Editing IPCC:AR6/WGII/Chapter-7 (section)

==== 7.4.2.9 Incorporating Disaster Risk Reduction into Health Adaptation ====

<div id="h3-51-siblings" class="h3-siblings"></div>

''Integrating health into national disaster risk management plans has wider benefits for resilience and adaptation to climate change risks'' ( ''high confidence'' ) ''( [[#UNFCCC--2017a|UNFCCC, 2017a]] ; [[#Watts--2019|Watts et al., 2019]] )'' . DRR, including disaster preparedness, management and response, is widely recognised as important for reducing health consequences of climate-related hazards and extreme weather events ( [[#Keim--2008|Keim, 2008]] ; [[#Phalkey--2016|Phalkey and Louis, 2016]] ). A systematic review by [[#Islam--2020|Islam et al. (2020)]] identified multiple, ongoing challenges to integrating climate adaptation and DRR at global and national levels, including a lack of capacity among key actors and institutions, a lack of coordination and collaboration across scales of government and general lack of funding—challenges that are particularly relevant for the health sector. Global events, including climate-related extreme events and public health emergencies of international concern (for example, Ebola, Middle East respiratory syndrome (MERS) and COVID-19) have influenced the development of national public health preparedness and response systems and attracted significant investment over the last two decades ( [[#Khan--2015|Khan et al., 2015]] ; [[#Murthy--2017|Murthy et al., 2017]] ; [[#Watson--2017|Watson et al., 2017]] ). The Sendai Framework for Disaster Risk Reduction and the International Health Regulations establish important global and regional goals for increasing health system resilience and reducing health impacts from biological hazards and extreme climate events ( [[#Aitsi-Selmi--2015|Aitsi-Selmi et al., 2015]] ; [[#Maini--2017|Maini et al., 2017]] ; [[#UNFCCC--2017b|UNFCCC, 2017b]] ; [[#Wright--2020|Wright et al., 2020]] ). There are explicit links between the health aspect of the Sendai Framework and UN SDGs 1, 2, 3, 4, 6, 9, 11, 13, 14, 15 and 17 ( [[#Wright--2020|Wright et al., 2020]] ). More specifically, reducing the number of disaster-related deaths, illnesses and injuries, as well as damage to health facilities are key indicators for achieving the goals set out in the Sendai Framework ( [[#UNFCCC--2017b|UNFCCC, 2017b]] ).

The intersection of health and multi-sectoral DRR and management, generally described as health emergency and disaster risk management (health-EDRM), encompasses multi-sectoral approaches from epidemic preparedness and response including the capacities for implementing the International Health Regulations (IHR, 2005), health systems strengthening and health systems resilience ( [[#Lo%20Iacono--2017|Lo Iacono et al., 2017]] ; WHO 2019; [[#Wright--2020|Wright et al., 2020]] ). Health-EDRM costs to governments are notably lower than the cost of inaction ( [[#Peters--2019|Peters et al., 2019]] ). Additional per capita costs in low-income countries have been estimated to range from USD 4.33 (capital) and USD 4.16 (annual recurrent costs), and in upper middle-income countries to an additional USD 1.35 in capital costs and USD 1.41 in extra annual recurrent costs ( [[#Peters--2019|Peters et al., 2019]] ). Adopting a health-EDRM approach supports the systematic integration of health and multi-sectoral EDRM to ensure a holistic approach to health risks and assists in the alignment of action in health security, climate change and sustainable development ( [[#Chan--2017|Chan and Peijun, 2017]] ; [[#Dar--2014|Dar et al., 2014]] ; WHO, 2019; [[#Wright--2020|Wright et al., 2020]] ).

Climate-informed health-EDRM is crucial for the climate resilience of health systems ( [[#WHO--2015a|WHO, 2015a]] ), particularly to account for additional risks and uncertainties associated with climate change and allow for well-planned, effective and appropriate EDRM and adaptation ( [[#Watts--2018a|Watts et al., 2018a]] ; [[#WHO--2013|WHO, 2013]] ; [[#WHO--2015a|WHO, 2015a]] ). Potential coherent approaches to addressing climate change and disaster risks to health include: strengthening health systems; vulnerability and risk assessments that incorporate disaster and climate change risk; building resilience of health systems and health infrastructure; and climate-informed EWSs ( [[#Banwell--2018|Banwell et al., 2018]] ; [[#Phalkey--2016|Phalkey and Louis, 2016]] ). However, a review of DRR projects including climate change in south Asia found that the health sector was the least represented with only 2% of 371 projects relating to health ( [[#Mall--2019|Mall et al., 2019]] ), indicating a need to strengthen the incorporation of climate change in health-EDRM. Current tracking under the Sendai Framework of Disaster Risk Reduction 2015–2030 shows that most countries (particularly low-income countries and lower middle-income countries) still lack robust systems for integrated risk monitoring and early warning ( [[#UNEP--2018|UNEP, 2018]] ). The incorporation of DRR and management strategies into climate adaptation for health and health systems at local scales is particularly important, given that it is at local scales where health services are most often delivered and where knowledge of specific needs and challenges is often greatest ( [[#Amaratunga--2018|Amaratunga et al., 2018]] ; [[#Schramm--2020a|Schramm et al., 2020a]] ). Indigenous knowledge has been shown to be valuable in DRR, with particularly strong evidence existing for drought risk reduction in sub-Saharan Africa ( [[#Fummi--2017|Fummi et al., 2017]] ; [[#Muyambo--2017|Muyambo et al., 2017]] ; [[#Dube--2018|Dube and Munsaka, 2018]] ; [[#Macnight%20Ngwese--2018|Macnight Ngwese et al., 2018]] ). In the USA, DRR strategies that draw upon traditional knowledge and local expertise are being incorporated into climate adaptation planning for health in a number of indigenous communities under the ‘Climate-ready Tribes Initiative’ ( [[#Schramm--2020b|Schramm et al., 2020b]] ).

<div id="7.4.2.10" class="h3-container"></div>

<span id="monitoring-evaluation-and-learning"></span>