Can climate change have an impact on NHI?

Following the introduction of the National Health Insurance (NHI) Bill to parliament in August this year, a group of scientists from the South African Medical Research Council (SAMRC) have also weighed in on the discussion, focusing on what may not have been stated on the bill but needed to be known.

In a paper published in the latest issue of the South African Journal of Science, Dr. Caradee Wright and Profs Matthew Chersich and Angela Mathee focus on possible direct and indirect impacts of climate change on NHI. In the paper, this team of researchers from the SAMRC’s Environment and Health Research Unit (EHRU) describe how climate change will present substantial challenges to the Bill, especially to the vulnerable communities who are expected to benefit the most from it.

One of the fundamental goals of the NHI is to eliminate inequality in access to primary healthcare and to be the catalyst behind an improvement in primary healthcare services and infrastructure across South Africa. However, the paper notes that while climate change health impacts are not mentioned in the White Paper on the NHI since first gazetted, some serious thought needs to be given to it.

According to the paper, potential direct climate change impacts on NHI and primary healthcare include extreme weather events on health service infrastructure such as heatwaves affecting the functionality of medical equipment, changes to cold chain requirement for transporting medicine and vaccines, thermal comfort in hospitals, and working conditions, productivity and staff well-being. Also, the hotter conditions may constrain health workers’ outreach work which often involves walking long distances for home visits. Flooding may interrupt water and power supplies, impede the ability of staff to get to work, affect the safety of staff and patients at health centres, and also jeopardise access to, or integrity of, systems for maintaining patient records.

It is estimated that by the end of the 21st century, climate change in the country is predicted to result in, on average, temperatures 4ºC warmer than they are now and according to the World Health Organization (WHO), additional deaths will occur globally each year from the direct and indirect climate change impacts.

Dr Wright, Senior Specialist Scientist at the SAMRC and primary author of the paper says even though these climate predictions are not certain, it is important to prepare for climate change impacts. “Already, the country has a high burden of disease and climate change will only exacerbate and even create new public health challenges”, Wright said.

The paper concludes that by making climate change an integral consideration in planning and development it is possible to deliver an NHI that contributes more effectively to reducing inequalities that are likely to stem from evolving environmental hazards to health associated with climate change.

Paper available on the South African Journal of Science website. https://www.sajs.co.za/article/view/5800