Climate Change, Health, and Costs Table 2 7 Number of People Affected by Extreme Weather Events, 1960–2007 1960–1969 1970–1979 117,899,704 Flood Storm Drought Extreme temperature Total 1980–1989 1990–1999 2000–2007 263,706,885 592,746,376 309,913,523 631,553,213 42,374,639 207,877,106 468,400,647 1,436,005,223 845,939,199 30,244,783 52,539,673 141,405,617 224,336,097 333,244,475 – 600 40,202 7,134,684 5,376,889 190,519,126 524,124,264 1,202,592,842 1,977,389,527 1,816,113,776 – = no data available. Note: Estimates based on the International Emergency Events Database (EM-DAT) maintained by the Centre for Research on the Epidemiology of Disasters (CRED). The database covers 210 countries. Source: Laplante, B. 2010. Poverty, Climate Change, and the Economic Recession. In Bauer, A., and M. Thant, eds. Poverty and Sustainable Development in Asia: Impacts and Responses to the Global Economic Crisis. Manila: Asian Development Bank. Climate change threatens to reverse the gains made toward achieving the Millennium Development Goals. In particular, climate change threatens to worsen poverty and burden marginalized and vulnerable groups with additional hardships. In Southeast Asia, many poor people live in coastal areas and lowlying deltas, which are expected to experience the brunt of the impacts related to sea-level rise and the intensification of storm surges (Dasgupta et al. 2011). Anecdotal and empirical evidence strongly support the hypothesis that the lower a household’s level of income is, the greater the likelihood of it being adversely impacted by natural hazards.5 Several factors explain the nature of this relationship. First, the livelihoods of poor people are known to be significantly dependent on natural resources. When disasters disrupt the flow of goods and services provided by these resources, and more generally by ecosystems, the poor find themselves in a precarious situation. When disasters destroy capital (e.g., machines or cattle) the poor typically lack access to financial resources to restore capital to its pre-disaster level. Second, increases in income enable individuals and households to respond to increased risk (including risk associated with disasters) by employing additional precautionary measures.6 Third, the poor are often located in areas that are more susceptible to high variability in temperature and rainfall, such as hilly and steep slopes and flood plains.7 Fourth, richer societies are more resilient as a result of the positive correlation between income and education, financial development, and greater institutional capacity. Finally, poor households and communities often have limited access to adequate information to make informed decisions pertaining to climate change and its projected impacts, as well as limited influence on policy making processes. These considerations may partly explain why Tajikistan ranks very low in terms of adaptive capacity, while being most vulnerable to climate change (Figure 7). Health Costs of Climate Change Estimating the future costs of the health impacts of climate change is a daunting task, fraught with uncertainty and incomplete information. This task is made even more difficult when analyzing specific subsets of defined populations, such as those living in poverty. 5 See Laplante (2010) for a review of the empirical evidence. 6 Both the demand for security and the private capacity to invest in security (through better access to financial capital and private savings) increase as income increases. 7 “Ninety percent of the disaster victims worldwide live in developing countries where poverty and population pressures force growing numbers of poor people to live in harm’s way on flood plains, in earthquake prone zones, and on unstable hills. The vulnerability of those living in risk-prone areas is perhaps the single most important cause of disaster casualties and damage.”— Secretary General of the United Nations Kofi Annan, 1999.