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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


Outdoor air pollution World population living in areas with WHO air quality guidelines levels not met in 2014: 92% Data: WHO, Global Health Observatory


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

https://upload.wikimedia.org/wikipedia/commons/4/4a/Waste_incineration_and_air_pollution_in_Lagos_Island_01.jpg


Indoor air pollution

Proportion of population relying on solid fuel worldwide: 41% Data: WHO, Global Health Observatory

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Who Photo library


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 ---


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


Urban development

60 million additional urban residents per year worldwide

Data: UN-Habitat

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Photos © UN-Habitat


Slums and informal settlements

One in three urban dwellers lives in slums or informal settlements

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Mathara slum in nairobi�Image 1: Nairobi Photos © UN-Habitat


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


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


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


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)


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


Global and environmental health

Many of the global health challenges we face today are linked to the decline of biodiversity and ecosystems.


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


We need to move on from inconvenient truths to convenient actions!

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Mention court cases and government responsibility


What and where are the opportunities?


1) The SDGs: intersectoral action for health


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)


Intersectoral action: air pollution

Disease burden

attributable to air pollution

Limited capacity and

resources

Additional capacity

and resources

Only 3% for prevention


Game changer for health: energy

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Image 4: Partners in Health/Haiti


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


3) Are we using international treaties and conventions sufficiently?


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

• …


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.


Game changer for health: housing


5) Global Coalition: Health, Environment,Climate Change WHO-UNEP-WMO Member States Launched at COP November 2016


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


Thank you !

More information:

World Health Organization http://www.who.int/

Public Health and Environment

http://www.who.int/phe/en/

Climate Change http://www.who.int/globalchange/climate/

Health in Sustainable Develompment/Green Economy

http://www.who.int/hia/green_economy/en/ http://www.who.int/hia/health_indicators/en/index.html

http://www.who.int/

http://www.who.int/phe/en/

http://www.who.int/globalchange/climate/

http://www.who.int/globalchange/climate/

http://www.who.int/hia/green_economy/en/

http://www.who.int/hia/health_indicators/en/index.html

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