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Climate, Development and the Social Determinants of Health

2015 | Source: - Author: Alessandra Ninis

2015 has been a landmark year for global development. The new development agenda, approved in September 2015 – Sustainable Development Goals or the 2030 Agenda – audaciously proposes 17 comprehensive goals – that go from the eradication of extreme poverty to the combat of climate change – with 169 targets to be achieved by 2030.

Identifying that the eradication of poverty is the greatest challenge to sustainable development reinforces actions on the social determinants of health that transversally involve the 17 goals of the document “Transforming Our World: the 2030 Agenda for Sustainable Development”.

The list of actions of the 2030 Agenda demonstrates that the issue of social determinants of health and social welfare touch all dimensions of the Agenda, both with regard to actions for the promotion of equality and equity towards healthy lives, and actions for urbanization, access and protection of natural resources and climate. The challenges of the Sustainable Development Goals, in connection with the social determinants of health, indicate a great ambition of this new global Agenda.

However, all of these efforts are seriously threatened by the uncertainties of climate change. Even though the Report establishes actions aiming at climate protection, generally speaking, it also envisions a level of full development that requires not only commitments and chimerical agreements by countries, but also real actions for the mitigation of impacts and adaptability to the new social-planetary system.

The climate crisis is a pre-announced tragedy. The COP 21, which took place in Paris, aimed to achieve a new international agreement on climate, which would be applicable to all countries, with the intention of keeping global warming below 2°C. But is it still possible?

The consensus about the acknowledgement that climate change originates from anthropogenic actions should mobilize concrete attitudes towards the reorientation of man’s actions in the planet towards a real change in production and consumption. This reorientation essentially involves the eradication of extreme poverty, the reduction of inequalities, the containment of accumulation and consumerism, in a pact for a new system that is more solidary, equal and, as a consequence, healthier. But even with all the risk involved, there is a breach between the agreed goals and concrete results.

The 5th Report of the IPCC (Intergovernmental Panel on Climate Change), issued in 2014, warns that climate warming is faster than expected. Even though the United Nations have established a target of a limited increase in temperature of 2°C until the end of the 21st Century, there is a risk that this target will be achieved in 2030, which is exactly the target year for the Sustainable Development Goals. But would the humanity have enough time to adapt, adequate and propose actions for the mitigation of this vicious circle of production-consumption-poverty-emissions?

In the 2014 Report, the IPCC presents a quite pessimistic scenario – an average temperature increase of around 4.8°C until the end of this century with a mean sea level rise of 26 to 98 cm (the previous estimate was of 18 to 59 cm), which will cause massive migration flows, extreme weather events and the increase and dissemination of diseases.

In addition, there is the imminent Permafrost thawing (resulted from global warming) and the consequent liberation of 45 billion metric tons of carbon from methane and carbon dioxide in the atmosphere over the next 30 years, which could reach 300 billion tons in 2100 and would aggravate the phenomenon of global warming and impact on all Earth systems. This means a warming that is 20 to 30% faster than it is today.

This imminent catastrophe, together with the scenario of political, ideological, religious, environmental and social multicrisis threatens the possibility of an effective agreement for human societies to reach the development proposed by the United Nations.

Changing the economic model means adopting a series of measures and public and private commitments, industrial conversions, financial compensations and coercive measures of renunciation of available resources that are rentable in the short term. But countries have different levels of development, with different conceptions and different negotiation powers.

Apart from countries, another great challenge is to convince big corporations and the real owners of wealth and power to renounce their financial free rides. It is very clear to everyone who studies development that, in a clash between the economic power and the social-ecological crisis, the latter always loses and progresses are not very effective.

In the Paris Conference, the belief in an unprecendented agreement prevailed, but no one realized that what they should actually be preparing was a contingence plan and practical and effective solutions of adaptability and survival. In this scenario, it would be prudent that everyone involved would listen to the propositions of the civil society and search for a global pact for the planet.

At the Thematic Meeting previous to Habitat III – Medium-sized Cities – held in Ecuador in November, the declarations were limited to the implementation of the new Sustainable Development Goals agenda at the local level. The watchwords were citizen participation and new development paradigm. It was agreed that there is no possibility of converting the vicious development model into a virtuous model without a substantial change in economic, political and social models.

A new paradigm of territorial planning must be effectively implemented for the attainment of the targets of the 2030 Agenda so that cities are environmentally sustainable, socially equal, culturally sensitive, politically democratic (participatory), economically prosperous and, above all, more resilient.

Therefore, the incorporation of the Sustainable Development Goals (2030 Agenda) must start from a comprehensive social consultation in order to search for new planning tools that are able to promote a paradigmatic change in municipal management.

The Cuenca Declaration, base document for Habitat III (Quito, 2016), highlights the challenges of this new urbanization with regard to environmental and climatic changes, aiming at a more balanced relation with rural surroundings, ensuring food safety (supply chain), health, public safety and citizenship education at all levels of school. The commitment of the Cuenca Declaration is to create a new urban agenda through a complex interconnected and interdisciplinary vision that promotes a new sustainable and dignified urban development model to all people.

All these changes, which are expected for the new few years, require new initiatives, actions and policies that impact on health services. They transform the social determinants of health in an increasingly complex challenge. Social policies to fight poverty and inequality must be reinforced and safeguarded, as well as social participation and the guarantee of citizens’ rights.

Amidst this whole process, ISAGS-UNASUR has been debating and acting in order to promote the social determinants of health in times of global crisis. In a meeting held from November 4 to 6 in Rio de Janeiro, the participants agreed upon the importance of cash transfer policies as an efficient mechanism towards the reduction of poverty and health promotion.

The strengthening of intersectoral actions, intersectoral dialogue and the transdisciplinary capacity building of public managers can enable some progresses concerning the design of effective public policies towards this other paradigm. The State must ensure equal conditions and opportunities so as to promote health, equity and guarantee rights.

It will be necessary to adequate and strengthen health systems in order to face the new challenges with regard to climate change and as a response to the 2030 Agenda. Hence, the working group proposes the enhancement of planning and management for more integrated and intersectoral health systems, the strengthening of social participation and the creation of a political pact about the sustainability of health systems in the countries of the bloc.

Countries must have a clear dimension of the challenge posed by climate change to the processes of the social determinants of health concerning the need to strengthen and create a more resilient health system, and that it will require the promotion of new management and planning paradigms that include more complex, comprehensive, interdisciplinary, participatory approaches for the elaboration of plans towards the mitigation of impacts and the comprehensive human, social and environmental health care.

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