Accounting for health in climate change policies: a case study of Fiji.
BACKGROUND
Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change.


OBJECTIVE
The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change.


METHODS
The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations.


RESULTS
The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts.


CONCLUSIONS
The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to consider climate change and its impact on human health. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the Health in All Policies approach. Future research could support the Fiji health sector in developing climate change and health programmes.
Institute of Tropical Medicine and International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; gmorrow22@gmail.com.
Georgina
G
Morrow
National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
Kathryn
K
Bowen
D057231:Climate Change; D003715:Dengue / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D004813:Epidemiology / Q000706:statistics & numerical data; D005367:Fiji / Q000453:epidemiology; D006291:Health Policy / Q000331:legislation & jurisprudence; D006801:Humans; D044342:Malnutrition / Q000453:epidemiology; D011050:Policy Making; D011640:Public Policy; D014881:Water Supply
Fiji; climate change; health; pacific islands; policy; policy analysis