The Pakistan floods have dealt a body blow to its public health system

A patient with dengue fever receives treatment in an isolation ward at a hospital in Karachi, Pakistan. EPA

Flooded areas have become infested with diseases including malaria, dengue fever, diarrhoea and skin problems, the southern Sindh provincial government says. AP

A health worker sprays an area to kill mosquitoes and prevent the outbreak of dengue fever in Hyderabad, Sindh province. EPA

About 2.3 million patients have been treated for various diseases since July 1 in the field and mobile hospitals set up in the flooded region, authorities say. EPA

Unprecedented floods in Pakistan that have killed nearly 1,500 people have also led to a steep rise in dengue cases across the country. EPA

The devastating floods in Pakistan are yet another manifestation of our changing climate. They have resulted in the loss of hundreds of lives and left more than one third of the country submerged. While monsoon rains and floods are normal phenomena, these floods were twice as high as the 30-year average.

Pakistan’s floods can be clearly linked to anthropogenic climate change. This change disproportionately affects the poorest, the most vulnerable and those least responsible for the changes they experience. The direct impact of climate change is now felt around the world with more frequent intense weather – storms, floods, droughts and record-high temperatures resulting in loss of lives and livelihoods, decreased food supplies and more widespread disease.

The effects of climate change on health are numerous. Beyond the direct mortality caused by excessive heat or floods, they cause disruption to health infrastructure, services and supply chains, impeding access to medical care and treatment.

In this changing climate, infectious disease outbreaks and the re-emergences of almost eradicated diseases, such as polio, are increasing. Decades of health gains are in jeopardy. Research suggests that the risk of disease transmission and emergence of infections from animal sources (including insect-borne diseases) is on the rise as ecosystems change, creating more favourable conditions for pathogens and their vectors to thrive. The transmission of malaria, for example, is expected to increase and to re-emerge at higher altitudes and latitudes as temperatures rise.

In Pakistan, one of the two remaining countries where wild polio remains endemic, the destructive flooding threatens the polio response – from immunisation campaigns through to essential environmental surveillance and monitoring, and exacerbates diseases such as malaria, dengue, cholera and Covid-19.

Neglected Tropical Diseases, a collection of 20 parasitic, bacterial, fungal and viral infections that affect more than 1.7 billion people, are expected to spread further, as they are directly influenced by changes in temperature, rainfall and relative humidity. An estimated 500 million more people could become exposed to mosquito-borne NTDs, such as chikungunya and dengue, as these diseases spread to new geographic locations. The risk of exposure to other diseases such as lymphatic filariasis is not yet understood. We need more research focused on the nexus of climate change and health to help inform disease elimination and eradication strategies.

The Global Institute for Disease Elimination – or Glide – a UAE-based global health institute, works to advance thinking and accelerate progress towards disease elimination by elevating awareness and engagement, advancing elimination strategies, and fostering and scaling innovation through partnership. As we look to Cop28, which the UAE will host in 2023, Glide is commissioning additional research through our Falcon Awards for Disease elimination and climate change, to better understand the intersections between climate change and health, especially as it relates to disease elimination and eradication targets. We will learn from others, putting countries and communities at the centre. Without those most affected shaping and driving the agenda, we will not succeed in developing sustainable solutions.

As countries gather at the 77th UN General Assembly in New York, we must work together to find innovative solutions to the complex challenges that climate change is increasingly posing to our societies. International co-operation is essential to achieve shared goals and targets for people, planet and prosperity. The health of our current and future generations depends on taking action to reverse the drivers of climate change, to better understand the complex interrelationships between climate and health, to strengthen global health systems and to invest in new diagnostics and medicines.

Better-integrated healthcare programmes incorporating NTDs, malaria and other diseases, and ensuring facilities are resistant to climate shocks are needed now more than ever. The need to design climate-resilient health systems at the national, regional as well as global levels has never been more pressing.

The bold commitments made at Cop26 in Glasgow last year to limit global warming, reverse forest loss and end global use of fossil fuels cannot be achieved without strong partnerships, country-specific policy development and accountability mechanisms. We must increase the ambition and scope of global discussions on financing health systems. We can’t pause, we can’t let the lessons from Covid-19 go to waste. If we stand still on health care, we will go backwards. A changing climate, increasing drug resistance and new pathogens should all tell us that it is time to get on the front-foot and invest in the front line, the health systems around the world.