A/74/161 vector-borne diseases and mental illness. 35 Dengue fever is the most rapidly spreading vector-borne disease, with a thirtyfold increase in global incidence that is largely attributable to climate change. Hundreds of millions of people are exposed to extreme weather events annually, resulting in injuries, illnesses and mental health impacts. Climate change also erodes many of the key social and environmental determinants of health, including access to adequate food and water, clean air, culture and livelihoods. 36 Health is also affected by climate-related displacement, migration and reduced access to health-care services. 32. According to the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental hea lth, “the international community has not confronted the health threats posed by global warming. The failure of the international community to take the health impact of global warming seriously will endanger the lives of millions of people across the world.” 37 The World Health Organization concluded that climate change already has negative effects on health and is undermining the right to health. 38 The Lancet Commission on Health and Climate Change warned that climate change is the biggest global health threa t of the twenty-first century and could reverse five decades of progress in global health. 39 C. Right to food 33. The Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights include food as part of the right to an adequate standard of living, with the Covenant referring to the “fundamental right of everyone to be free from hunger”. 34. Food production, food security and the enjoyment of the right to food are affected by shifting precipitation patterns, higher temperatures, extreme weather events, changing sea ice conditions, droughts, floods, algal blooms and salinization. Changes in climate are already undermining the production of major crops, such as wheat, rice and maize. Without adaptation, or where adaptations fall short, this is expected to worsen as temperatures increase and become more extreme. In the oceans, temperature changes, bleaching of coral reefs and ocean acidification are affecting fisheries. Climate change also exacerbates drivers of food insecurity and malnutrition, such as conflict and poverty. 35. In 2016 and 2017, an encouraging decade -long trend towards lower levels of hunger and malnutrition reversed. According to the Food and Agriculture Organization of the United Nations, “climate variability and extremes are among the key drivers behind the recent uptick in global hunger and one of the leading causes of severe food crises. The cumulative effect of changes in climate is undermining all dimensions of food security – food availability, access, utilization and stability”. 40 The World Bank estimates that a 2ºC increase in the average global temperature would put between 100 million and 400 million more people at risk of hunger and could result in over 3 million additional deaths fro m malnutrition each year. 41 36. The negative impacts of climate change on food production and availability are unequally distributed both among and within States. States in sub -Saharan Africa and south Asia, where agriculture production, food systems and livelihoods are especially vulnerable to climate variability and extremes, face the greatest risk of food insecurity, malnutrition and violations of the right to food. Within countries, people living in mountain areas face high levels of food insecurity and are more vulnerable to climate change. 42 D. Rights to water and sanitation __________________ 35 36 37 38 39 40 41 42 19-11977 IPCC, Climate Change 2014: Impacts, Adaptation, and Vulnerability (IPCC, 2014). A/HRC/32/23. A/62/214. WHO, COP 24 Special Report: Health and Climate Change (WHO, 2018). N. Watts and others, “Health and climate change: policy responses to protect public health”, Lancet, vol. 386, issue 10006, pp. 1861–1914 (November 2015). FAO, IFAD, UNICEF, WFP and WHO, The State of Food Security and Nutrition in the World 2018. Building climate resilience for foo d security and nutrition (Rome, FAO, 2018). World Bank, World Development Report 2010: Development and Climate Change (World Bank, 2010). FAO, Mapping the vulnerability of mountain peoples to food insecurity (FAO, 2015). 11/22