Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions

Abstract

Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.

Keywords: Air pollution; Climate change; Eastern Mediterranean; Extreme heat; Health; Middle East; Population displacement; Vector-borne diseases; Water shortage.

Fig. 1

Map of the EMME region. The countries included in the EMME region are Bahrain, Cyprus, Egypt, Greece, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Palestine, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates (UAE) and Yemen.

Fig. 2

The effects of increasing environmental temperatures on human health.

Fig. 3

Cities where future environmental temperatures could surpass the limits for human survival. By the year 2100, five cities (represented with stars) located in four EMME countries (Iran, Qatar, Saudi Arabia and the United Arab Emirates) could reach environmental “wet bulb” temperatures above 35 °C, surpassing the threshold for the human body's physiological adaptability. UAE: United Arab Emirates. Source: Pal et al. 2016 (Pal and Eltahir, 2016).

Fig. 4

Direct and indirect impacts of freshwater scarcity on human health. *Source: World Health Organization (WHO), (2020a).

Fig. 5

Expected changes in revenue from agricultural exports in selected EMME countries. Source: Figure modified from Borgomeo et al. (2018).

Fig. 6

Distribution of atmospheric dust loads around the world. Source: Figure modified from De Longueville et al. (2010)).

Fig. 7

Current distribution of Aedes aegypti and Aedes albopictus in the EMME region. Data sources: Ducheyne et al. (2018) and European Centre for Disease Prevention and Control (ECDC), 2021a, European Centre for Disease Prevention and Control (ECDC), 2021b.

Fig. 8

International population displacement by country of origin and destination, 2019. Figure shows the 10 countries either generating (left panel) or receiving (right panel) the largest internationally displaced populations in the world. *EMME countries. DRC: Democratic Republic of the Congo. USA: United States of America. Source: Figure modified from UNHCR (2020).

Fig. 9

Direct and indirect effects of population displacement on human health.

Fig. 10

Visual summary of policy suggestions. If implemented on a regional scale, these policies would enhance the resilience of the EMME against climate change.