Thank you for having us speak.
My name is Dr. Courtney Howard. I am the climate-health board lead for the Canadian Association of Physicians for the Environment, otherwise know as CAPE. CAPE is Canada's only physicians' education and advocacy organization that is committed to protecting the health of people by protecting the planet. I'm also an emergency physician here in Yellowknife.
I received the invitation to speak only about three days ago, so this analysis does not represent my having read 6,000 pages of text. It represents a literature review of what the public health community has written about this issue in the peer-reviewed literature and some discussions with some of the lead authors, as well as looking at that information through the lens of environmental health.
The first thing to understand—this wasn't clear to me when I was going through medical school—is that the social and ecological determinants of health actually have a much greater impact on people's overall health status than does the health care system. I can assure you that when I figured that out, after having spent 12 years becoming a doctor, I was a little bit frustrated, which is why I now do this work. What it means is that anything that impacts determinants of health—such as water, food, the ability to have housing, and income—have a much bigger proportion of impact on overall health status than anything I do, unfortunately, in the hospital.
For CAPE and for myself and for the international medical community now, of all the things that could impact health, the main focus has become climate change and health. The World Health Organization now calls climate change the biggest health threat of the 21st century. In 2015 the Lancet second commission on climate change and health said that tackling climate change was the biggest public health opportunity of the 21st century. The Canadian Medical Association recently recognized this by making climate change a focus of its recent CMA general council in Vancouver. The keynote speaker, Dr. James Orbinski, who accepted the Nobel Peace Prize on behalf of Doctors Without Borders, said that without an intact ecosystem, there's no chance that humans can thrive. In fact, Dr. Orbinski now does research on climate change up here with us in Yellowknife, on wildfires.
This is now CAPE's main focus, and we have concerns about the impact of TPP. Here in Yellowknife, we're already 2°C over our temperatures in the 1950s, and in Inuvik they're already over 3°C. This is a fact of life. There are workmen at my house right now, unfortunately, working on my foundation; I sit on permafrost, and it's all going like....
This has major consequences for respiratory health from wildfires. There have been evacuations, as you know. Lyme disease is spreading across Canada. Our population is experiencing unstable ice conditions. We're already having trouble dealing with what we have going on, including malnutrition across the world. I spent six months working on a pediatric malnutrition project in the Horn of Africa. I can tell you, unfortunately, that the deaths are real. The WHO anticipates having an additional 250,000 deaths per year from climate change between 2030 and 2050. That's actually considered by most in the public health world to be a vast underestimate.
In terms of the TPP, we know that we need to leave at least 80% of fossil fuel reserves in the ground to have a hope of staying below 2°C. NAFTA contains, as does the TPP, investor-state dispute settlement provisions that allow corporations to sue governments for a change in regulation. Under NAFTA, we've already seen TransCanada Corporation seeking US$50 billion in damages after the U.S. rejected Keystone XL. We've seen Lone Pine Resources suing the Government of Canada subsequent to the decision in Quebec to stop fracking in the St. Lawrence area. We can anticipate similar things here.
We require, to give Canadians a soft landing on climate change, a full-scale low-carbon transition and a laser-like focus on things like clean water, food security, and pharmaceutical security. Public health needs to be our main focus, and if trade provisions get in the way, it's a problem.
It must be recognized that all mitigation and adaptation manoeuvres are public health measures, but the TPP chapter that potentially says that if trade isn't a priority means we can be open to the investor state legislation. Unfortunately, the public health exceptions under the WTO dispute system have only been successful one out of every 43 times. If the public health exceptions were effective, why is there a particular exception for tobacco?
Clearly, people other than us are worried that the public health exceptions, as written into the agreement, are not adequate.
Additionally, the increased patent expiration and the—