Editing IPCC:AR6/WGII/Chapter-9 (section)

==== 9.10.3.1 Risk Assessment and Warning Systems ====

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Improved institutional capacity for risk monitoring and early warning systems is key to support emergency preparedness and responsiveness in Africa, as well as shock-responsive and long-term social protection ( [[#FAO%20and%20ECA--2018|FAO and ECA, 2018]] ). Climate risk assessments grounded in evidence and locally appropriate technologies are important for identifying priority actions, the scale of intervention needed and high-risk geographical areas and populations. Potential tools include those developed by WHO ( [[#Ceccato--2018|Ceccato et al., 2018]] ) and the Strategic Tool for Analysis of Risk ( [[#Ario--2019|Ario et al., 2019]] ).

Warning systems that predict seasonal to intra-seasonal climate risks could assist in improving response times to extreme weather events (such as droughts, flooding or heat waves) and shifts in infectious diseases. Weather and other types of forecasting provide an advanced warning—a central tenet of disaster risk reduction ( [[#Funk--2017|Funk et al., 2017]] ; [[#Okpara--2017a|Okpara et al., 2017a]] ; [[#Lumbroso--2018|Lumbroso, 2018]] ). Models encompassing each component of the human–animal–environmental interface, including disease surveillance in humans and animals and remote sensing of vegetation indexes, water and soil can be used to project patterns of zoonose outbreaks ( [[#UNDP--2016|UNDP, 2016]] ; [[#Bashir--2019|Bashir and Hassan, 2019]] ; [[#Durand--2019|Durand et al., 2019]] ). Early warning systems may help better prepare for these and other forms of infectious disease outbreaks ( [[#Thomson--2006|Thomson et al., 2006]] ) but adaptation is possible in the absence of statistical tools through vaccination and surveillance, for example.

Surveillance systems for diseases and vectors are well-established in many parts of Africa ( [[#Ogden--2017|Ogden, 2017]] ). However, many data gaps remain, especially in monitoring climate-sensitive conditions such as diarrheal- and arbovirus-related diseases, and morbidity and mortality stemming from heat exposure ( [[#Ogden--2017|Ogden, 2017]] ; [[#Buchwald--2020|Buchwald et al., 2020]] ).

Climate and health adaptation indicators are required for Africa to strengthen institutional capacity for risk monitoring and early warning systems, emergency preparedness and response, vulnerability reduction measures, shock-responsive and long-term social protection, and planning and implementing resilience-building measures ( [[#FAO%20and%20ECA--2018|FAO and ECA, 2018]] ). National-level progress is assessed through the Lancet Countdown indicators ( [[#Watts--2018|Watts et al., 2018]] ), however, district- and local-level indicators are needed to measure levels of vulnerability and response effectiveness at a local level, and for informing planning local service delivery. Potential indicators include monitoring the number of excess health conditions during extreme heat events. Indoor temperature monitoring in sentinel houses and health facilities is a related indicator ( [[#Ebi--2017|Ebi and Otmani Del Barrio, 2017]] ), linked with threshold temperature levels at which health impacts occur, and the ability of the built environment to protect against these impacts (e.g., for heatwaves).

Measuring climate-health linkages is challenging due to the considerable diversity of the exposures, impacts and outcomes, as well as constraints in key technical areas. Increasing our understanding of this diversity and how this is influenced by adaptative changes is a major knowledge gap. This could be facilitated through a pan-African database of climate and other environmental exposures, together with real-time statistical support for analyses of climate and health associations.

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