National Policy on Climate Change Adaptation for the Health Sector

March 13, 2012

DOH ADMINISTRATIVE ORDER NO. 2012-0005

 

I. Rationale

The Philippines signals of a changing climate are now evident. Annual mean temperature has increased by about 0.57ºC during the last fifty nine (59) years. Hot days and warm nights are increasing while cold days and cold nights are decreasing. Extreme events are also seen to be more frequent (PAGASA, 2010).This is consistent with global trends.

The recent findings of the Intergovernmental Panel on Climate Change (IPCC) reveal that climate change amplifies health risks. This contributes to the increasing burden from malnutrition, diarrhea, cardio-respiratory and infectious diseases, injury and deaths due to extreme weather events and through altered distribution of some disease vectors. The developing countries, small island developing states and the vulnerable local communities are most affected. It is recognized that climate change can jeopardize the achievement of the Millennium Development Goals, particularly the health-related goals. 

Accordingly, the 61st World Health Assembly of 2008 adopted a resolution urging Member States to take decisive action to address health impacts from climate change focusing on the following measures: (1) develop health measures and integrate them into adaptation plans, (2) build the capacity of public health leaders to be proactive and take rapid and comprehensive action, (3) strengthen the capacity of health systems to prepare for and respond to natural disasters, (4) promote health sector engagement with other sectors to reduce risks, and (5) commit to meeting the health challenges of climate change. HAaDcS

Two landmark legislations made it possible for the Philippines to develop action plans that will address the threats of climate change. The R.A. 9729 — Philippine Climate Change Act and R.A. 10121 — Disaster Risk Reduction and Management Act support government actions on dealing with the impacts of climate change. DOH Circular No. 2010-0187 was issued to adopt the National Climate Change Framework Action for Health set forth under the National Framework Strategy on Climate Change 2010-2022. The National Climate Change Action Plan (NCCAP) was formulated under this strategy and prioritized health security, that aims to focus immediate outcomes on ensuring that health and social protection delivery systems are responsive to climate change risks. A corresponding National Environmental Health Action Plan (2010-2013) formulated through the Inter-Agency Committee on Environmental Health (IACEH) included climate change concerns. A Climate Change Unit was created under the National Center for Disease Prevention and Control (DPO No. 2011-2458) to guarantee effective implementation of current initiatives. Vulnerability assessments and development of monitoring and evaluation frameworks and systems have been initiated in partnership with the National Economic and Development Authority and with support from the Millennium Development Goals Achievement Fund (MDG-F).

Considering the significant contribution of the climate change adaptation strategies for health, there is a need to enhance policy systems, processes and programs to support the attainment of Universal Health Care and the Millennium Development Goals.

II. Objectives

The objectives of this Administrative Order are as follows:

1. To set overall policy directions on addressing the impact of climate change on health.

2. To create an enabling environment for capacity strengthening of health systems, engagement of key partners in supporting comprehensive actions on climate change adaptation, and in protecting the health of all Filipinos from the impact of climate change.

III. Scope and Coverage

This issuance shall apply to all units and instrumentalities, including attached agencies of the DOH. It also applies to local government units (LGUs), nongovernment organizations (NGOs), professional organizations, private sector and other relevant partners involved in the implementation of climate change adaptation for health programs. CSIcHA

IV. Definition of Terms

For purposes of this Order, the following terms are defined as follows:

1. "Acceptable levels" refers to the level at which a health risk is reduced for the body to perform its normal levels of defense over time.

2. "Adaptation" refers to the adjustment in natural or human systems in response to actual or expected climatic stimuli or their effects, which moderates harm or exploits beneficial opportunities.

3. "Climate Change (CC)" refers to a change in climate that can be identified by changes in the mean and/or variability of its properties and that persists for an extended period, typically decades or longer, whether due to natural variability or as a result of human activity.

4. "Climate Change Adaptation for Health (CCAH)" refers to national and local health responses to improve community and health system resilience to adapt to the public health challenges and health risks posed by climate change.

5. "Climate change proof (CC Proof)" refers to a process of identifying and reducing health risks as a consequence of climate change, and ensuring that those risks are reduced to acceptable levels through long-lasting and environmentally sound, economically viable, and socially acceptable modifications.

6. "Climate sensitive diseases (CSD)" are those diseases and health risks that are influenced by seasonal and extreme changes in temperature and rainfall. These may include, but are not limited to: vector-borne diseases (e.g., malaria, and dengue fever); food and water-borne diseases (e.g., cholera); malnutrition, and other health conditions related to air pollution and extreme temperatures. CIcTAE

7. "Disaster" refers to a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts which exceed the ability of the affected community or society to cope using its own resources.

8. "Disaster risk reduction (DRR)" refers to the concept and practice of reducing disaster risks through systematic efforts to analyze and manage the causal factors of disasters, including through reduced exposure to hazards, lessened vulnerability of people and property, wise management of land and the environment, and improved preparedness for adverse events.

9. "External Development Partners" refers to public and private sector entities, recognized international donors, equivalent government partners, accredited non government organizations, imparting valuable technical assistance.

10. "Global Warming" refers to the increase in the average temperature of the Earth's near-surface air and oceans that is associated with the increased concentration of greenhouse gases in the atmosphere.

11. "Greenhouse gases" (GHG) refers to constituents of the atmosphere that contribute to the greenhouse effect including, but not limited to, carbon dioxide, methane, nitrous oxide, hydro fluorocarbons, per fluorocarbons and sulfur hexafluoride.

12. "Health Sector" refers to both the public and private health sectors which contribute to the overall public health outcomes.

13. "Health System" is the sum total of all the organizations, institutions and resources whose primary purpose is to improve health. Strengthening health systems means addressing key constraints related to health worker staffing, infrastructure, health commodities (such as equipment and medicines), logistics, tracking progress and effective financing. HTCAED

14. "Kalusugan Pangkalahatan" (KP) refers to the Department of Health thrust and strategy in the provision of Universal Health Care (UHC) for all Filipinos; it is embodied in Department Order 2010-0032.

15. "Mainstreaming" refers to the integration of policies and measures that address climate change into development planning and sectoral decision-making.

16. "Mitigation" in the context of climate change refers to human intervention to address anthropogenic emissions by sources and removals of all GHG, including Ozone-Depleting Substances and their substitutes.

17. "Vulnerability" refers to the degree to which a system is susceptible to, or unable to cope with, the adverse effects of climate change, including climate variability and extremes.

V. Guiding Principles

A. Equity and Social Protection. In line with the Philippine national framework strategy on climate change, health in the context of social protection and human security is given emphasis to highlight the government thrust to reduce existing health and environmental inequities by developing healthy and resilient populations, communities, and human environments.

B. Integration. Integrate climate change mitigation and adaptation to health plans, programs and activities; to empower communities and encourage adaptation strategies that maximize health co-benefits and minimize unintended consequences.

C. Sustainability. Provide and maintain resources required to implement comprehensive strategies to minimize the impacts of climate change on human health and well-being. Appropriate the necessary financial resources from government and non-government entities in response to the identified strategies.

D. Proactive Response. Increase public awareness and understanding of climate change impacts on human health, the need to prepare for these changes, and the likelihood that adaptation and preparedness efforts will be overwhelmed, thus requiring the need to take urgent and strong actions.

E. Evidence-Based. Identify and provide information and research to develop and continually refine comprehensive strategies to minimize the impacts of climate change on human health.

VI. Policy Statement

The Department of Health hereby declares Climate Change Adaptation for Health Program (CCAHP) as a national policy and program priority as expressed in the national climate change action plan under the national framework strategy for climate change.

This policy supports the goals of the Philippine Development Plan (2011-2016), the Philippine Climate Change Act of 2009, the Philippine Disaster Risk Reduction and Management Act of 2010, the National Framework Strategy on Climate Change (2010-2022), and adopts the approach consistent with DOH Administrative Order No. 2010-0036 "Kalusugan Pangkalahatan" in the implementation of climate change adaptation measures for health.

VII. Strategies

Consistent with the "Kalusugan Pangkalahatan" (Universal Health Care) principles applicable to the implementation of Climate Change Adaptation for Health, the following are the strategic components:

A. Policy, Plans and Partnerships

1. Health Policy, Plans and Programs — to develop appropriate implementing instruments for local adaptation of the national climate change and health response initiatives. ECHSDc

2. Standards and Regulation — to ensure effective and efficient intervention measures, such as, but not limited to preparedness and response to health emergencies, appropriate standards, regulations and accreditation mechanisms shall be established.

3. Resource Mobilization/Financing — mechanisms to generate resources optimize its allocation and guarantee equitable distribution shall be developed. Investments shall be encouraged for the development of climate change adaptation for health technologies.

4. Networking and Partnership-Building — through inter-sectoral response and community participation, collaborative efforts shall be undertaken for advocating and implementing the Philippine Climate Change Adaptation Plan for Health.

B. Service Provision, Capacity and Infrastructure enhancement

1. Service Delivery — provides appropriate adaptation response and services related to, but not limited to managing the health effects of climate change.

2. Capability-Building — this shall include climate change adaptation for health-responsive (CCAH-responsive) human resource development.

3. Facilities Enhancement — upgrading of hospitals and other health facilities to make them climate change-proof, in adherence to infrastructural and service standards.

C. Health Promotion, Research, Surveillance and Monitoring

1. Health Promotion and Advocacy — communication interventions shall be developed to influence societal and community actions toward climate change adaptation and health.

2. Research and Development — high-quality studies shall be utilized for evidence-based decision-making; with emphasis on establishing links connecting climate change and adverse health. TaEIcS

3. Information Management System and Surveillance — generation of reliable, relevant and up-to-date information is essential to respond to the negative health effects of climate change. Surveillance systems shall be developed for climate change-sensitive diseases.

4. Monitoring and Evaluation — emphasis will be done on documenting events and progress in implementation, lessons learned, and sharing of good practices.

D. Strengthening Organizational Structure for Climate Change at different levels of governance.

Organizational structure at national, regional and LGU levels shall be established and strengthened. At national level, the Inter-Agency Committee on Environmental Health chaired by the Secretary of Health shall be the main coordinating body with secretariat support from the Climate Change Unit under the National Center for Disease Prevention and Control. At regional level, the Regional Inter-Agency Committee for Environmental Health chaired by the CHD Director shall manage the CCAH sub-sector. For the LGU level, the composition and organizational arrangements shall correspond to the structure at the regional level to be headed by the local chief executive.

VIII. Budget and Funding

In compliance to the R.A. 9729 — Philippine Climate Change Act and R.A. 10121 — Disaster Risk Reduction and Management Act, the Department of Health shall allocate a corresponding budget based on the implementation plan of the CCAH.

The DOH shall encourage the Local Government Units to fund their local CCAH plans and programs by providing the necessary technical assistance. Likewise, the DOH shall encourage other health sector agencies to implement and fund CCAH in their respective offices and establishments.

IX. Separability Clause

In the event that any provision or part of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected by such declaration shall remain valid and effective. aDIHTE

X. Repealing Clause

Unless otherwise, provisions from previous issuances and other related orders that are inconsistent or contrary to this order are amended and repealed accordingly.

XI. Effectivity

This Order shall take effect immediately.

(SGD.) ENRIQUE T. ONA, MDSecretary of Health