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Climate Change and Health Working Group

Note Rainer Sauerborn was one of 9 members/authors of the Scientific Council of the
Federal German Government on Global Environmental Change/ Wissenschaftlicher
Beirat der Bundesregierung für Globalen Umweltwandel (www.WBGU.de) (2000-
2004). All white books are available in English translation and as hardcopy

1. Grassl H, Schubert R, Epiney A, Kulessa M, Luther J, Nuscheler F, Sauerborn R,
Schellnhuber HJ, Schulze ED (2001) Die Chance von Johannisburg - Eckpunkte
einer Verhandlungsstrategie (Politikpapier 1)/ The Johannesburg Opportunity –
Key Elements of a Negotiation Strategy (policy paper 1). WBGU, Berlin.

2. Grassl H, Schubert R, Epiney A, Kulessa M, Luther J, Nuscheler F, Sauerborn R,
Schellnhuber HJ, Schulze ED (2002) Entgelte für die Nutzung globaler Gemeingüter
(Sondergutachten)/ Charging the Use of Global Commons (Special Report). WBGU,

3. Grassl H, Schubert R, Epiney A, Kulessa M, Luther J, Nuscheler F, Sauerborn R, Schellnhuber HJ, Schulze ED. (2003) Energiewende zur Nachhaltigkeit (Hauptgutachten)/ Towards sustainable energy systems (White Book). WBGU, Berlin/ Earthscan London.

4. Grassl H, Schubert R, Epiney A, Kulessa M, Luther J, Nuscheler F, Sauerborn R,
Schellnhuber HJ, Schulze ED (2004) Über Kyoto hinaus denken -
Klimaschutzstrategien für das 21. Jahrhundert (Sondergutachten)/ Climate
protection strategies for the 21st century (Special report). WBGU, Berlin.

5. Grassl H, Schubert R, Epiney A, Kulessa M, Luther J, Nuscheler F, Sauerborn R,
Schellnhuber HJ, Schulze ED (2004) Welt im Wandel: Armutsbekämpfung durch Umweltpolitik/ World in Transition: Fighting poverty through environmental policy.

Climate change & health: what are the challenges and on which topics do we work

The links between climate change and health have only recently become center stage both of the scientific and the policy communities ((Verner et al. 2016, Marrakesh declaration, Ref. 1). Clim can be devided into the five areas below.

1) Impacts of climate change

General introduction

This involves quantifying and attributing them to climate change among the many other factors that contribute to ill health. Typically, we need long term, decade long time series data of weather and health outcomes. Once we have established the so-called climate-health impact functions, we can start including health impacts in the current climate models: this will allow us to project the negative impacts of climate change to various policy relevant time horizons (2030, 2050, 2100). It is very clear that those countries who have historically contributed least to emissions are the ones with the largest exposures, the largest health impacts, and the smallest capacity to respond. The issue of (in-) equity is writ large across the entire climate change-health nexus.

These analyses can further be carried out on specific subgroups:

(i) by different climate -sensitive disorders, such as malaria, malnutrition, stroke or asthma; an alternative which is very attractive for policy is to aggregate ALL health impacts of climate change into one currency and one number: e.g. DALYs lost from climate change.

(ii) by particularly vulnerable sub-groups: the elderly, infants, women, the poor, urban versus rural populations, tropical versus moderate climates etc.

Focus of our group:

We first focused on all-cause mortality in low income countries with a UNESCO funded project:


In terms of diseases/disorders, as well as on disease-specific impacts on malaria, dengue, malnutrition heat and non-communicable diseases (as a group, specifically on stroke and asthma/COPD). Regarding vulnerable groups: we particularly study the effect on the elderly (Germany, Burkina Faso), women and children under 5.

A pilot project for the attribution of malnutrition to climate change is Project NUTRICLIM. It compares the nutritional status of households across several years linking it to preceding weather, to harvest yields of at the household plot level, as well as to a myriad of socio-economic factors characterizing the households. https://publichealthreviews.biomedcentral.com/articles/10.1186/s40985-016-0031-6

2) Adaptation

General introduction

Adaptation can be broken down in spontaneous and planned. The policy focus is clearly on the latter: what can individuals, households, communities and countries to reduce the impact of climate change. These measures include measures targeting the health sector, such strengthening and climate -proofing first and second line health services, as setting up early warning systems for climate sensitive diseases. It also involves many other sectors, such as communication, agriculture, transport and more. Adaptation comes at a cost, so we need to understand which interventions provide the best health protection for the least resources they require. We need to look at the equity of such adaptation measures,

Health adaptation and its cost are probably the most understudied areas within the nexus of climate change and health.

Focus of our group:

In our EMIRA Project (Ecological Management of Malaria in Africa), we develop and adapt targeted treatment of surface water with the biological larvicide BTI. This is currently weather and satellite guided and can in the future be linked to climate projections.


The PALUCLIM project developed and validated the methods applied in EMIRA. It was a cooperation project of Heidelberg university with several French partners: the French Space Agency (Centre National des Études Spatiales, Toulouse), Météo France and the Université de Toulouse. It was funded by the French "Programm Gestion et Impacts du Changement Climatique".


3) Health co-benefits of mitigation

General introduction

They arise, when either individuals or policies meant to reduce emissions improve health at the same time. Individual behavior change towards reducing one's personal carbon footprint includes  (i) more walking and biking (increasing cardiovascular fitness, weight loss, lower risk of diabetes, (ii) eating less meat reduces the risk of colon cancer, (iii) insulating our homes decreases noise levels and hence blood pressure). In low income countries there are two huge co-benefits increasing health and reducing admissions at the same time: (i) child spacing has been known to increase mother and child health, it also reduces in the long run the number of people contributing to emissions. (ii) Indoor air pollution kills 4 million people each year (3 times more people than AIDS ), mainly women and children. This has been known for decades and many stove projects have been developed with mixed success to reduce toxic fumes due to indoor cooking with biomass. In the past 10 years it has been shown that in addition to producing health-damages the smoke form cooking with biomass emits a highly climate active short lived pollutant: black carbon or soot. So providing clean cooking fuel would save lives and reduce emissions. (iii) Out-door air pollution is another major health threat, killing 3 million people per year. Decarbonizing energy systems would generate climate and health benefits.

Focus of our group:

Project HOPE studies in a randomized community trial, whether households in European high-income countries are more likely to engage in reducing their carbon foot-print, if they are given information on the health benefits they reap while engaging in climate-friendly behavior. For each of 65 options a household has to reduce their carbon footprint, the respondents were given the information on the net costs, the carbon savings and, if applicable, the health benefits of the respective behavior change.



4) Communicating health to promote climate policy

General introduction

Health has received very little attention in the policy and scientific debate surrounding climate change. We believe that health is much more than just one of dozens of sectors being affected by climate change. Rather, health is a key argument for climate policy. Watch our MOOC teaser on this topic, developed for the COP21 at https://iversity.org/de/my/courses/climate-change-health-for-policy-makers/info

There are two positive arguments:

1. Health is a positive motivator, a driving force for citizens and policy-makers to care about and act on climate change.

2. The huge health co-benefits must enter the risk-benefit calculations.

However, there are also two "warning" arguments pertain to the restrictions that our health and physiology impose on humans under climate change, particularly in a world that is +4°C warmer:

1. There are health limits to adaptation.

2. Decreased work productivity in hot countries.

Focus of our group:

We analyze the role of the health argument in the scientific literature, in the IPCC reports, in climate legislation both in Europe and globally as well as in print and social media. We do this in close collaboration with the Centre Virchow Villermé de Santé Publique, which belongs to the Université Paris Descartes, which in turn is part of the Université Sorbonne Paris-Cité.



5) Reducing the carbon footprint of health sector

General introduction

The health sector itself has a significant carbon footprint. Studies in the UK and the US report that it contributes to 3% and 7% of national emissions respectively. This is a larger percentage as air transport represents in global emissions. Surprisingly most of the emissions are NOT due to energy or transport of patients, but to consumables, and here to drugs.

Focus of our group:

We have set up a working group including the Heidelberg University Hospital Pharmacy, a local consulting firm specialized in Carbon foot print assessment (https://www.ifeu.de) and a major pharmaceutical company, Sanofi in order to quantify and attribute the emissions of drugs along the long chain of value added from suppliers of drug companies to hospital patients and the final waste management of pharmaceuticals.

Group Leader

Prof. Dr. Dr. Rainer Sauerborn
Former director of the Institute
(till 8/16)

Visiting Professor for "Climate change and Health" at the Harvard Chan School of Public Health Designated Senior Professor (as of 9/17)

In Neuenheimer Feld 130.3
R. 309
69120 Heidelberg
Tel: + 49 (0) 6221 56-5344
Fax: + 49 (0) 6221 56- 5948

Tagesschau Interview with Prof. Sauerborn


‚Impacts World‘ Konferenz in Potsdam - Forscher beraten über den Klimawandel
Interview from October 11, 2017 in "Tagesschau"