12 Accounting for Health Impacts of Climate Change World Bank (2010) studies include cost estimates for other infectious diseases that are known to be climate sensitive (such as dengue), heat and cold stresses, population displacement, and increased air pollution. Health in Sector Project Investments Perhaps more importantly, the World Bank (2010) explicitly recognizes that the estimated adaptation costs in the health sector would be considerably higher if adaptation investments in the water infrastructure sector (some of which are related to mitigating adverse health outcomes associated with the provision of poor water supply and sanitation services), agriculture (some of which are related to mitigating malnutrition), and natural disasters (some of which have important health outcomes) were to fail to deliver intended benefits. Similarly, Ebi (2008) and Kovats (2009) also recognize that adaptation in other sectors is probably more important for reducing the health impacts of climate change (through disaster mitigation, food and water security, and providing decent infrastructure) than adaptation in the health sector itself. ADB’s Strategy 2020 (2008b) describes ADB’s role in health: ADB recognizes that health is vital to development, productivity, social inclusion, and gender equity. ADB will contribute to improvements in health mainly through infrastructure projects, such as water financing programs, and through governance work that focuses on public expenditure management for cost-effective delivery of health programs and services to all population groups. ADB seeks to promote health improvements in DMCs through investment in infrastructure projects. WHO makes explicit reference to the needs of addressing health concerns in sectors other than the health sector per se. Through its Regional Committee for Western Pacific, WHO developed a Regional Framework for Action to Protect Human Health from the Effects of Climate Change in the Asia–Pacific Region. In a resolution adopted in 2008, member states are urged to (i) (ii) (iii) (iv) (v) (vi) develop national strategies and plans to incorporate current and projected climate change risks into health policies, plans, and programs to control climate-sensitive health risks and outcomes; strengthen existing health infrastructure and human resources, as well as surveillance, early warning, and communication and response systems for climate-sensitive risks and diseases; establish programs to reduce greenhouse gas emissions by the health sector; assess the health implications of the decisions made on climate change by other sectors, such as urban planning, transport, energy supply, food production and water resources, and advocate for decisions that provide opportunities for improving health; facilitate the health sector to actively participate in the preparation of national communications and national adaptation programs of action; and actively participate in the preparation of a work plan for scaling up WHO’s technical support to member states for assessing and addressing the implications of climate change for health. However, experience to date indicates that the health impacts of infrastructure investment projects and climate change adaptation projects are rarely explicitly accounted for. Even in projects where health impacts (either positive or negative) are mentioned or referred to, most assessment of these health impacts remain of a qualitative nature. In most instances, there is no attempt to explicit quantify and monetize the health impacts of the projects (Box 1 presents typical examples of this approach). These impacts remain peripheral to the assessment of the costs and benefits of projects, including projects aimed at adaptation or climateproofing. These health impacts, not being explicitly quantified, monetized, and included in such analysis, will therefore not play any decisive role in the decision-making process pertaining to the acceptance or rejection of projects, or the selection of a specific option when many options are feasible.