Second National Communications 3.0 Vulnerabilities Assessment As we look at the health impacts of climate change, we should look at the current and future of human health vulnerabilities and adaptation. We already know that vulnerabilities are closely linked to development. With the Philippines considered as a developing country, its public health systems are already challenged where the infectious disease era is still rife. Put on top of these experiencing extremes of climate events. This will make it more vulnerable to the impacts and coping becomes a heavier burden. The capacity to cope then becomes a measure of the short term response that a community comes up with. It is the immediate solution that spells its survival. Table 1. Examples of current and future human health vulnerability and adaptation. Definition Current Future Vulnerability: the degree to which Populations living in areas on the fringe individuals and systems are of the current distribution of malaria are susceptible to or unable to cope at risk for epidemics if the range of with the adverse effects of Anopheles vector changes. climate change Whether these populations might be vulnerable in the future depends, the in part, on the implementation of timely and effective prevention activities. Adaptation baseline: the adaptation measures and actions in place in a region or community to reduce the burden of a particular health outcome. Increasing access to and use of air conditioning will reduce the percentage of older adults who could be adversely affected by future heat events. The exposure–response relationship is influenced by the current prevention measures aimed at reducing the burden of a disease. For example, the number of older adults adversely affected by a heat event depends on the numbers who have access to and who use air conditioning during a heat event. Coping capacity: the adaptation Several cities in middle-latitude countries Over time, adaptation options can options that could be have the level of material resources, move from being possible to being implemented now. Specific effective institutions, and quality of public implemented (i.e., being part of the adaptation plans arise from a health infrastructure to establish and adaptation baseline). For example, region or community’s coping maintain early warning systems for heat universal access to adequate capacity. events. Until implemented, these systems quantities of safe water is not yet are within a city’s coping capacity. possible, although significant progress has been made. Adaptive capacity: the general Adaptive capacity is the theoretical ability Over time, it is hoped that regions ability of institutions, systems, of a region or community to respond to and communities will increase their and individuals to adjust to the threats and opportunities presented resilience to what the future climate potential harm, to take advantage by climate change. It encompasses both brings. of opportunities, or to cope with coping capacity and the options that have the consequences of climate the potential to expand future coping variability and change. capacity. Adapted from Kovats et al. (2003b). In the Philippines, the health sector coping capacity has been to a large extent a function each of the local government units’ availability of resources. The devolution of health services has been in place for more than a decade now and this has lead to differences in health responses depending on the level of participation and political will of local chief executives and health managers. Local health systems have been coping in their own way oblivious or unaware of climate change impacts. Dengue hospital fast 13