Health impact of climat change in France – What are the challenges for the French Institute for Public Health Surveillance (InVS)?

Recognizing that climate change will impact human health, an interdisciplinary climate change working group has identified the main needs for adaptation of the Public Health sector, focusing on surveillance and alert. Risks considered included extreme weather events, infectious diseases, and long-term environmental changes. The flexibility and adaptability of existing surveillance and alert programmes covering these risks were assessed by the working group based on a literature review, expert consultations and analysis of past events in France. Both environmental monitoring systems and health end points surveillance systems were included in the review. For most risks, surveillance of the environment and of the health effects is already available. Strengthening these systems is essential, and data quality, data availability and linkage of environmental and health databases are key steps in this process. A better understanding of the determinants of exposure would improve the understanding of climate risks. Syndromic surveillance could be fruitfully used to complement classical systems. A strong interaction with research is also required through the development of interdisciplinary partnerships relying on existing networks. Finally, mitigation strategies have the potential to generate major health co-benefits. Decision-makers should have access to health impact assessments of the different available options. Surveillance should be used to monitor and evaluate the efficiency of these strategies.