A/HRC/32/23 people living in extreme poverty by 2030.38 Climate change increases the incidence and range of diseases like malaria and diarrhoea that disproportionately affect the poor. The Intergovernmental Panel on Climate Change has also highlighted the fact that health losses due to climate change-induced undernutrition occur mainly in areas that are already food insecure.39 These types of impact increase health expenditures and ill-health among those who can least afford it, contributing further to the vicious cycle of poverty. 1. Health impacts and gender 25. Gender differences in health risks are likely to be exacerbated by climate change. 40 At the global level, natural disasters kill more women than men, with younger women being more vulnerable. Evidence suggests that differences are also present in vulnerability to indirect and long-term effects of climate change. For example, during droughts, the health of women and girls suffers disproportionately due to reduced water availability for drinking, cooking and hygiene, and food insecurity. The poorest households in the world typically rely on the most polluting energy sources for household activities such as cooking, which are often performed by women and girls. Use of such energy sources is associated with more than 4.3 million deaths each year. 41 2. Health impacts on children 26. Many of the countries that are highly vulnerable to climate change also have higher proportions of children in their overall population. According to the United Nations Children Fund (UNICEF), the right to health of children is particularly affected by climate change. Children are especially vulnerable to changes in air and water quality, temperature, humidity, and vector-, water-, and food-borne infections due to their less developed physiology and immune systems. The majority of the existing global disease burden resulting from climate change occurs in children, and their main causes of death (diarrhoea, malaria, malnutrition) are likely to increase owing to the impact of climate change. Children are also more likely than adults to die because of natural hazards or succumb to malnutrition, injuries or disease in their aftermath.42 The risk of extreme weather events and other climatic impacts can affect children’s futures in a number of other significant ways. There has, for example, been a link to an increase in child marriage as a component of family survival strategies.43 27. Climate change has a disproportionate effect on marginalized and excluded individuals and groups, including those whose ways of life are inextricably linked to the environment, such as indigenous children. It exacerbates existing health inequities and threatens the very notion of intergenerational equity because its impacts will be felt most severely by children and future generations who have contributed little or nothing to its making. 38 39 40 41 42 43 See S. Hallegatte and others, Shock Waves: Managing the Impacts of Climate Change on Poverty, Climate Change and Development Series (Washington, D.C., World Bank, 2016). Smith and others, “Human health”. See WHO, Gender, Climate Change and Health (2014); and Mainstreaming Gender in Health Adaptation to Climate Change Programmes: User’s Guide (2012). See WHO, ”Climate change and health”. UNICEF input. Human Rights Watch input. 9