Establishment Of Policy Indicators Of Adaptation To Climate Change Impacts On The Transmission Of Major Vector-borne Diseases In China And On-site Validation

Nowadays, climate change is one of the most pressing challenges in the 21st century. Characterized with climate warming, it deteriorates human survival environment and may greatly impact the global ecology and sustainable development. Among these negative impacts, human health is undoubtedly the most urgent outcome of climate change. Apart from direct impacts on increase incidence and death, climate change indirectly causes problems on human health. Researches show that vector-borne diseases such as schistosomiasis, malaria are susceptible to the change of climate, and both the endemic intensity and range of the diseases will be increasingly enlarged. In order to effectively tackle the impacts of climate change, Chinese government attached greater importance on mitigation than adaptation. To explore adaptation policies and strategies on public health, we selected vector-borne diseases as the targeted diseases to formulate an indicator system consisting of 2-level indicators to guide policy making on climate change adaptation by using Delphi method. Schistosomiasis and malaria were selected as the second targets presenting both water-borne and arthropod transmitted infectious diseases, in order to establish the the indicators of the second level by using Delphi method. A total of 59 experts are involved in the first investigation,22 and 18 experts focusing on both schistosomiasis and malaria respectively in the second investigation. Results show that the system includes 4 indicators at first level, i.e. surveillance, scientific research, disease control and intervention, and adaptation capacity building, A total of 25 and 21 indicators at the second level were found for schistosomiasis and malaria, respectively. Among indicators at the first level, disease control ranks the first one with the average score and the highest coordination index. Among the indicators at the second level, vector control scores the highest in terms of both schistosomiasis and malaria (8.15 for schistosomiasis and 8.16 for malaria).On the basis of the indicators established, taking schsitosomiasis for example, combined with current control strategies in China, indicators in control and intervention are translated into specific measures, including cattle elimination and sanitary toilets building, which are conducted on the spot to assess and validate the indicators.In conclusion, among all the indicators, disease control and intervention are considered as the most important adaptation strategy of climate change with the lease variation. Study shows the indicators are practical, applicable and universal and effective ones using in field, which is also useful to technically support the establishment of adaptation to climate change in the field of public health.