APPENDIX ■ 283longer-term actions that require more complex coordination with citizens and
the private sector. Th e goal of the paper is to highlight how and why cities in a
country with limited national leadership have chosen to act. Th is provides an
opportunity for cities starting to initiate action, both in states that are actively
engaged in national GHG emission reduction eff orts and in those that are not,
to understand how cities in Canada have independently taken action and how
future collaborations with other cities and levels of government might evolve to
better mitigate and adapt to climate change.
Understanding and Improving Urban Responses to Climate Change.
Refl ections for an Operational Approach to Adaptation in Low- and
Middle-Income Countries
Roberto Sanchez Rodriguez
Th is article refl ects on the construction of an operational approach for adapta-
tion to climate change in low- and middle-income countries. I depart from
the assumption that climate change is a development challenge for urban areas
and that adaptation to its impacts needs to be considered a learning process
rather than a single product. I argue that an operational approach to climate
change needs to address the formal and the informal process of urban growth
in order to be effi cient. Th is requires attention to the balance between struc-
ture and agency in the construction of the urban space and the combination
of top-down and bottom-up actions. Th e article considers the role of urban
institutions and the collaboration among scholars and local governments and
stakeholders as part of an operational approach for adaptation.
City Health System Preparedness to Changes in Dengue Fever
Attributable to Climate Change: An Exploratory Case Study
Jostacio M. Lapitan, Pauline Brocard, Rifat Atun, and
Chawalit Tantinimitkul
City health system preparedness to changes in dengue fever attributable to
climate change was explored in this collaborative study by Imperial College
London and World Health Organization Kobe Centre. A new toolkit was devel-
oped, and an exploratory case study in Bangkok, Th ailand, was undertaken in
- Th is study found that there is a clear lack of research in this area, as most
research looked at impacts and not at responses and preparedness for eff ective
response. Th ere is also a clear need to develop and scale up national capital
city eff orts to assess and address the implications of climate change for health
systems. It recommends further case studies to validate the toolkit and generate
guidelines on how to develop eff ective response plans.