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She added that a “shift in our thinking is needed, away from the management of individual cases and towards the longer term building of capacities in countries to cope with these added burdens. Fetal malformations place a heartbreaking strain on families and communities, as well as systems for healthcare and social support.”WHO said that Zika virus transmission has been reported in 33 countries and territories of the Americas and that Cuba and Dominica were the latest to report local transmission. An increase in the number of cases of microcephaly has been reported in Brazil and French Polynesia, and an increased incidence of Guillain-Barré syndrome has been reported in 12 countries.

News reports have stated that Panama reported its first case of microcephaly linked to the Zika virus on 19 March, although this has not yet been confirmed by WHO.Christopher Dye, director of strategy, policy, and information at WHO, told the press conference that studies currently suggest that about 1% of cases of the infection will lead to severe neurological disorders.

She said a lot of work is already being done by Canadian physicians but the CMA "is committed to finding the best way to support efforts that are taking place from coast-to-coastto-coast." Dr. Orbinski presented delegates with a grim catalogue of the health impacts of climate change, including a rise in infectious disease, drought and rising water levels that cause mass displacement, and even violent conflict. But, worst of all, he said, "climate change is a threat that magnifies other threats." Dr. Orbinski cited the example of the Darfur region of Sudan, where tensions between farmers and herders over disappearing pasture and evaporating water holes have degenerated into violent clashes and civil war.

"You will do anything to feed your children, even if it means going to war," he said. Darfur is often described as the world's first climate-change war, but there could be many more to come, Dr. Orbinski warned. He noted that the world is in the midst of an unprecedented refugee crisis - with 60 million people worldwide displaced - and increasingly those mass movements are driven by drought and climate change. For example, 29 million people are now on food assistance in southern Africa. "The No. 1 health issue there is no longer AIDS; it's drought." Dr. Orbinski, who currently holds the research chair in global health at the Balsillie School of International Affairs in Waterloo, Ont., said that while climate change disproportionally affects developing countries, especially the poor and marginalized, even wealthy countries such as Canada are not immune from the devastation wrought by climate change.

The rate of increase in temperature in Canada is two times higher than the global average," he said, and that will have dramatic impacts, especially in the Far North and the country's coastal regions. "There are real questions about the viability of Vancouver as a city due to rising sea levels in the coming decades," Dr. Orbinski said. A study published in 2008 by the Canadian Medical Association estimated that 21,000 Canadians die prematurely each year due to air pollution. (Worldwide, there are eight million preventable deaths attributed to bad air.)

The rise of carbon dioxide emissions, caused largely by the burning of fossil fuels, is one of the principal drivers of climate change. With the global population increasing by one billion people every 13 years, "we're going to see massive increases in CO2 emissions unless we take radical action," Dr. Orbinski said. The Canadian Medical Association, which represents the country's 83,000 physicians, is holding its 149th annual general council meeting in Vancouver this week.