WHO / UNFCCC Climate & Health Profile 2020

National Context

Country Background

Grenada is a small tri-island state in the Eastern Caribbean (1). The island lies in the southern belt which has a hurricane season from June to November (2). A mountainous central range stretches from north to south with settlements in the flatter areas and along the coastline. Grenada’s economy is primarily driven by tourism while agriculture has declined from being the traditional mainstay (3).

Climatic conditions are significant for the economic and physical well-being of Grenada’s population, and vulnerabilities to a changing climate have the potential for both direct and indirect impacts on health (4). While susceptible to long-term climate impacts such as sea level rise and changes in precipitation, Grenada was historically at low risk of tropical storms compared to other Caribbean islands. The need to ensure resilience of the island’s infrastructure and health system to extreme weather events became evident with the passages of hurricanes Ivan and Emily in 2004 and 2005, respectively (5). An unprecedented drought in 2010 as well as increasing events of flooding and forest fires highlight the need for affirmative actions for food and nutrition security. The distribution of disease vectors and non-communicable diseases continue to be priority areas for public health (5).

In its Initial National Communication to the United Nations Framework Convention on Climate Change (UNFCCC), the health sector was identified as being particularly vulnerable to the impacts of climate change (2). The health vulnerability and adaptation assessment identified vulnerable groups to the impacts of climate change, including women, children, elderly people and low-income families (5). This has led the Government and people of Grenada to take concrete actions to build health sector resilience to climatic events.

Highest Priority Climate Sensitive Health Risks

Climate Hazards Relevant for Health

Climate Hazard Projections for Grenada

Country-specific projections are outlined up to the year 2100 for climate hazards under a ‘business as usual’ high emissions scenario compared to projections under a ‘two-degree’ scenario with rapidly decreasing global emissions (see Figures 1–5). The climate model projections given below present climate hazards under a high emissions scenario, Representative Concentration Pathway 8.5 (RCP8.5 – in orange) and a low emissions scenario (RCP2.6 – in green). ¹ ¹Model projections are from CMIP5 for RCP8.5 (high emissions) and RCP2.6 (low emissions). Model anomalies are added to the historical mean and smoothed.

The text describes the projected changes averaged across about 20 global climate models (thick line). The figures ² ²Analysis by the Climatic Research Unit, University of East Anglia, 2018. also show each model individually as well as the 90% model range (shaded) as a measure of uncertainty and the annual and smoothed observed record (in blue).³ ³Observed historical record of mean temperature is from CRU-TSv3.26 and total precipitation is from GPCC. Observed historical records of extremes are from JRA55 for temperature and from GPCC-FDD for precipitation. In the following text the present-day baseline refers to the 30-year average for 1981–2010 and the end-of-century refers to the 30-year average for 2071–2100.

Modelling uncertainties associated with the relatively coarse spatial scale of the models compared with that of small island States are not explicitly represented. There are also issues associated with the availability and representativeness of observed data for such locations.

FIGURE 1: Mean annual temperature, 1900–2100

Under a high emissions scenario, the mean annual temperature is projected to rise by about 2.9°C on average by the end-of-century (i.e. 2071–2100 compared with 1981–2010). If emissions decrease rapidly, the temperature rise is limited to about 0.9°C. Total annual precipitation is projected to decrease by about 24% on average under a high emissions scenario, although the uncertainty range is large (-55% to +5%). If emissions decrease rapidly there is little projected change on average: a decrease of 6% with an uncertainty range of -22% to +7%.

FIGURE 2: Total annual precipitation, 1900–2100

Total annual precipitation is projected to decrease by about 22% on average under a high emissions scenario, although the uncertainty range is large (-52% to +3%). If emissions decrease rapidly there is little projected change on average: a decrease of 5% with an uncertainty range of -15% to +5%. Under a high emissions scenario, the proportion of total annual rainfall from very wet dayse (about 30% for 1981–2010) could decrease a little by the end-of-century (to around 25% on average with an uncertainty range of about 5% to 45%), with little change if emissions decrease rapidly. Total annual rainfall is projected to decrease.

FIGURE 3: Percentage of hot days (‘heat stress’), 1900–2100

The percentage of hot days⁴ ⁴A ‘hot day’ (‘hot night’) is a day when maximum (minimum) temperature exceeds the 90th percentile threshold for that time of the year. is projected to increase substantially from about 23% of all observed days on average in 1981–2010 (10% in 1961–1990). Under a high emissions scenario, almost 100% of days on average are defined as ‘hot’ by the end-of-century. If emissions decrease rapidly, almost 90% of days on average are ‘hot’. Note that the models tend to overestimate the observed increase in hot days (about 30% of days on average in 1981–2010 rather than 23%). Similar increases are seen in hot nights (not shown).

FIGURE 4: Contribution of very wet days (‘extreme rainfall’ and ‘flood risk’) to total annual rainfall, 1900–2100

Under a high emissions scenario, the proportion of total annual rainfall from very wet days⁵ ⁵The proportion (%) of annual rainfall totals that falls during very wet days, defined as days that are at least as wet as the historically 5% wettest of all days (about 30% for 1981–2010) could decrease a little by the end-of-century (to around 25% on average with an uncertainty range of about 5% to 45%), with little change if emissions decrease rapidly. Total annual rainfall is projected to decrease (see Figure 2).

FIGURE 5: Standardized Precipitation Index (‘drought’), 1900–2100

The Standardized Precipitation Index (SPI) is a widely used drought index which expresses rainfall deficits/excesses over timescales ranging from 1 to 36 months (here 12 months, i.e. SPI12).

Under a high emissions scenario, SPI12 values are projected to decrease to about -0.8 on average by the end of the century (2071–2100), with a number of models indicating substantially larger decreases and hence more frequent and/or intense drought. Year-to-year variability remains large with wet episodes continuing to occur into the future.⁶ ⁶SPI is unitless but can be used to categorize different severities of drought (wet): above +2.0 extremely wet; +2.0 to +1.5 severely wet; +1.5 to +1.0 moderately wet; +1.0 to +0.5 slightly wet; +0.5 to -0.5 near normal conditions; -0.5 to -1.0 slight drought; -1.0 to -1.5 moderate drought; -1.5 to -2.0 severe drought; below -2.0 extreme drought.

Tropical cyclones

It is anticipated that the total number of tropical cyclones may decrease towards the end of the century. However, it is likely that human-induced warming will make cyclones more intense (an increase in wind speed of 2–11% for a mid-range scenario (i.e. RCP4.5 which lies between RCP2.6 and RCP8.5 – shown on pages 4/5) or about 5% for 2˚C global warming). It is probable that the most intense events (category 4 and 5) will become more frequent (although these projections are particularly sensitive to the spatial resolution of the models). It is also likely that average precipitation rates within 100 km of the storm centre will increase – by a maximum of about 10% per degree of warming. Such increases in rainfall rate would be exacerbated if tropical cyclone translation speeds continue to slow (7–15).⁷ ⁷Information and understanding about tropical cyclones (including hurricane and typhoons) from observations, theory and climate models has improved in the past few years. It is difficult to make robust projections for specific ocean basins or for changes in storm tracks. Presented here is a synthesis of the expected changes at the global scale.

Compared to other Caribbean countries, Grenada was historically at low risk of tropical storms. Since 1955, no major hurricanes affected the island until the passages of hurricanes Ivan and Emily, 10 months apart, in 2004 and 2005, respectively. The total damage from Hurricane Ivan alone was estimated at Eastern Caribbean dollars (XCD) 2.4 billion, twice the value of Grenada’s gross domestic product (16). Grenada’s location within the Atlantic Ocean’s hurricane track could further increase its vulnerability to catastrophic climatic events (16). Hurricane intensity is projected to increase an average 8% for every 1°C rise in the sea surface temperature (17). The official season in Grenada for tropical cyclones is between June and November (2).

Sea level rise

Sea level rise is one of the most significant threats to low-lying areas on small islands and atolls. Research indicates that rates of global mean sea level rise are almost certainly accelerating as a result of climate change. The relatively long response times to global warming mean that sea level will continue to rise for a considerable time after any reduction in emissions (19,20). A 0.5 m rise in sea level could lead to 60% of beaches in some areas of Grenada being lost (21).⁸ ⁸Estimates of mean net regional sea level change were evaluated from 21 CMIP5 models and include regional non-scenario components (adapted from WGI AR5 Figure 13-20). The range given is for RCP4.5 annual projected change for 2081-2100 compared to 1986-2005.

The average change in Caribbean sea level over the period 1993–2010 (19) is projected at 1.7 mm/year (± 1.3), with substantial spatial variability across the region. A further 0.5–0.6m rise is expected in the Caribbean by the end of the century (20) with variation amongst models and emissions scenarios.

Potential impacts of sea level rise include:

Coastal erosion
Ecosystem disruption
Higher storm surges
Population displacement
Water contamination and disruption
Mental health

Health Impacts of Climate Change

Some of the world’s most virulent infections are also highly sensitive to climate: temperature, precipitation and humidity have a strong influence on the life-cycles of the vectors and the infectious agents they carry, and influence the transmission of water- and foodborne diseases (23,24).

Small island developing States (SIDS) are vulnerable to disease outbreaks. Climate change could affect the seasonality of such outbreaks, as well as the transmission of vector-borne diseases. Figure 7 presents modelled estimates for Grenada of the potential risk of dengue fever transmission under high and low emission scenarios.⁹ ⁹A suite of mathematical models was systematically developed, then applied and interpreted by a team of researchers at Umeå University (Sweden)
to assess the potential for mosquito-borne disease outbreaks (e.g. dengue, chikungunya, Zika and malaria) in terms of climate-dependent VC.
The baseline year is 2015, Climatic Research Unit CRU-TSv4.01. Future projections are represented for two emissions futures (Representative
Concentration Pathways: RCP2.6, RCP8.5), five climate change projections (Global Climate Models: gfdlesm2m, hadgem2-es, ipsl-cm5a-lr, miroc-esmchem, noresm1-m). (2018) Umeå University, Sweden. The seasonality and prevalence of dengue transmission may change with future climate change, but Grenada is consistently highly suitable for dengue transmission under all scenarios and thus vulnerable to outbreaks (25–28).¹⁰ ¹⁰Given the climate dependence of transmission cycles of many vector-borne diseases, seasonality of epidemic risk is common; however, many SIDS, due to tropical latitudes, tend to have less seasonality than more temperate areas.¹¹ ¹¹The actual occurrences/severity of epidemics would be quite different for each disease in each setting and could depend greatly on vector- and host-related transmission dynamics, prevention, surveillance and response capacities that are not captured in this model.

FIGURE 7: The mean relative vectorial capacity for dengue fever transmission is projected to increase towards 2070 under both low emissions (RCP2.6) and high emissions (RCP8.5) scenarios.

National Response

Health System Capacity and Adaptation: Monitoring Progress

The following section measures progress in the health sector in responding to climate threats based on country reported data collected in the 2021 WHO Health and Climate Change Country Survey (42).

Governance And Leadership

National Planning for Health and Climate Change

Question	questioncategory	question	Answer
Has a national health and climate change strategy or plan been developed ?			NO
Are the health co-benefits of climate change mitigation action considered in the strategy/plan?			N/A
Level of implementation of the strategy/plan?			N/A
Portion of estimated costs to implement the strategy/plan covered in the health budget			N/A
Are health adaptation priorities identified in the strategy/plan?			N/A

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A).
Definition: In this context, a national strategy or plan is a broad term that includes national health and climate strategies as well as the health component of national adaptation plans (H-NAPs).

Intersectoral Collaboration to Address Climate Change

Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?

Question	questioncategory	Answer
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Transportation	NO
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Electricity generation	NO
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Household energy	NO
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Agriculture	NO
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Social services	NO
Is there an agreement in place between the ministry of health and this sector which defines specific roles and responsibilities in relation to links between health and climate change policy?	Water, Sanitation & Waste-water management	NO

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)
Yes = Specific roles and responsibilities between the national health authority and the sector indicated are defined in the agreement.

Vulnerability and Adaptation Assessments for Health

Question	questioncategory	question	Answer
Has an assessment of health vulnerability and impacts of climate change been conducted at a national level?			YES
→ Level of influence of the assessment findings on policy prioritization to address the health risks of climate change			MINIMAL
→ Level of influence of the assessment findings on human and financial resource allocation to address the health risks of climate change			MINIMAL

Notes
Table Legend:
Question 1: Yes (√) / No (X) / Unknown/Not applicable (N/A)
Questions 2 and 3: None, Minimal, Somewhat, Strong

Climate-sensitive diseases and health outcomes	qid	Health surveillance system is in place (a)	Health surveillance system includes meteorological information (b)
Thermal stress (e.g. heat waves)	22111	NO	NO
Vector-borne diseases	22121	YES	NO
Foodborne diseases	22131	YES	NO
Waterborne diseases	22141	YES	NO
Nutrition (e.g. malnutrition associated with extreme-climatic events)	22151	NO
Injuries (e.g. physical injuries or drowning in extreme weather events)	22161	NO	NO
Mental health and well-being	22171	NO	NO
Airborne and respiratory diseases	22181	YES

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)
(a) A positive response indicates that the health surveillance system is in place, it will identify changing health risks or impacts AND it will trigger early action.
(b) Meteorological information refers to either short-term weather information, seasonal climate information OR long-term climate information

Climate hazard	qid	Health early warning system (HEWS) in place?	Health sector response plan in place?	Health sector response plan includes meteorological information?
Heat waves	23111	NO	NO	NO
Storms (e.g. hurricanes, monsoons, typhoons)	23131	YES	YES	YES
Flooding	23141	YES	YES	NO
Drought	23161	YES	YES	NO
Air quality (e.g. particulate matter, ozone levels)	23171

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Human Resource Capacity

Question	questioncategory	question	Answer
Is there a national curriculum developed to train health personnel on the health impacts of climate change?			NO
Does your human resource capacity as measured through the International Health Regulations Monitoring Framework (IHR) adequately consider the human resource requirements to respond to climate-related events?			NO

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Health Care Facilities, Infrastructure and Technology

Question	questioncategory	question	Answer
Has there been a national assessment of the climate resilience of health infrastructure and technology?
Have measures been taken to increase the climate resilience of health infrastructure and technology?
Is there a national initiative/programme in place to promote the use of low-carbon, energy-efficient, sustainable technologies in the health sector?

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Finance

Question	questioncategory	question	Answer
Is your government currently accessing international funds to support climate change and health work?			YES

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Funding Challenges

Greatest challenges faced in accessing international climate funds

Question	question	Answer
Greatest challenges faced in accessing international climate funds	Lack of information on the opportunities	YES
Greatest challenges faced in accessing international climate funds	Lack of country eligibility	YES
Greatest challenges faced in accessing international climate funds	Lack of connection by health actors to climate change processes	NO
Greatest challenges faced in accessing international climate funds	Lack of capacity to prepare country proposals	YES
Greatest challenges faced in accessing international climate funds	Lack of success in submitted applications
Greatest challenges faced in accessing international climate funds	None (no challenges/challenges were minimal)
Greatest challenges faced in accessing international climate funds	Not applicable
Greatest challenges faced in accessing international climate funds	Other (please specify)	Lack of information sharing between agencies

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Opportunities for Action

Develop the Institutional Structure for Leadership and Governance of Multisectoral Health and Climate Change Actions

Institutional structures for developing and coordinating health co-benefits programmes need to be further developed and formalized between the Ministry of Health and individual ministries of different sectors. Establishing an institutionalized governance mechanism is recommended in the Caribbean Action Plan as essential to ensure integrative, deliberate, and sustainable responses. This should also focus on developing a national health and climate change policy to create a supportive environment for developing and implementing health co-benefit actions.

Develop a National Curriculum to Facilitate Health and Climate Change Education Using an Ecological Approach

Education is essential to understanding climate change impacts and appropriate responses. Educational programmes should be incorporated into schools’ curriculum, targeting young children, alongside public education. A national curriculum will ensure that the population is targeted along important demographic lines and at critical points.

Improve and Expand Risk Surveillance and Early Warning Systems

Creating a knowledge management mechanism for development will contribute to generating and disseminating information on climate-related hazards and risks for the general population. The District Health Information Software (DHIS-2) should be activated as the data collection platform to facilitate health and climate change cross-analysis and dissemination. The system should include the capability to detect multiple hazards, as well as develop an integrated and advanced warning system for vulnerable areas. Training and system tools should be provided to enable continuous data collection from national, regional, and international sources, including meteorological data, analysis and dissemination.

Improve Resilience of Health Sector Infrastructure and Operations

The SMARTing of health care facilities is important to ensure safe and efficient operation. Expansion of the SMART project to include all facilities across the island, including private facilities, will ensure continuity of health services that are responsive to the immediate needs of the population. Health facilities should be upgraded so they can withstand climate-related events. Greening of the facilities should also be targeted to reduce carbon emissions.

Address Barriers to Accessing International Climate Change Finance to Support Health Adaptation

Financial and technical resources will be secured to develop the climate change mitigation–adaptation project portfolio and local human resource capacity to design projects. This includes providing training and coaching to craft projects addressing mitigation–adaptation gaps identified in the Climate Risk and Vulnerability Assessment Report. Alignment of the projects with the National Climate Change Policy (2017) is essential to secure governmental and public support.

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Inter-American Institute (IAI), 2022

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WHO / UNFCCC Climate & Health Profile 2020

National Context

Country Background

Highest Priority Climate Sensitive Health Risks

Climate Hazards Relevant for Health

Climate Hazard Projections for Grenada

Tropical cyclones

Sea level rise

Health Impacts of Climate Change

Heat Stress Climate change is expected to increase the mean annual temperature and the intensity and frequency of heat waves, resulting in a greater number of people at risk of heat-related medical conditions.

Noncommunicable diseases, food and nutrition security Small island developing States (SIDS) face distinct challenges that render them particularly vulnerable to the impacts of climate change on food and nutrition security

National Response

Health System Capacity and Adaptation: Monitoring Progress

Governance And Leadership

National Planning for Health and Climate Change

Notes Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A). Definition: In this context, a national strategy or plan is a broad term that includes national health and climate strategies as well as the health component of national adaptation plans (H-NAPs).

Intersectoral Collaboration to Address Climate Change

Notes Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A) Yes = Specific roles and responsibilities between the national health authority and the sector indicated are defined in the agreement.

Vulnerability and Adaptation Assessments for Health

Notes Table Legend: Question 1: Yes (√) / No (X) / Unknown/Not applicable (N/A) Questions 2 and 3: None, Minimal, Somewhat, Strong

Notes Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Human Resource Capacity

Notes Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Health Care Facilities, Infrastructure and Technology

Notes: Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Finance

Notes: Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Funding Challenges

Notes: Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Opportunities for Action

Develop the Institutional Structure for Leadership and Governance of Multisectoral Health and Climate Change Actions

Develop a National Curriculum to Facilitate Health and Climate Change Education Using an Ecological Approach

Improve and Expand Risk Surveillance and Early Warning Systems

Improve Resilience of Health Sector Infrastructure and Operations

Address Barriers to Accessing International Climate Change Finance to Support Health Adaptation

WHO Resources for Action

References

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The IAI Compendium on Climate Change Impacts in Latin America and the Caribbean

Caribbean Action Plan on Health and Climate Change

Human Climate Horizons (HCH)

SIDS Dynamic Data Dashboard on Health and Climate Change

Pan American Health Organization (PAHO) / WHO Regional Office for the Americas

Caribbean Drought and Precipitation Monitoring Network (CDPMN)

EU/CARIFORUM Caribbean Climate Change and Health Leaders Fellowship Training Program

WHO and WMO Launch Global Knowledge Platform for Climate and Health

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A).
Definition: In this context, a national strategy or plan is a broad term that includes national health and climate strategies as well as the health component of national adaptation plans (H-NAPs).

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)
Yes = Specific roles and responsibilities between the national health authority and the sector indicated are defined in the agreement.

Notes
Table Legend:
Question 1: Yes (√) / No (X) / Unknown/Not applicable (N/A)
Questions 2 and 3: None, Minimal, Somewhat, Strong

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Notes
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)

Notes:
Table Legend: Yes (√) / No (X) / Unknown/Not applicable (N/A)