2011 Articles

Final Report on Activities of the Integrated National Adaptation Pilot Project (INAP)

Connor, S. J.

Climate change is considered to be a major global environmental problem that could
have significant effects on human health. One of its potential ecologically‐mediated
impacts is the change in the incidence and the spatial distribution of climate‐
sensitive vector‐borne diseases, including malaria. Changes in climatic conditions
associated with long‐term climate change, as well as those associated with more
short‐term fluctuations such as the El Niño‐Southern Oscillation, could influence the
behavior of vectors, their geographical distribution, and the development rate at
which pathogens mature.
This is particularly true in Colombia, where malaria has already reemerged as a
significant public health burden. Malaria incidence during epidemic years has
increased from less than 15 positive cases per 10,000 inhabitants in 1964, to 58 per
10,000 in 1983, to almost 165 per 10,000 in 1998. More recently, Colombia’s
Ministry of Social Protection calculated that 85 percent of Colombia’s rural territory
has adequate climatic, geographic, and epidemiologic characteristics for malaria
transmission; it also reported that more than 25 million Colombians were at risk of
contracting the disease (Ministry of Social Protection 2003).
The incidence of malaria in Colombia has continued to rise despite a wide range of
interventions in both vector control and treatment. To curb this, Colombia has
proposed a very ambitious adaptation strategy to mitigate the possible adverse
effects of climate change on human health: the National Integrated Surveillance and
Control System (ISCS), which is part of the Integrated National Adaptation Pilot
Project, first initiated by the country in 2006.
The National Integrated Surveillance and Control System is based on five linked
components: (i) an early warning system (EWS) framework; (ii) a platform of
climate forecasts, monitoring and analysis of scenarios; (iii) epidemiological
surveillance and control activities; (iv) entomological surveillance and control
activities; and (v) improvement of the activities for early diagnosis and treatment of primary cases. The major phases of the implementation of this adaptation strategy
include: the design of the early warning system, the strengthening of institutional
capacity, and the implementation of the knowledge management, monitoring, and
evaluation systems.