Climate change, water resource development and malaria in Ethiopia Eline Boelee, Matthew McCartney, Mekonnen Yohannes, Fitsum Hagos, Jonathan Lautze, Solomon Kibret Presented at "Water and Health: Where Science Meets Policy" The University of North Carolina at Chapel Hill, USA October 25-26 2010

1. Climate change, water resource development and malaria in Ethiopia Eline Boelee, Matthew McCartney, Mekonnen Yohannes, Fitsum Hagos, Jonathan Lautze, Solomon Kibret Presented at “Water and Health: Where Science Meets Policy,” The University of North Carolina at Chapel Hill, USA October 25-26 2010

2. Key message Climate change necessitates water storage, which may increase health risks that can be mitigated.

3. Malaria in Ethiopia as an example Koka reservoir (Source: MoH & WHO 2007)

4. Impacts of climate change Increased variability of rain Reduced availability of water Reduced water & food security Need for water resources development Water storage has a role to play in adaptation to climate change Impacts on mosquitoes, parasites, transmission cycle

5. Water resources development in Ethiopia Per capita water availability declining Water Sector Development Program 2002-2016 River diversion / irrigation systems Rainwater harvesting ponds Large multipurpose dams Small reservoirs DWSS* Photo Credit: Eline Boelee (Source: Awulachew et al. 2005) *DWSS: Drinking Water Supply and Sanitation

6. Water storage Focus on water for agriculture, incl. livestock Integrated into most water systems Save water over time for access at critical periods Diverted from rivers, rainwater harvesting, aquifers High variety Tanks, reservoirs Groundwater Large / small Open / closed Man-made / natural Photo Credit: Eline Boelee

7. Water storage continuum (Source: McCartney & Smakhtin 2010)

8. Reduced climate vulnerability Increased adaptive capacity Water storage Increased availability and access to water Increased agricultural productivity Present climate vulnerability Future climate vulnerability post-adaptation adaptation strategy Increased water security pre-adaptation Future climate vulnerability < present climate vulnerability (Source: Adapted from McCartney & Smakhtin 2010)

9. Health risks of open water Expanded water surface for longer periods Drowning, water quality, vector-borne diseases Increased malaria transmission associated with Small reservoirs < 100 Surface irrigation (estates & small-scale) Rainwater harvesting ponds > 100,000 Increasingly higher altitudes Current control strategies insufficient Bednets, house spraying Shift in biting rhythm Foreign currency, resistance

10. Malaria at Koka Lake, Rift Valley Increased transmission near lake Decision support for dam operation Potential for larval control by dam operation (water level fluctuation) Photo Credit: Solomon Kibret

12. Distance from reservoirs

13. Water level fluctuations(Source: Kibret et al. 2009) (Source: Lautze 2008)

15. More breeding sites near shore line, mainly in hoof prints(Source: Lautze 2008)

18. Can malaria control be incorporated into dam management?(Source: Kibret et al. 2009)

19. Small reservoirs, Tigray Mosquito breeding in seepage areas Increased transmission, year round, near micro-dams Limited impact on agricultural productivity Photo Credit: Eline Boelee Photo Credit: Eline Boelee

20. Water harvesting ponds Photo Credit: Eline Boelee Even tiny plots require labor at critical times

21. Water harvesting ponds Significantly more malaria near ponds Determinants of malaria House type Distance to wells Toilets Bed net Season Photo Credit: Photo Credit: Martine Jeths Source: graph created by E.Boelee for this presentation based on Hagos et al. 2006 Photo Credit: Eline Boelee

23. Peak in biting activity after midnight

24. Change to early evening(Source: Kibret et al. 2010) Rift Valley

25. Reduced climate vulnerability Increased adaptive capacity Water storage Increased availability and access to water Increased agricultural productivity Present climate vulnerability Future climate vulnerability post-adaptation pre-adaptation adaptation strategy Increased water security Increased malaria Future climate vulnerability > present climate vulnerability (Source: Adapted from McCartney & Smakhtin 2010)

26. Way forward Photo Credit: Eline Boelee In Ethiopia No additional small dams Large hydropower dams <10 Upgrading and expansion of irrigation Water harvesting: ponds and in situ No capacity for mitigating measures Try to influence policy, planning and design

27. Intervention options Complementary to early diagnosis and treatment Transmission reduction Zooprohylaxis? Source reduction Participatory approaches Engineering / agricultural measures Alternative water storage options Aquifers Soil moisture Wetlands Photo Credit: Michiko Ebato

28. safe Water storage Reduced climate vulnerability Increased adaptive capacity Increased availability and access to water Increased agricultural productivity Present climate vulnerability Future climate vulnerability post-adaptation pre-adaptation Increased water security adaptation strategy Increased malaria Future climate vulnerability < present climate vulnerability (Source: Adapted from McCartney & Smakhtin 2010)

29. Key message Climate change necessitates water storage, which may increase health risks that can be mitigated Thank you!

30. Related Publications Kibret, S.; Alemu, Y.; Boelee, Eline; Tekie, H.; Alemu, D.; Petros, B. 2010. The impact of a small-scale irrigation scheme on malaria transmission in Ziway area, central Ethiopia. Tropical Medicine and International Health, 15(1):41-50 McCartney, Matthew; Smakhtin, Vladimir. 2010. Water storage in an era of climate change: addressing the challenge of increasing rainfall variability. Blue paper. Colombo, Sri Lanka: International Water Management Institute (IWMI). 14p. Kibret, S.; McCartney, Matthew; Lautze, Jonathan; Jayasinghe, G. 2009. Malaria transmission in the vicinity of impounded water: evidence from the Koka Reservoir, Ethiopia. Colombo, Sri Lanka: International Water Management Institute (IWMI). 39p. (IWMI Research Report 132) Kibret, Solomon; McCartney, Matthew; Lautze, J. 2008. Mosquitoes and malaria in the vicinity of the Koka Reservoir, Ethiopia. In Humphreys, E.; Bayot, R. S.; van Brakel, M.; Gichuki, F.; Svendsen, M.; Wester, P.; Huber-Lee, A.; Cook, S. Douthwaite, B.; Hoanh, Chu Thai; Johnson, N.; Nguyen-Khoa, Sophie; Vidal, A.; MacIntyre, I.; MacIntyre, R. (Eds.). Fighting poverty through sustainable water use: proceedings of the CGIAR Challenge Program on Water and Food, 2nd International Forum on Water and Food, Addis Ababa, Ethiopia, 10-14 November 2008. Vol.1. Keynotes; Cross-cutting topics. Colombo, Sri Lanka: CGIAR Challenge Program on Water and Food. pp.34-37. More related publications continued on next slide…..

31. Related Publications Lautze, J. 2008. Incorporating malaria control into reservoir management: a case study from Ethiopia. PhD thesis, Tufts University, Boston, USA. Hagos F, Yohannes M, Linderhof V, Krusemand G, Mulugeta A, G/Samuel G, Abreha Z (2006) Micro water harvesting for climate change mitigation: Trade-offs between health and poverty reduction in Northern Ethiopia. PREM Working Paper 06/05. Poverty Reduction and Environmental Management (PREM), Institute for Environmental Studies. Amsterdam: VrijeUniversiteit. http://www.prem-online.org/archive/12/doc/PREM06-05.pdf Awulachew, S. B.; Merrey, D. J.; Kamara, A. B.; Van Koppen, B.; Penning de Vries, F.; Boelee,E.; Makombe, G. 2005. Experiences and opportunities for promoting small–scale/micro irrigation and rainwater harvesting for food security in Ethiopia. Colombo, Sri Lanka: IWMI. v. 86p. (Working paper 98) For further information, please visit: www.iwmi.org