Better Health. Better Environment. Sustainable Choices. Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017 Are we at a turning point for Global Health and the Environment? Dr Maria Neira Director, Department of Public Health, Environmental and Social Determinants of Health
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Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Are we at a turning point for Global Health and the Environment?
Dr Maria Neira Director, Department of Public Health, Environmental and Social Determinants of Health
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Outdoor air pollution World population living in areas with WHO air quality guidelines levels not met in 2014: 92% Data: WHO, Global Health Observatory
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Mexico City, Mexico
Lima, Peru Lagos, Nigeria Beijing, China
Air pollution: urban crises
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Image 1: CC BY-SA 3.0 File:AerialViewPhotochemicalSmogMexicoCity 2.jpg Created: 22 December 2010 www.wikipedia.org Image 2: Worldbank Blogs, http://blogs.worldbank.org/voices/access-quality-information-crucial-tackle-peru-s-environmental-problems Image 3: Joshua Okunfolami - Own work CC BY-SA 4.0 File:Waste incineration and air pollution in Lagos Island 01.jpg Created: 8 January 2017 Image 4: CC BY 2.5 File:Smog pekin.JPG Created: 10 August 2006 www.wikipedia.org
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Indoor air pollution
Proportion of population relying on solid fuel worldwide: 41% Data: WHO, Global Health Observatory
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Who Photo library
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
The burden of household air pollution
Deaths due to ambient air pollution: 4.3 million/year
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Women using electric cookstove in Northern India Trend = the population relying on polluting fuels has not changed in number over the past 3 decades ---
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Population growth
World population by 2050: 9.7 billion
Data: United Nations Department of Economic and Social Affairs, Population Division
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Image 1: Oshodi market in Lagos http://www.nature.com/news/development-slow-down-population-growth-1.19415 doi:10.1038/530409a
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Urban development
60 million additional urban residents per year worldwide
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Climate change: emerging health crisis Climate change might jeopardize all efforts and progress made in the field of health and development in the last decades.
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Image 2: Serguei S. Dukachev - Own work CC BY-SA 3.0 File:North Sahara. Anti-sand shields.jpg Created: 12 August 200
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Desertification and food security • Higher threats of
malnutrition from reduced food and water supplies
• More water- and foodborne diseases from lack of clean water
• Respiratory diseases caused by atmospheric dust
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Image 1: Johntarantino1 - Own work A scene in the high desert right outside of Marrakech, Morocco. A shepherd is guiding his sheep through the landscape in search of vegetation. CC BY-SA 3.0 File:Morroco-arid-climate.jpg Created: 17 January 2010 Image 2: Serguei S. Dukachev - Own work CC BY-SA 3.0 File:North Sahara. Anti-sand shields.jpg Created: 12 August 200 Map: �Date: 1998 �Source: http://www.nrcs.usda.gov/wps/portal/nrcs/detail/national/nedc/training/soil/?cid=nrcs142p2_054003�Author: USDA employee
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Water, sanitation, hygiene 842 000 Diarrhoeal diseases deaths per year resulting from lack of safe drinking-water and inadequate sanitation and hygiene 58% Proportion of the total diarrhoeal deaths that could be averted through safe drinking-water, sanitation and hygiene Open defecation perpetuates a vicious cycle of disease and poverty.
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Image 1: WHO Image 2: SuSanA Secretariat - https://www.flickr.com/photos/gtzecosan/3683494818/ Photo by: Ashley Wheaton April 2009 Children stand beside the main drain of Malgudam community. Each morning, many children from the community come to the drain together to defecate and urinate. Permission details The Sustainable Sanitation Alliance (SuSanA) is a network formed by organisations active in the field of sustainable sanitation. The secretariat is currently located at Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ, German Agency for International Cooperation) in Eschborn, Germany.View more CC BY 2.0view terms File:Drain? Or Toilet? (3683494818).jpg Created: 12 April 2009 Access to piped water on the premises declined from 43% to 33% in African cities from 1990-2015
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Increasing exposure to chemicals
3m deaths and 43m DALYs attributed to selected chemicals
Source: OECD Environmental Outlook to 2050: The Consequences of Inaction, (Chapter 6: Health and
Environment)
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Obesity and lifestyles
39% of adults worldwide were overweight in 2014 – that is more than 1.9 billion
Data: WHO, Global Health Observatory
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WHO Photo Library
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Global and environmental health
Many of the global health challenges we face today are linked to the decline of biodiversity and ecosystems.
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Environmental health risks and burden of disease
12.6 million deaths/year attributable to the environment 596 million DALYs/year attributable to the environment
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Credits: NASA Goddard Space Flight Center Image by Reto Stöckli (land surface, shallow water, clouds). Enhancements by Robert Simmon (ocean color, compositing, 3D globes, animation). Data and technical support: MODIS Land Group; MODIS Science Data Support Team; MODIS Atmosphere Group; MODIS Ocean Group Additional data: USGS EROS Data Center (topography); USGS Terrestrial Remote Sensing Flagstaff Field Center (Antarctica); Defense Meteorological Satellite Program (city lights). - http://earthobservatory.nasa.gov/Newsroom/BlueMarble/Images/globe_west_2048.jpg Public Domain File:1024px-Antichthon.jpg Created: 1 January 2001 - Dietary risks: low in fruits, low in vegetables, low in whole grains, low in nuts and seeds, low in milk, high in red meat, high in SSB, low in fiber, suboptimal in calcium, low in seafood, low in polyunsaturated fatty acids, high in sodium
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
We need to move on from inconvenient truths to convenient actions!
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Mention court cases and government responsibility
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
What and where are the opportunities?
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
1) The SDGs: intersectoral action for health
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
WHO - custodian for the SDGs WHO is the custodian agency for SDG indicators (number of targets): SDG 2 malnutrition (1)
SDG 3 health (8), health services (4), and health impacts from determinants (3)
SDG 6 access to water and sanitation (6)
SDG 7 access to modern energy (1)
SDG 11 air pollution in cities (1)
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Intersectoral action: air pollution
Disease burden
attributable to air pollution
Limited capacity and
resources
Additional capacity
and resources
Only 3% for prevention
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Game changer for health: energy
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Image 4: Partners in Health/Haiti
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
2) The health sector: leading by example
• A healthy and “green” health sector
• Health based targets and monitoring for other sectors policies (water, etc.)
• Guidance on health implication of other sectors’ policies
• Assessment of costs of other sectors policies and decisions
• Health sectors community engagement and advocacy
• Capacity building
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Image 1: WHO Photo library Image 2: WHO Photo library
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
3) Are we using international treaties and conventions sufficiently?
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
From convention to action!
• Convention on long-range transboundary air pollution, 1979
• Aarhus convention, 1998
• Rio political declaration on social determinants of health, 2011
• Minamata convention on Mercury, 2013
• Paris agreement, 2015
• A new urban agenda, 2016
• …
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
4) Are we doing enough on urban environments?
HOUSING
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017 Healthy Urban Planning
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Make it easier for people to walk and bicycle. You can reallocate street space to pedestrians and cyclists. WHO EURO has developed an economic model to help cities to estimate the health benefits of increasing the mileage allocated to pedestrians and cyclists. Measured as health costs averted to help cities to justify making the right choice for people and not cars. Reducing road traffic fatalities is a function of reducing the number of cars on the road, the distances they travel, and their speed. It should come as no surprise that lower income neighborhoods tend to have fewer traffic calming devices than wealthier neighborhoods and higher road traffic fatality rates.
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
Game changer for health: housing
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
5) Global Coalition: Health, Environment,Climate Change WHO-UNEP-WMO Member States Launched at COP November 2016
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017
6) The underexploited potential of primary prevention
Expenditure on Prevention and Public Health
Services accounted for an
estimated 3.6% of total health
expenditures worldwide in 2013
Source: WHO GHO, OECD , UK NHS, EIU, PHE Estimates
Sixth Ministerial Conference on Environment and Health, Ostrava, Czech Republic, 13-15 June 2017