Conclusions and Recommendations 29 (vii) Establish a systematic observation network for short-term climatic monitoring, prediction, and assessment to be shared in regional climate programs for the explicit purpose of signaling possible outbreak of climate-related diseases (Box 5). (viii) Provide high-quality data for impact assessment and adaptation activities, utilizing above observation network to monitor and implement responses related to extreme events. (ix) Monitor systems for climate indices, extremes, trends, droughts, floods, sea-level rise, phenology, poverty, and other variables, as well as capacity and resources to maintain and use these systems to be available at the local and national levels. Information generated should reach and benefit the communities at the local level. For its part, ADB can implement specific actions to address climate change and health, including: (i) (ii) (iii) (iv) (v) Box 5 Support DMCs in preparing climate resilient sector road maps. Help DMCs guide adaptation interventions that address health impacts and cost-effective responses. Support knowledge generation and dissemination on evidence-based good practices on climate change and health. Develop operational guidelines for health adaptation options. Work in partnerships to complement ADB’s own capacities on climate change analyses and responses to health impacts. Recommended Institutional Arrangements and Coordination in Nepal In the changed political context, a health services network—including regional and/or federal level, district and/or local level, and community level with essential facilities for the health services delivery—should be established and its function and responsibility should be autonomous. Public and private sectors for health service delivery should work in a complementary way. However, the public sector should formulate policy measures and create an environment that involves the private sector for effective delivery of health services. The health organization should work in a coordinated and/or integrated manner with other agencies like the Ministry of Environment, Science and Technology; the Department of Hydrology and Meteorology; and the Department of Water Supply and Sewerage. The Ministry of Environment, Science, and Technology is the focal point for the United Nations Framework Convention on Climate Change (UNFCCC), while the Department of Hydrology and Meteorology is the focal point of the Intergovernmental Panel on Climate Change (IPCC). The health sector requires formulating short- (5 years) and long-term (6–10 years) planning to address issues concerning climate change and health impacts. The short-term planning may include the development of surveillance and monitoring systems, the provision of safe water supply, sanitation (the elimination of open defecation), the use of alternative energy sources, the setting up of weather stations, resettlement, increased greenery, etc. Meanwhile, the infrastructure and facilities, early warning system, etc. may come under long-term planning. Awareness and dissemination, medication, preparedness, and monitoring and evaluation should be a part of continuous process. The issues should be identified based on research and participatory workshops. The Ministry of Health and Population should be a lead agency to deal with the climate and health matters and coordinate all the activities with those organizations stated above. The Ministry of Environment, Science, and Technology should be the co-lead agency in this context. A Steering Committee of Climate Change and Health Impacts, led by the Ministry of Health and Population together with the Ministry of Environment, Science, and Technology as subcoordinator should be formed. Other agencies should be the members of the committee. The following activities should be performed to address the issues in climate change and health impacts: (i) research and human resources development; (ii) database creation and communication; (iii) meetings, conferences, and workshops; (iv) formulation and implementation of policy measures and programs; (v) information gathering and dissemination; and (vi) monitoring and evaluation. Source: Pradhan, B. 2010. Key Sector Analysis: Health Adaptation in Nepal. Mimeo. Kathmandu.