Interview MEDICC Review: You both have worked for over a decade on climate change and health-conducting research, designing national programs and implementing policies. Can you give us an overview of the work done in Cuba to date on the issue?Paulo Ortiz: First, let me say that Cuba has taken a different approach from many others around the world. Elsewhere, climate change is the subject of intense scientifi c study, but often little research is dedicated to the intersection of climate change and health. From the start, Cuba has studied the link between climate variability and its potential adverse effects on population health-specifi cally health problems particular to our context. The fi rst study we undertook in the 1990s examined climate change projections and the impact on infectious diseases: chicken pox, hepatitis and meningococcal disease, primarily. At that time, we consulted with a group of experts from the USA; we discussed methodology, diseases specifi c to the Caribbean region, and we debated Cuba's priorities, which at the time did not include vector-borne diseases as a serious health problem. Our second study, later in the nineties, focused on climate change and diseases transmitted by vectors.Since then, the Ministry of Public Health (MINSAP) has prioritized research into climate change and health and provided the political will and guidance to take an intersectoral, interministerial approach to the problem. Centers collaborating on current studies include the Pedro Kourí Tropical Medicine Institute, CLAMED (its work now merged into the National School of Public Health), the Cuban Red Cross, MINSAP itself, and the Ministry of Science, Technology and the Environment (CITMA), through CENCLIM. Organizing our work through this consortium of interdisciplinary research centers gives us new tools and approaches for how to mitigate and adapt to climate change. For instance, CITMA is responsible for setting priorities and designing policies for environmental protection. Concurrently, MINSAP sets priorities and designs policies for protecting and improving health-the intersection of climate change and health means these ministries must work together.
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