How great a threat is climate change to human health, and why?

Melting icebergs is one indicator scientists analyse to assess climate change on planet Earth

Climate change is perhaps the most complex issue facing modern society, affecting every aspect of human life, including health.

There will be beneficial health impacts from milder winters which could help to reduce the winter-time peak in deaths. Hotter than average summers could also help to limit disease-transmitting mosquito populations, for example.

However, scientists agree that most impacts will be adverse, with some declaring a public health emergency. According to WHO, between 2030 and 2050, climate change is expected to cause approximately 250 000 additional deaths per year.

The transmission of vector and water-borne diseases like malaria, dengue fever and cholera will increase with small changes in temperature and precipitation; increasing air pollutants such as methane, black carbon and sulphate aerosols will result in more respiratory illnesses and early deaths; and more frequent extreme weather events – such as droughts, typhoons, hurricanes and snowstorms – will endanger populations, put food supply at risk and place huge pressures on healthcare systems.

Even for those living in less-affected areas, the uncertainty of the Earth’s future is likely to have an adverse effect on millions of people’s mental wellbeing. So much so, the term “eco-anxiety” has been coined by doctors to describe a new psychological disorder where people worry (to an extreme) about the climate crisis.

 

To what extent are these health risks being explored? Why do you think this subject has attracted comparatively little attention?

   

While the health risks are increasingly being explored, there’s a much lower degree of understanding when compared to economic activities, infrastructure and ecosystems. In fact, less than 4 percent of spending on climate change adaption is channelled into health according to a report by Lancet.

This is because many health implications are secondary to an initial event or change in the environment. Today, most are focused on slowing or even reversing climate change, so the effects associated with changing temperatures, levels of precipitation or large-scale environmental emergencies are being somewhat overlooked.

Another reason why investment is lagging is because climate action requires a lot of right-now sacrifice for a down-the-line payoff. There are many competing factors with climate change which are all considered to be imperative to address quickly.

However, the tide seems to be turning and WHO recently set out its global strategy to efficiently reduce environmental risks to health and build health-supportive and enabling environments the world over. Part of the current challenge is closing knowledge gaps on certain risks to health, including climate change, and new evidence needs to be communicated better through new platforms available.

 

What kind of role will the pharma industry play in mitigating the health impacts of climate change? How should the industry be preparing itself?

Whether it be a fast-developing public health emergency caused by an extreme weather event in a specific region, or a slow but steady increase in respiratory diseases from worsening air population levels in urban populations, the pharma industry needs to have the agility to respond quickly and support the effective functioning of healthcare systems.

The pharma and biotech industries are no stranger to the chaos caused by extreme weather on their research and manufacturing capabilities. In 2017, Pfizer’s manufacturing facilities in Puerto Rico were wiped out during a devastating hurricane season, resulting in a loss of an estimated $195 million in inventory. So, pharma must prepare itself in order to support others.

Investment in sites’ resilience is key to preparing for extreme weather in advance and patching vulnerabilities which could close plants, such as flood barricades, emergency power generators, and keeping critical digital infrastructure on higher floors.

Governments and regulators may start to enact policies to force big pharma companies to geographically diversify the locations of their production facilities, particularly for products that are lifesaving and have no substitutes, as well as carry heavy inventory to protect against supply chain disruption.

Keeping global supply chains moving in the aftermath of a large-scale climate event is also vital.

To facilitate the new pharmaceutical landscape, a fresh and agile approach is needed, one which leans towards an all-in-one solution that isn’t restricted to one manufacturing location or field of expertise.

Teams on the ground need to be capable of creating a solution, to any problem, anytime, and anywhere. However, at the moment it’s common for multiple teams to be managing multiple international supplier sites.

Consolidating the supply chain under one roof brings a large range of benefits including, but not limited to:

  • reduced risks and overheads
  • greater innovation
  • assurance of supply
  • compliance
  • tighter quality control
  • local availability via regional distribution sites on a global scale.

 

How much attention is being paid to creating sustainable supply chains? What are the main challenges here, what needs to change, and what kind of progress have we seen to date?

Pharma, as one of the largest global industries, is both part of the problem and the solution when it comes to minimising the adverse effects of climate change. However, many trailblazers in the industry are leading the way in changing the status quo and creating a more sustainable pharma supply chain.

There are multiple ways pharma can help reduce its carbon footprint.

Any new pharma plants should incorporate green spaces and energy-saving technologies into site plans. From the installation of rainwater harvesting systems, solar panels, inverter driven machinery and reactive lighting designed to maintain a consistent lux output whenever an area is occupied, to robotics which increase production yields and accuracy with reduced input.

Pharmaceutical waste continues to be a huge problem, so to eliminate non-biodegradable and single-use plastics from the supply chain, more research is taking place around bio-based PET. It’s made from ethylene derived from sugarcane which has a negative carbon footprint, using CO2 and releasing oxygen when cultivated.

Researchers are now testing pioneering technology which converts PET waste back into virgin grade material to be used again. Cutting edge manufacturing methods like 3D visualisation and printing are also helping to reduce waste by eliminating the need for multiple prototype designs.

Working with a hybrid partner, pharma companies can design or redesign their product’s primary and secondary packaging to support compliance and make it easier (and cheaper) to transport, while simultaneously reducing the amount of materials used overall or facilitate a switch to more eco-friendly alternatives. A virtuous circle if you will.

These cost-saving and efficiency gains will help the industry fulfil its social responsibilities, including the need to both pioneer more sustainable manufacturing processes and to produce more effective and safer medicines the entire world can afford.

 

Is now the time to act? What is the business case for investing in sustainability measures now, rather than waiting?

When we think about the future of the pharmaceutical industry – and the future of Planet Earth – we’re actually not talking about the future at all, but the here and now. The effects of the climate crisis are already being seen and felt by everyone.

Investing in climate resiliency and reducing the impact of the pharma industry on the environment will be costly to the sector and the commercial benefits of doing so will not be realised for some time.

But the most successful pharma companies of tomorrow will be those who invest in and build agile and efficient supply chains – both virtual and physical – today.

 

What are some of the key questions the industry needs to start asking itself in relation to climate change?

We are only as healthy as the environment in which we live.

Pharma has social and environmental responsibilities to fulfil, as does every other industry. Patient safety has always and will always continue to be the number one priority for the pharmaceutical industry but doing so is going to become much more complex in the coming decades.

It’s important to remember that the people who will suffer the most from climate impacts are low income, very young, very old, and people with chronic conditions. If action isn’t taken, we’re at risk of widening the health inequalities which we’ve worked so hard to close over the past half Century through healthcare delivery and medical advances.

It’s not an overstatement to say that a level of opacity still exists in big pharma. It isn’t uncommon for large multi-national companies to group their environmental data across their product divisions – pharmaceutical, medical equipment and agricultural. This can make it difficult to see the collective impact of the pharmaceutical supply chain on the environment.

This needs to change as a matter of urgency if pharma is to succeed in minimising the health implications of climate change and supporting global efforts to reverse it.

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