How climate change affects diseases and drug availability
In times of turmoil, it can be tempting to imagine getting away from it all to a beautiful island paradise. Sun, sand, and surf can seem like the ultimate escape from the 24-hour news cycle, but the reality of island living is not immune to the effects of climate change or to the subsequent effects on healthcare access.
In 2004, Hurricane Ivan ripped through the island nation of Grenada, damaging or destroying 90% of homes. In 2014, the mosquito-borne chikungunya virus (CHIKV) infected about 60% of the population, leaving half of those infected with enduring joint pain. This year Grenada was one of the many countries affected by the giant Saharan dust plume, causing problems for people with asthma.
“It was strange for me because I’ve always heard people speak about the Sahara dust, but I’ve never seen it,” said Kwami Jones, a biochemist from St. George’s University in Grenada. “It’s never been this visible. People with asthma were experiencing it, but it was never this visible as far back as I could remember. I feel like this year it was actual worst that I’ve seen.”
Taken together, these disparate events point to similar conclusions: Grenadian’s health and safety are linked to climate change. Hurricanes are becoming more frequent and more dangerous, mosquito populations are exploding, and unusual weather events like the dust plume are increasing in frequency. While each of these events can have obvious health ramifications, they can also indirectly affect other areas of healthcare.
“I think weather events could have an effect on drug availability because we don’t manufacture drugs in Grenada,” said Jones. “If you have spikes in fuel prices, because [drugs] have to be shipped here, then it could affect the price. It could affect the availability. If there is some major weather events and ships can’t travel, then it means that we wouldn’t be able to get the drugs as we’re supposed to.”
The current COVID-19 pandemic, while likely not caused by climate change itself, illustrates the extent of the problem. Drug shipments from Miami have been delayed or cancelled, leading to shortages of commonly used drugs like insulin for diabetes and hydroxychloroquine for lupus. The government’s lack of funds means the country is not able to maintain a stockpile of necessary drugs to get through times of unusual economic stress – and “unusual” stressors are becoming more usual.
The problem is complicated on all fronts. Most Grenadians get their health care from the government, which provides free services to citizens. However – since their economy is based mainly on tourism – weather and health events that limit travel can have serious impacts on the economy and therefore on healthcare. The COVID-19 pandemic is hitting the quarantined country hard economically since ports have been closed, mimicking similar interruptions from weather and disease events. Pandemics are especially dangerous for islands, and governments take stringent action to protect their people.
“We have zero cases, but the effort that the government and the ministry of health has made has been very significant,” said Jones. “From very early on they shut down the borders. No one was able to come in. People who wanted to leave were also not able to leave unless they had chartered flights. There was no commercial airline travel in or out of the island.”
The effects of climate change on Grenada are similar to those seen throughout the Caribbean. Rising sea levels, warmer oceans, and extreme weather events are obvious symptoms of climate change, with obvious effects on the agriculture and economy of Caribbean nations. The effect of climate on healthcare is less obvious, but no less pressing.
“We don’t do much manufacturing, so the economy is largely dependent upon tourism and the agriculture that we do,” said Jones. “If they’re both affected, there isn’t so much that that can be done.”
The indirect effect of booming mosquito populations is also evident in Grenada, which has experienced cases of dengue fever and Zika along with CHIKV. An outbreak is bad enough in each case, but outbreaks coupled with limited access to drugs for treatment could be devastating.
A less obvious climate-related disease is cancer, due to both increased exposure to UV radiation and to new exposure pathways to toxins from flooding or pollutants. Chemotherapy drugs are also difficult to come by in Grenada – and cancer mortality is rising. According to this study, mortality in Grenada has more to do with lack of medical options than with cancer rates, tying back to the government’s need for more funding for health care.
There are no easy answers, though there is no lack of trying. St George’s University, for example, has been running a public health program to bring more preventative care to the people of Grenada.
“They call it One Health One Medicine, where they look at the way the well being of animals can affect the well being of humans,” Jones said. “A lot of people are not aware of the zoonotic diseases that can go from animals to humans. They figure as long as you take good care of yourself, you don’t need to pay so much attention to the animals. This program brings that awareness to them.”
In the meantime, Grenadians can still enjoy the beaches that some of us can only daydream about.
“The beaches are beautiful,” Jones said. “The beaches really are beautiful.”