中国应对气候变化和改善公众健康的挑战与政策建议

China's challenges and policy recommendations for addressing climate change and improving public health

近期,知名医学期刊Lancet（柳叶刀）发表了2017年度＂柳叶刀倒计时：公众健康和气候变化的全球进展＂（以下简称＂柳叶刀倒计时＂）报告[1].该报告指出,全球气候变化不仅意味着热浪高温天气增多、空气污染加重,人们的劳动生产效率受到影响,在某种程度上还加速了某些传染病的扩散,对人们的健康产生了恶劣影响.这些气候变化带来的挑战与影响健康的社会环境因素相互作用,对人类健康构成了前所未有的威胁.

The health impacts of climate change are experienced through both direct and indirect pathways. These may take the form of an increase in the frequency or severity of extreme weather events such as heatwaves, floods, droughts, and storms. These directly impact human health, resulting in heat-related mortality, injury, and loss of livelihoods. Indirectly, climate change may interact with other environmental systems, for example, altering the burden and pattern of distribution of vector-, water-, or food-borne infectious diseases. Increasingly, the effects of climate change interact with already vulnerable social systems, for example by threatening the availability of adequate nutrition or safe drinking water. These challenges interact with many of the social and environmental determinants of health, presenting an unprecedented threat to human health which, left un-mitigated, could work to reverse the last half-century of gains made in public health. Conversely, the response to climate change presents the potential for enormous health co-benefits. For example, efforts to phase-out coal-fired power not only reduces greenhouse gas emissions, but also reduces local air pollution, thus improving the cardiopulmonary health of surrounding populations. It is vital to understand（1） the impacts that climate change is having on human health and（2） the health consequences of the global response to climate change. Thus, recently, Lancet published ＂2017 Lancet Countdown＂ report to inform people about the effects of climate change on human health and the global health effects of climate change. China is a hotspot country in health and climate change because it has the world’s largest population, with the second largest burden of disease and the largest total carbon dioxide emissions of any country. To provide a unique national analysis and policy recommendations for health and climate change, scholars from Department of Earth System Science, Tsinghua University, who had involved in the ＂2017 Lancet Countdown＂ report, reviewed four indicators mostly related to China’s national conditions. This review will help readers quickly understand the impacts of climate change on the health of Chinese residents, China’s measures to address climate change and health impacts, as well as related challenges and opportunities. Specifically, this policy brief makes the following major recommendations：（1） Further analyze the role of climate change on diseases and on human health to make more customized prevention policies： although China has established a fairly good detection, early warning, preparedness and response system to health emergencies, further analysis and better understanding on the drivers are needed, especially the role of climate change, behind the change of incidence rate or vectorial capacity. This will greatly facilitate a prevention-oriented and more cost-effective response strategy to climate change.（2） Continue phasing out coal while properly handling the consequent social problems： systematic solutions including developing new industrial fields and products, expanding domestic and overseas market, providing free training and career guidance, developing market-oriented vocational education, giving adequate government support for those who want to start their own businesses are urgently needed to avoid social unrest problems.（3） Integrate health in the climate policy-making process： fully consider the health effects of potential climate technologies and policies, in order to re-evaluate the proposed policy and develop more cost-effective and socially acceptable technology roadmap and policies.（4） Tighten the emission control on potential large-emitting sectors such as transport and buildings： study and publish more policies to encourage climate-friendly productions and consumptions in these two sectors（such as speeding up the development and deployment of electric vehicle, strengthening the standards of energy conservation in building sector, etc.）, in order to avoid the potential lock-in effects.