Climate and Health Observatory: studies on the influence of climate change on public health

"We have spent at least five years having to start our presentations by explaining that climate change does exist." The reminder comes from researcher Renata Gracie, a member of the Climate and Health Observatory, which turns 15 in 2024. The speech refers to a time (not so long ago) when changes in the planet's climate were not yet viewed with the necessary urgency, but the Observatory was already up and running.

Linked to the Institute for Scientific and Technological Communication and Information in Health (Icict/Fiocruz), the Observatory was created in 2009 to gather and analyze data generated by different institutions to relate climate and environmental changes to health. The information collected results in systems, maps and graphs, in addition to subsidizing the Observatory in publishing books, scientific articles and technical notes and in preparing courses and workshops.

"Our idea has always been to have representatives from various areas in the Observatory, such as researchers, managers and civil society. The first meeting was for everyone to tell us what they did, so that we could start working from a common point," recalls Renata, who has been involved in the project since the beginning.

The initiative was born out of the development of a system for water quality, sanitation and diseases related to inadequate environmental sanitation (DRSAI), with funding from Icict/Fiocruz's Research and Technological Development Induction Program (PIPDT). Based on this first initiative, the Ministry of Health requested the development of another system, this time focused on climate change. At that point, the idea of a climate emergency seemed more distant.

At first, it was agreed among the participants that the Observatory would use information gathered from all over Brazil and would focus its analysis on four areas of interest, which have remained the same to this day: water, air, vectors and extreme events (disasters). The information would also have to be public, with unrestricted access.

"The data from the Climate and Health Observatory is not just health data, it is data of interest to health, which helps to understand a context. We do not produce data, we transform it into useful information for diagnosing a health situation, e.g. to assess leptospirosis or dengue contexts," explains Christovam Barcellos, a researcher at Icict/Fiocruz and coordinator of the Observatory.

The Observatory's trajectory can be told through milestones: when the first information was deposited in the system; when researchers were able to cross-check the data and analyze the information for the first time; and when the project began offering courses to train other researchers to use the system. Researcher Diego Xavier also highlights the international partnerships, which "have opened up a range of opportunities for our work".

Over the years, the Observatory has become a reference in the analysis and dissemination of information on the impacts of climate change on health, collaborating in the development of public policies. "The observatory has accumulated a wealth of knowledge and detailed studies on the increased incidence of climate-related diseases, analyzing the impacts of environmental devastation on traditional and original populations, such as indigenous peoples, riverside dwellers, quilombolas and caiçaras," says Diego.

This expertise is essential for understanding emerging risks and for developing care, prevention and health promotion strategies,” says Hermano Albuquerque de Castro, vice president of Environment, Care and Health Promotion at Fiocruz (VPAAPS/Fiocruz). "Over the last 15 years, the Observatory has contributed significantly to the development of surveillance systems for monitoring the impacts of climate change on health, with special emphasis on fires in Brazil, especially in the legal Amazon region and in the Central-West. We must also emphasize the importance of promoting awareness of the interconnection between health and climate," he praises.

Partnerships with national and international institutions

The Climate and Health Observatory is the result of numerous partnerships. In addition to researchers from Icict/Fiocruz, other Fiocruz units are also participating, such as the Sérgio Arouca National School of Public Health (Ensp/Fiocruz) and the Oswaldo Cruz Institute (IOC/Fiocruz), as well as external organizations such as the Ministry of Health, the Pan American Health Organization (PAHO) and the National Institute for Space Research (INPE), among others.

In recent years, the Observatory has expanded its work in collaboration with other institutions, both inside and outside Brazil. The Observatory is currently cooperating with the French Institut de Recherche pour le Développement (IRD) in French Guiana through the International Mixed Laboratory (LMI) for monitoring vector-borne diseases in the Amazon.

And, in April this year, the Observatory team was in Santiago, Chile, to take part in a seminar as part of the international cooperation agreement signed between Fiocruz and the Chilean Ministry of Health. The agreement, signed in November 2023, provides for the creation of a Chilean climate and health observatory, based on the experience of the Brazilian project.

The Climate and Health Observatory has also intensified its partnerships with peripheral populations, providing support and training so that they can act directly in generating citizen data. This movement began during the COVID-19 pandemic. In June, the Peripheries' Potentialities Map was launched, a partnership between the Observatory, the Ministry of Health and the National Secretariat for the Peripheries of the Ministry of Cities. The launch took place during the 1st National Meeting of Health Observatories in the Peripheries, in Rio de Janeiro.

The Map gathers information on projects from more than 10,000 urban peripheries in all Brazilian states. These are initiatives in the fields of health; social assistance; education and research; the environment and animal protection; culture and recreation; religion; housing; development and defense of human rights; employers' associations, professionals and rural producers' organizations, as well as local businesses.

"We have noticed that the more these organizations establish themselves in these territories, the more these people's quality of life improves. We want to create a network where people can look up to, be inspired and develop themselves," said researcher Renata Gracie at the launch of the initiative. She, who worked directly on the development of the platform, is already seeing a change in the way this information is viewed, which used to be the exclusive responsibility of large research centers. "In general, many groups from peripheral populations have collected their own data. Often, they have specificities that are not covered by the Census, for example, but which the Census itself is reviewing. The proof is that the term 'favela' has returned to the questionnaire," she said.

In addition to the data work carried out by the researchers, the Observatory is consolidating itself as an important translator of the messages that the environment is sending to researchers. "Public management always faces difficulties with resources. What we are trying to do is prioritize the diagnosis of health situations, which will point out where the situation is worst and needs more urgent investment. This is the power of the Observatory," Christovam reflects. "And the moment civil society has access to this information and understands how much it will be affected by climate change, it is better able to demand action from public authorities."