CLIMATE AND HEALTH COUNTRY PROFILE – 2015 KUWAIT
OVERVIEW The State of Kuwait is located at the northwestern end of the Arabian Peninsula and has an area of 17,818 square kilometres. Kuwait has approximately 500km of coastline along its mainland and islands. Kuwait has an arid climate with average annual rainfalls of approximately 116 millimetres and average daily high temperatures in the summer typically above 40°C (Kuwait's Initial Communication to the UNFCCC, 2012). Humidity in August and September months can reach levels above 95% and dust storms can be common in summer months which result in increased health risks (Kuwait's Initial Communication to the UNFCCC, 2012). Kuwait's economy is highly dependent on oil exports with oil operations comprising over 50% of GDP in 2010 (Kuwait's Initial Communication to the UNFCCC, 2012). Kuwait is vulnerable to the impacts of climate change on health, particularly, the impact of increasing mean annual temperatures, changes in precipitation patterns, sea-level rise, and changes in extreme weather events on human settlements, heat stress, biodiversity, economic activities, water security and infrastructure.
SUMMARY OF KEY FINDINGS • In Kuwait, under a high emissions scenario, mean annual temperature is projected to rise by about 6.2oC on average from 1990 to 2100. If global emissions decrease rapidly, the temperature rise is limited to about 1.7oC. • In Kuwait, under a high emissions scenario, and without large investments in adaptation, an annual average of 594,500 people are projected to be affected by flooding due to sea level rise between 2070 and 2100. If global emissions decrease rapidly and there is a major scale up in protection (i.e. continued construction/raising of dikes) the annual affected population could be limited to about 300 people. Adaptation alone will not offer sufficient protection, as sea level rise is a long-term process, with high emissions scenarios bringing increasing impacts well beyond the end of the century [page 3]. • In Kuwait, under a high emissions scenario heat-related deaths in the elderly (65+ years) are projected to increase to about 51 deaths per 100,000 by 2080 compared to the estimated baseline of under 3 deaths per 100,000 annually between 1961 and 1990. A rapid reduction in global emissions could limit heat-related deaths in the elderly to about 11 deaths per 100,000 in 2080.
DEMOGRAPHIC ESTIMATES Population (2013)a Population growth rate (2013)a Population living in urban areas (2013)b Population under five (2013)a Population over 65 (2013)a 3.6 million 4.7 % 98.3 % 9.5 % 1.9 %
ECONOMIC AND DEVELOPMENT INDICATORS GDP per capita (current US$, 2013)c Total expenditure on health as % of GDP (2013)d Percentage share of income for lowest 20% of population (2012)c HDI (2013, +/- 0.01 change from 2005 is indicated with arrow)e 48,463 USD 2.9 % N/A 0.814
HEALTH ESTIMATES Life expectancy at birth (2013)f Under-5 mortality per 1000 live births (2013)g 78 years 9
a b c d
World Population Prospects: The 2015 Revision, UNDESA (2015) World Urbanization Prospects: The 2014 Revision, UNDESA (2014) World Development Indicators, World Bank (2016) Global Health Expenditure Database, WHO (2014)
e United Nations Development Programme, Human Development Reports (2014) f Global Health Observatory, WHO [2014] g Levels & Trends in Child Mortality Report 2015, UN Inter-agency Group for Child Mortality Estimation [2015]
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CURRENT AND FUTURE CLIMATE HAZARDS
Due to climate change, many climate hazards and extreme weather events, such as heat waves, heavy rainfall and droughts, could become more frequent and more intense in many parts of the world. Outlined here are country–specific projections up to the year 2100 for climate hazards under a ‘business as usual’ high emissions scenario compared to projections under a ‘two-degree’ scenario with rapidly decreasing global emissions. Most hazards caused by climate change will persist for many centuries.
COUNTRY-SPECIFIC CLIMATE HAZARD PROJECTIONS The model projections below present climate hazards under a high emissions scenario, Representative Concentration Pathway 8.5 [RCP8.5] (in orange) and a low emissions scenario, [RCP2.6] (in green).a The text boxes describe the projected changes averaged across about 20 models (thick line). The figures also show each model individually as well as the 90% model range (shaded) as a measure of uncertainty and, where available, the annual and smoothed observed record (in blue).b,c
MEAN ANNUAL TEMPERATURE 34 32
DAYS OF WARM SPELL (‘HEAT WAVES’)
300
°C
30 34 28 32 26
Days
200 300 100
°C
30 24 28 26 1900 1950 2000 2050 2100
Days Year
200 0 100 1900 1950 2000 2050 2100
24 Under a high emissions scenario, mean annual temperature is projected to rise by about 6.2°C on average from 1990 to 2100. 1900 1950 2000 2050 rise 2100 If emissions decrease rapidly, the temperature is limited to about 1.7°C. 3.0 2.5 2.0
Year
Year
0 Under a high emissions scenario, the number of days of warm spelld is projected to increase from about 10 days in 1990 to 1900on average 1950 in 2000 2100 about 260 days 2100. If 2050 emissions decrease rapidly, the days of warm spell are limited to about 70 350 Year on average. 300 250 CONSECUTIVE DRY DAYS (‘DROUGHT’) 200 350 150 300 100 250 50 200 0 150 50 0
DAYS WITH EXTREME RAINFALL (‘FLOOD RISK’)
Days
1.5 3.0 1.0 2.5 0.5 2.0 0.0 1.5 1.0 1900 0.5 0.0 1900 1950 2000 2050 2100 1950 2000 2050 2100
Days
Days
Days Year
100 1900
1950
2000
2050
2100
Year 1900 1950 2000 2050 2100
Year Under a high emissions scenario, the number of days with very heavy precipitation (20 mm or more) could increase by almost 0.5 days on average from 1990 to 2100, indicating a slight increase in the risk of floods. Some models indicate slightly larger increases but the number of such days remains very low, particularly under a low emissions scenario. a b c d
Year Under both high and low emissions scenarios, the longest dry spell is not indicated to change much from an average of about 185 days, with continuing large year-to-year variability.
Model projections are from CMIP5 for RCP8.5 (high emissions) and RCP2.6 (low emissions). Model anomalies are added to the historical mean and smoothed. Observed historical record of mean temperature is from CRU-TSv.3.22; observed historical records of extremes are from HadEX2. Analysis by the Climatic Research Unit and Tyndall Centre for Climate Change Research, University of East Anglia, 2015. A ‘warm spell’ day is a day when maximum temperature, together with that of at least the 6 consecutive previous days, exceeds the 90th percentile threshold for that time of the year. 2
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CURRENT AND FUTURE HEALTH RISKS DUE TO CLIMATE CHANGE
Human health is profoundly affected by weather and climate. Climate change threatens to exacerbate today’s health problems – deaths from extreme weather events, cardiovascular and respiratory diseases, infectious diseases and malnutrition – whilst undermining water and food supplies, infrastructure, health systems and social protection systems.
ANNUAL EXPOSURE TO FLOODING DUE TO SEA LEVEL RISE, KUWAIT (2070–2100) Severity of climate change scenario RCP2.6 Without Adaptation 378,300 594,500 With Adaptation 300 500
KEY IMPLICATIONS FOR HEALTH Kuwait also faces inland river flood risk. It is projected, that by 2030, an additional 4,300 people may be at risk of river floods annually as a result of climate change and 750 due to socioeconomic change above the estimated 360 annually affected population in 2010.a In addition to deaths from drowning, flooding causes extensive indirect health effects, including impacts on food production, water provision, ecosystem disruption, infectious disease outbreak and vector distribution. Longer term effects of flooding may include post-traumatic stress and population displacement.
* Medium ice melting scenario
RCP8.5
** Values rounded to nearest ‘00
Under a high emissions scenario, and without large investments in adaptation, an annual average of 594,500 people are projected to be affected by flooding due to sea level rise between 2070 and 2100. If emissions decrease rapidly and there is a major scale up in protection (i.e. continued construction/ raising of dikes) the annual affected population could be limited to about 300 people. Adaptation alone will not offer sufficient protection, as sea level rise is a long-term process, with high emissions scenarios bringing increasing impacts well beyond the end of the century. Source: Human dynamics of climate change, technical report, Met Office, HM Government, UK, 2014.
INFECTIOUS AND VECTOR-BORNE DISEASES Mean relative vectorial capacity for dengue fever transmission in Kuwait Mean relative vectorial capacity
KEY IMPLICATIONS FOR HEALTH Some of the worlds most virulent infections are also highly sensitive to climate: temperature , precipitation and humidity have a strong influence on the life-cycles of the vectors and the infectious agents they carry and influence the transmission of water and foodborne diseases.b Socioeconomic development and health interventions are driving down burdens of several infectious diseases, and these projections assume that this will continue. However, climate conditions are projected to become significantly more favourable for transmission, slowing progress in reducing burdens, and increasing the populations at risk if control measures are not maintained or strengthened.c
0.40
0.30
0.20
0.10
0
Baseline 1961–1990
RCP26 RCP85 2021–2050
RCP26 RCP85 2041–2070
Under both high and low emissions scenarios, the mean relative vectorial capacity for dengue fever transmision is projected to decline only slightly towards 2070. Additional analysis indicates that in the baseline period of 1961-1990, the entire geographic area of Kuwait (100%) was above a threshold deemed suitable for dengue transmission for at least 3 months of the year. The risk level for dengue transmission remains at 100% of the geographic area of Kuwait towards 2070. Source: Rocklöv, J., Quam, M. et al., 2015.d
a b c d
World Resources Institute, http://www.wri.org. Aqueduct Global Flood Analyzer. Assumes continued current socioeconomic trends (SSP2) and a 100-year flood protection. Atlas of Health and Climate, World Health Organization and World Meteorological Organization, 2012. Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. Geneva: World Health Organization, 2014. Country-level analysis, completed in 2015, was based on health models outlined in the Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. Geneva: World Health Organization, 2014. The mean of impact estimates for three global climate models are presented. Models assume continued socioeconomic trends (SSP2 or comparable). 3
HEAT-RELATED MORTALITY Heat-related mortality in population 65 years or over, Kuwait (deaths / 100,000 population 65+ yrs) 60 Deaths/100,000 population 65+ years 50 40 30 20 10 0 Baseline 1961–1990 RCP2.6 RCP8.5 RCP2.6 RCP8.5 RCP2.6 RCP8.5 2030 2050 2080
KEY IMPLICATIONS FOR HEALTH Climate change is expected to increase mean annual temperature and the intensity and frequency of heat waves resulting in a greater number of people at risk of heat-related medical conditions. The elderly, children, the chronically ill, the socially isolated and at-risk occupational groups are particularly vulnerable to heat-related conditions.
Under a high emissions scenario heat-related deaths in the elderly (65+ years) are projected to increase to about 51 deaths per 100,000 by 2080 compared to the estimated baseline of under 3 deaths per 100,000 annually between 1961 and 1990. A rapid reduction in emissions could limit heat-related deaths in the elderly to about 11 deaths per 100,000 in 2080. Source: Honda et al., 2015.a
UNDERNUTRITION Climate change, through higher temperatures, land and water scarcity, flooding, drought and displacement, negatively impacts agricultural production and causes breakdown in food systems. These disproportionally affect those most vulnerable people at risk to hunger and can lead to food insecurity. Vulnerable groups risk further deterioration into food and nutrition crises if exposed to extreme climate events.b Without considerable efforts made to improve climate resilience, it has been estimated that the global risk of hunger and malnutrition could increase by up to 20 percent by 2050.b In Kuwait, the prevalence of underweight children under age 5 was 3% in 2014.c
a Country-level analysis, completed in 2015, was based on health models outlined in the Quantitative risk assessment of the effects of climate change on selected causes of death, 2030s and 2050s. Geneva: World Health Organization, 2014. The mean of impact estimates for three global climate models are presented. Models assume continued socioeconomic trends (SSP2 or comparable). b World Food Project 2015 https://www.wfp.org/content/two-minutes-climate-change-and-hunger c World Health Organization, Global Database on Child Growth and Malnutrition [2015 edition]. Child malnutrition estimates are for % underweight, defined as: Percentage of children aged 0–59 months who are below minus two standard deviations from median weight-for-age of the World Health Organization (WHO) Child Growth Standards. 4
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CURRENT EXPOSURES AND HEALTH RISKS DUE TO AIR POLLUTION
Many of the drivers of climate change, such as inefficient and polluting forms of energy and transport systems, also contribute to air pollution. Air pollution is now one of the largest global health risks, causing approximately seven million deaths every year. There is an important opportunity to promote policies that both protect the climate at a global level, and also have large and immediate health benefits at a local level.
OUTDOOR AIR POLLUTION EXPOSURE Outdoor air pollution in cities in Kuwait annual mean PM2.5 (μg/m3) 2014* 100 Annual mean PM2.5, μg/m3 90 80 70 60 50 40 30 20 10 0 Al-Ahmadi Al-Fahaheel Ali Subah Al-Salem Al-Jahra AlMansouriya Al-Mutla AlRumaithyia Al-Salam Al-Shuwaikh Saad AlAbdullah Shuaiba
WHO annual mean PM2.5 guideline value (10 μg/m3)
The cities for which there was air pollution data available had annual mean PM2.5 levels that were above the WHO guideline value of 10 µg/m3. Source: Ambient Air Pollution Database, WHO, May 2016. * For most cities, the PM2.5 values have been converted from the PM10 measured data with the exceptions of Al-Ahmadi and Al-Jahra cities which had measured PM2.5 data available. Please see source for more information on conversion methods.
KEY IMPLICATIONS FOR HEALTH Outdoor air pollution can have direct and sometimes severe consequences for health. Fine particles which penetrate deep into the respiratory tract subsequently increase mortality from respiratory infections, lung cancer and cardiovascular disease.
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CO-BENEFITS TO HEALTH FROM CLIMATE CHANGE MITIGATION: A GLOBAL PERSPECTIVE
Health co-benefits are local, national and international measures with the potential to simultaneously yield large, immediate public health benefits and reduce the upward trajectory of greenhouse gas emissions. Lower carbon strategies can also be cost-effective investments for individuals and societies. Presented here are examples, from a global perspective, of opportunities for health co-benefits that could be realised by action in important greenhouse gas emitting sectors.a
Transport Transport injuries lead to 1.2 million deaths every year, and land use and transport planning contribute to the 2–3 million deaths from physical inactivity. The transport sector is also responsible for some 14% (7.0 GtCO2e) of global carbon emissions. The IPCC has noted significant opportunities to reduce energy demand in the sector, potentially resulting in a 15%–40% reduction in CO2 emissions, and bringing substantial opportunities for health: A modal shift towards walking and cycling could see reductions in illnesses related to physical inactivity and reduced outdoor air pollution and noise exposure; increased use of public transport is likely to result in reduced GHG emissions; compact urban planning fosters walkable residential neighborhoods, improves accessibility to jobs, schools and services and can encourage physical activity and improve health equity by making urban services more accessible to the elderly and poor.
Electricity Generation Current patterns of electricity generation in many parts of the world, particularly the reliance on coal combustion in highly polluting power plants, contribute heavily to poor local air quality, causing cancer, cardiovascular and respiratory disease. Outdoor air pollution is responsible for 3.7 million premature deaths annually. High-income countries still have work to do in transitioning to cleaner and healthier energy sources. The health benefits of transitioning from fuels such as coal to lower carbon sources, including ultimately to renewable energy, are clear: Reduced rates of cardiovascular and respiratory disease such as stroke, lung cancer, coronary artery disease, and COPD; costsavings for health systems; improved economic productivity from a healthier and more productive workforce.
Food and Agriculture Agricultural emissions account for some 5.0–5.8 GtCO2eq annually, with food and nutrition constituting an important determinant of health. Many high- income countries are feeling the burden of poor diet and obesity-related diseases, with some 1.9 billion adults overweight globally. A wide range of interventions designed to reduce emissions from agriculture and land-use will also yield positive benefits for public health. For example, policy and behavioural interventions to encourage a reduction in red meat consumption and a shift towards local and seasonal fruit and vegetables, which tend to have lower carbon emissions associated with their production, will improve diets and result in reductions in cardiovascular disease and colorectal cancer.
Healthcare Systems Health care activities are an important source of greenhouse gas emissions. In the US and in EU countries, for example, health care activities account for between 3–8% of greenhouse gas (CO2-eq) emissions. Major sources include procurement and inefficient energy consumption. Modern, on-site, low-carbon energy solutions (e.g. solar, wind, or hybrid solutions) and the development of combined heat and power generation capacity in larger facilities offer significant potential to lower the health sector’s carbon footprint, particularly when coupled with building and equipment energy efficiency measures. Where electricity access is limited and heavily reliant upon diesel generators, or in the case of emergencies when local energy grids are damaged or not operational, such solutions can also improve the quality and reliability of energy services. In this way, low carbon energy for health care could not only mitigate climate change, it could enhance access to essential health services and ensure resilience.
a For a complete list of references used in the health co-benefits text please see the Climate and Health Country Profile Reference Document, http://www.who.int/globalchange/en/
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EMISSIONS AND COMMITMENTS
Global carbon emissions increased by 80% from 1970 to 2010, and continue to rise.a,b Collective action is necessary, but the need and opportunity to reduce greenhouse gas emissions varies between countries. Information on the contribution of different sectors, such as energy, manufacturing, transport and agriculture, can help decision-makers to identify the largest opportunities to work across sectors to protect health, and address climate change.
Kuwait ANNUAL GREENHOUSE GAS EMISSIONS (metric tonnes CO2 equivalent) 35,000,000
Metric tonnes CO2 equivalent
1994
30,000,000 25,000,000 20,000,000 15,000,000 10,000,000 5,000,000 0
A 2ºC upper limit of temperature increase relative to pre-industrial levels has been internationally agreed in order to prevent severe and potentially catastrophic impacts from climate change. Reductions are necessary across countries and sectors. In order to stay below the 2ºC upper limit it is estimated that global annual CO2-energy emissions, currently at 5.2 tons per capita, need to be reduced to 1.6 tons per capita.c
Energy Industries
Manufacturing and Construction
Transport
Agriculture
Waste
Other
Total excl LULUCF/LUCF
The most recent greenhouse gas emissions data for Kuwait is from 1994. At that time, carbon emissions were highest in the energy industries and transport sectors. Through intersectoral collaboration, the health community can help to identify the best policy options not only to eventually stabilize greenhouse gas emissions, but also to provide the largest direct benefits to health. Source: UNFCCC Greenhouse Gas Data Inventory, UNFCCC [2015].
NATIONAL RESPONSE d
1995 2005
THE STATE OF KUWAIT RATIFIED THE UNFCCC THE STATE OF KUWAIT RATIFIED THE KYOTO PROTOCOL
a Boden, T.A., G. Marland, and R.J. Andres (2010). Global, Regional, and National Fossil-Fuel CO2 Emissions. Carbon Dioxide Information Analysis Center, Oak Ridge National Laboratory, U.S. Department of Energy, Oak Ridge, Tenn., U.S.A. doi 10.3334/CDIAC/00001_V2010. b IPCC (2014) Blanco G., R. Gerlagh, S. Suh, J. Barrett, H.C. de Coninck, C.F. Diaz Morejon, R. Mathur, N. Nakicenovic, A. Ofosu Ahenkora, J. Pan, H. Pathak, J. Rice, R. Richels, S.J. Smith, D.I. Stern, F.L. Toth, and P. Zhou, 2014: Drivers, Trends and Mitigation. In: Climate Change 2014: Mitigation of Climate Change. Contribution of Working Group III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Edenhofer, O., R. Pichs-Madruga, Y. Sokona, E. Farahani, S. Kadner, K. Seyboth, A. Adler, I. Baum, S. Brunner, P. Eickemeier, B. Kriemann, J. Savolainen, S. Schlömer, C. von Stechow, T. Zwickel and J.C. Minx (eds.)]. Cambridge University Press, Cambridge, United Kingdom c Pathways to deep decarbonization, Sustainable development Solutions Network, 2014 report. d Columbia Law School, 'Climate Change Laws Of The World'. N.p., 2015.
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NATIONAL POLICY RESPONSE
The following table outlines the status of development or implementation of climate resilient measures, plans or strategies for health adaptation and mitigation of climate change (reported by countries).a
GOVERNANCE AND POLICY Country has identified a national focal point for climate change in the Ministry of Health Country has a national health adaptation strategy approved by relevant government body The National Communication submitted to UNFCCC includes health implications of climate change mitigation policies
NA NA NA NA NA NA NA NA
HEALTH ADAPTATION IMPLEMENTATION Country is currently implementing projects or programmes on health adaptation to climate change Country has implemented actions to build institutional and technical capacities to work on climate change and health Country has conducted a national assessment of climate change impacts, vulnerability and adaptation for health Country has climate information included in Integrated Disease Surveillance and Response (IDSR) system, including development of early warning and response systems for climate-sensitive health risks Country has implemented activities to increase climate resilience of health infrastructure
FINANCING AND COSTING MECHANISMS Estimated costs to implement health resilience to climate change included in planned allocations from domestic funds in the last financial biennium Estimated costs to implement health resilience to climate change included in planned allocations from international funds in the last financial biennium
NA NA
HEALTH BENEFITS FROM CLIMATE CHANGE MITIGATION The national strategy for climate change mitigation includes consideration of the health implications (health risks or co-benefits) of climate change mitigation actions Country has conducted valuation of co-benefits of health implications of climate mitigation policies
NA NA
a Supporting monitoring efforts on health adaptation and mitigation of climate change: a systematic approach for tracking progress at the global level. WHO survey, 2015.
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