens of India against climate sensitive illness, especially among the vulnerable like children, women and marginalized population. The goal of the national programme is to reduce morbidity, mortality, injuries and health vulnerability to climate variability and extreme weathers. It uses the established framework of top-to-bottom implementation, from centre to community level, under MoHFW. A special team called Environmental Health Cell is formed at the state level to oversee the implementation in the state. It will include state nodal officers, consultants and other staff. At district level, district nodal officers are in-charge of the programme activities.

Objectives

The key objectives of NAPCCHH are:

1.    To create awareness among general population (vulnerable community), health-care providers and Policy makers regarding impacts of climate change on human health. It includes development of IEC material, issuing advisories, organizing sensitization of workshops and advocacy through community awareness.

2.    To build capacity of health care professionals to reduce illnesses/ diseases due to variability in climate. Development of training modules, training of health professionals, issuing guidelines and sharing of best practices are focused.

3.    To strengthen health preparedness and response to climate change. This objective includes activities like health vulnerability assessment, health adaptation planning, strengthening of climate sensitive illness surveillance, early warning alerts and adopting green and resilient measures in health sector. Heat related illness and acute respiratory illness surveillance are the two new health surveillance system being implemented nationwide by the programme.

4.    To develop partnerships with other missions, ministries, health and non-health programmes, organizations to create synergy and ensure that health is adequately represented in the climate change agenda in the country. Eighteen national level institutes, recognized as Centres of Excellence (CoE) under the programme are providing technical support in drafting subject specific national health adaptation plan and training modules. NPCCHH also works with National Mission for Sustaining Himalayan Ecosystem & National Mission for Strategic Knowledge on Climate Change, India Meteorological Department, Central Pollution Control Board, National Disaster Management Authority, MoEFCC and WHO-India.

5.    To strengthen research capacity to fill the evidence gap on climate change impact on human health.

6.    The programme with Indian Council of Medical Research (ICMR) steers research strategy through a high-level committee. It also promotes research by CoE and State Institutions.