Introduction

Climate change presents Benin with formidable challenges. A rising sea level and increases in extreme weather events will affect large and vulnerable communities on the coast, around and on Lake Nokoué, and in Cotonou where a local market lies along the canal that separates the lake from the Atlantic Ocean. Increased flooding, rainwater runoff, lake salination and other changes to the water system will exacerbate existing risk factors for outbreaks of waterborne communicable diseases such as diarrhea and cholera. Risk factors include water pollution and deficiencies in sanitation, drinking water and waste collection. Benin’s Climate Action Plan classifies the densely populated region around Cotonou, Abomey-Calavi, and Sô-Ava as the most vulnerable to climate-related health and social risks. However, not all communities and groups are equally affected. This project aims to quantify climate-sensitive waterborne-disease risks more precisely and distinguish groups that are most affected by them. The research team and local stakeholders will work together to develop a targeted early warning and response system that can mitigate the risks in coastal settlements, the open-air market in Cotonou, and communities living around Lake Nokoué. When successful, the application of the system can be expanded to include other climate-sensitive diseases and geographical regions.

Context

Under the IPCC ‘mid-emission’ projection scenario (SSP2-4.5), the mean sea level in West Africa’s Gulf of Guinea is expected to rise between 0.15m and 0.31m by 2050. Sea level rise is projected to trigger changes in wave conditions, coastal erosion, flooding, and salt-water intrusion into freshwater lakes. The Benin government has recognized that, without adaptive measures, rising sea levels would destroy about one-third of current coastline settlements over the coming decades. In response to both projected scenarios and the frequent climate change related events experienced over the last decades, in 2018, the Benin Parliament passed legislation for the prevention and control of climate consequences (Law No. 2018-18, ‘Climate Change Act’). In addition, in 2022, Benin adopted a “National Action Plan (NAP) for climate change adaptation”, with the objective of increasing the resilience and adaptative capacity of local communities impacted by climate change by 2030. The proposed study is aligned with these national priorities by aiming to improve the country’s understanding of the interrelated climate and health risks present in coastal regions and to co-design early detection and response mechanisms with impacted populations. 

Approach and Methods

The project will conduct research with representatives of three study sites, i.e., Cotonou coastal residents (approx. 100,000 people), Dantokpa market (approx. 35,000 merchants and workers) and around Lake Nokoué (at least 100,000 people). The transdisciplinary project is organized into work packages: 

• Inclusive stakeholder mapping and analysis of climate change adaptation needs of different social Groups – use descriptive surveys, in-depth interviews, focus group discussions, photo-voice data collection, and extended case study methods to generate new knowledge and understanding of how climate change impacts people’s health and livelihood, how residents currently engage in adaptation activities and describe needs and opportunities for an improved early warning system.  
• Characterization of climate-sensitive waterborne pathogens and disease incidence in different social groups –  advanced genome sequencing enables rapid identification of complete pathogen genomic information. Clinical samples will be obtained by setting up active surveillance including a partnership with health centers in the study area through which swabs obtained from diarrhea cases. Levels of fecal pollution in food, water, and other environmental samples will be quantified by enumeration of E. coli. 
• Risk assessment and predictive modeling of exposure risk dynamics based on climate-induced variations in environmental conditions – Pathogen transmission routes will be mapped in coastal residents, traders, and workers at the Dantokpa market and Lake communities. A comparative exposure assessment of the identified transmission routes will allow a ranking of gender- and age-specific exposure estimates and characterization of major transmission pathways and subpopulations with the highest exposure.  
• Participatory development of a bottom-up early warning system and co-development of context specific preparedness and response plans – exploratory surveys (document review, site visit), in-depth individual qualitative interviews, group discussions, and field diaries. Existing information and climate change warning measures will be assessed for their applicability and effectiveness. Discussions with subpopulations and municipal authorities will be conducted to identify the best ways for them to receive and act on information from the predictive models. 

Data access will be secured by co-designing a sound data collection plan with participating groups and working collaboratively with the Directorate of Public Health and the Institute of Oceanographic Research, which will enable the use of retrospective national data from various sources.  

Expected Results

Expected results aim to benefit the groups most affected by increased disease incidence due to climate change, through a response system that is to be developed with and for these groups. The project will contribute precise knowledge about the relationships between climate change and health risks and ways to mitigate these in gender-sensitive and inclusive ways. Project activities are also expected to lead to greater visibility and strengthened roles for local women cooperatives and reduced gender and social inequalities in terms of health and livelihoods.  

Capacity strengthening includes data management and transdisciplinary research, in bioinformatic and sequencing analyses to rapidly collect and share information on epidemic-prone pathogens, in establishing effective collaboration between community stakeholders, innovation working groups, government officials, and researchers, among others. The team estimates to train at least: 1,200 people through working groups; 9 MSc students, 3 PhD students, 2 postdocs; and strengthen technical and management capacities at each partner institutions.  

In addition to traditional scientific output production and presentation, the plan includes a continuous engagement of communities, local authorities, and government agencies in project development and results dissemination, using culturally relevant modalities, such as through radio, talk shows, round table discussions, interviews, and meetings with authority representatives and opinion leaders. The team also plans to collaborate closely with policymakers to ensure the sustainability of IWGs and of implementation capacity for the early warning and response system.  

Photo Credit: IDRC/Bright Drah