Pushing Boundaries: Expanding Approaches to Health, Science and Resource Development at Home and Abroad Craig R. Janes September 17, 2015.

Pushing Boundaries: Expanding Approaches to Health, Science and

Resource Development at Home and Abroad

Craig R. Janes

September 17, 2015

Agenda

• Context: health challenges of extractive industry development

• Global strategies for prevention/mitigation• Briefly: Mongolia case• Contested terrain

– What determines health?– Project specific (pvt sector) vs. strategic (gov’t)

approaches– Interdisciplinarity

Context: Extractive Industries in LMICs

• Insatiable global demand for metals and energy

• ICMM: Many of most imp. mining countries are emerging economies; largest mines with largest “footprint” are in “developing countries.”

• Ernst and Young: “Rapid growth” and “Emerging” economies the “future growth engines for the mining industry.”

ICMM (2012). Mining’s contribution to sustainable development. London, UK. Ernst & Young (2015). Mining in rapid growth economies. http://www.ey.com/Publication/vwLUAssets/EY_-_Mining_in_rapid-growth_economies/$FILE/EY-Mining-in-rapid-growth-economies.pdf

Well-Documented Health Effects• Features of extractive industries that

pose risks (and some potential benefits) to community health– Hazardous materials control and

disposal– Population influx– Resettlement and relocation– Water management– Linear features (roads, energy

corridors)– Hazardous materials control and

disposal– Changes in expenditure and

consumption– Infrastructure/facilities (waste

management, sewage treatment, etc.)1IFC (2009) Introduction to Health Impact Assessment. Washington, DC: World Bank. www.ifc.org/sustainability.

Placer gold operation, central Mongolia

WHO: Other Important Considerations

• Social and health footprint of mineral extraction much larger than the deposit

• Not only the result of one project– Cumulative effects of

related activities, often regionally concentrated

Examples• Chad pipeline

– Unanticipated respiratory infections and disorders, mental health impacts, loss of livelihoods, nutrition-related disorders

– Social/political conflict– Facilitated HIV

transmission

• South Africa mining sector– Housing conditions and

TB/HIV– Apartheid, migration,

amplification of HIV

Chad-Cameroon Pipeline

Prevention Strategies

• Lessons:– Wide range of impacts across the determinants of

health that should have been identified and mitigated. Working in weak public governance contexts:

– Aligning multiple institutions to engage in appropriate regulation

• Expose weaknesses in the traditional “Environmental Impact Assessment” process

A few words about EIAs

• Built on the 1969 US-NEPA: 190 of 193 UN now countries legislate EIAs

• Original NEPA language: identify and mitigate impacts on human health

• In practice– Focus on air, water and soil contamination– Reinforce divide between “hard” and “soft”

science, direct and indirect, certainty and uncertainty

Last 15 Years• Strategies to comprehensively incorporate health

in EIAs endorsed by WHO, many European countries, Canada initially… the HIA

• Fused with WHO’s CSDH model: HIA based on the social determinants of health

• Parallel: private sector selective focus on “performance standards” IFC and the Equator Principles

• Both: focus outside narrowly specified risks related to air, water, and soil pollution, but differ in scale – community vs. national, practical vs. “aspirational.”

Struggle for Hearts & Minds

• Chinese direct investment: escape IFC performance standards, placing non-Chinese companies at competitive disadvantage; regulatory approach needed.

• But CSDH/strategic level discourse is “aspirational”, complex, difficult to implement and act on?

• Country level: what is possible/desirable? The aspirational or the practical?

• Effects on training of specialists, practitioners, and policymakers

Case Study: “Minegolia”• Mongolia: “The Asian

Eldorado”– Rapid scale-up of mining

activities– “World class” deposits of

copper, coal, gold, fluorspar, uranium

• Metallic mineral exports 78% of total exports– Ranks 4th in world in

dependence on mineral exports income

– Propelling, “one of the most dramatic transformations in human history” – Susan Wacaster, US Geological Survey

“Ninja” miners, central Mongolia

Mongolia Work• May 2009: International conference in Ulaanbaatar

– Major concerns raised regarding unregulated development, poor community consultation

• 2010-2011: CIHR supports knowledge translation (KT) “catalyst” project to develop HIA knowledge and tools in Mongolian resource sector

• 2010-2011: External assessment of Rio Tinto’s HIA of their Gobi (Oyu Tolgoi) project (IFC PS)

• 2011-2014: CIHR continues KT & dissemination support

• 2015: DFATD/CIHR support of intensive HIA training

Outcomes

• Broad engagement of large and diverse stakeholder groups

• Developed and practiced applying equity-based HIA tools

• *Some* appreciation of the CSDH

• Social and health impacts added to 2012 revisions to the EIA law

• Creation of HIA office in the MOH

Challenges and Debates

• Conflation of industrial hygiene approach with broader public health approach– Hegemony of “Soviet science”

• Also highly gendered

– Little interdisciplinary engagement (little to no social science)

• Research• Policy

– Disciplinary barriers reinforced by major US players

Concluding Questions• Considerable achievements! But

remaining conflicts and debates– Ontological, epistemological,

public/private sector responsibilities,

• Q: Is it possible to endorse IFC/EP approach w/o abandoning strategic-level CSDH perspective?

• Public and private sector conflicts

• Project-specific vs. strategic level focus

• How to push disciplinary boundaries?

Acknowledgments: the “Core” Team

Tsogtbaatar Byambaa: Director, Public Health Institute

Tserendorjiin Sodnompil: Former State Secretary, Mongolia MOH (ret.)Oyun Lkhagvasuren: SFU-FHS PhD candidate & Director, Leading Researchers (health research NGO) MongoliaColleen Davison: Ass’t Professor, Queen’s U.-Public Health & Emergency MedicineMeghan Wagler, SFU-FHS PhD candidate

Michaela Pfeiffer, Technical Officer, Department of Public Health and Environment, WHO Geneva