Second National Communications archipelago that has several island clusters that make response to climate change a challenge. We are also vulnerable with our high Dependency level for resources22 on Information Technology. We still lack the communications hardware and backbone to enhance early warning systems and response. Philippine Health Vulnerabilities and Non-health determinants • Changing disease patterns – Double burden of disease : (communicable) infectious diseases and (Non-communicable) lifestyle diseases • Climate sensitive diseases – Emerging and re-emerging diseases: multiple drug resistant tuberculosis, malaria • Health Infrastructure – Human Resource constraints – Physical Resource constraints • Non-health determinants – Disasters – Socio-economic (Poverty) – Geographical set up (multiple island archipelago)23 • Isolated Island Cities and Municipalities – Dependency level for resources24 • Information • Technology In the Philippine setting, quite a number of our vulnerable communities are affected already as to the present inadequate health system. These vulnerabilities become enhanced with the impacts of climate change on both the changing disease patterns and inadequate health infrastructure as well as nonhealth determinants that can amplify them. These should be taken into consideration as we link the climate-health (exposure –response) relationship and the future climate change and health outcomes. The World Health Organization estimates climate change has already directly or indirectly killed more than 1 million people globally since 2000. More than half of those deaths have occurred in the AsiaPacific area, the world's most populous region. Between 1994 and 2004, half of all people killed by flooding worldwide were living in Asia.25 Vulnerable Populations to climate change and health in the Philippines § Far-fetched barangays (mountainous or coastal) – with risk hazards that will increase with extreme climate change § Those populations that have least access to health services and are in dense/congested –urban slums (space vs. access) § Communities in areas that are endemic to certain ‘climate sensitive’ diseases ( ie. malaria -multi-drug resistant strains) on top of a bad health system (inadequate resources – financial and human to respond) § Communities (Indigenous People) that are culturally challenging – resistant to health education or change in their behavior towards health brought by culture - beliefs 22 Woodward A.Hales S and Weinstein P(1998)climate change and human health in the Asia Pacific region: who will be the most vulnerable? Climate research. 11:31-38 23 McMichael AJ and Woodward A.I (2000)Climate change and stratospheric ozone depletion: In climate change and Human Health Impact and Adaptation. WHO 2000. 24 Woodward A.Hales S and Weinstein P(1998)climate change and human health in the Asia Pacific region: who will be the most vulnerable? Climate research. 11:31-38 25 Asia-Pacific Countries See Effects of Climate Change on Health, Brace for More Margie Mason, Associated Press. July 3, 2007. Available at http://www.enn.com/top_stories/article/6862.Accessed March 25,2009 15