Towards healthier, safer environment

Towards a healthier and safer environment and as part of efforts to accelerate action to curb environmental health risks that cause an estimated 12.6 million deaths a year, the United Nation (UN) Environment and the World Health Organisation (WHO) have agreed a new, wide-ranging collaboration.

Last week in Nairobi, Kenya, Head of UN Environment, Mr. Erik Solheim, and Director-General of WHO, Dr. Tedros Adhanom Ghebreyesus, signed an agreement to step up joint actions to combat air pollution, climate change and antimicrobial resistance, as well as improve coordination on waste and chemicals management, water quality, and food and nutrition issues.

According to statement by the WHO, the collaboration also includes joint management of the BreatheLife advocacy campaign to reduce air pollution for multiple climate, environment and health benefits.This represents the most significant formal agreement on joint action across the spectrum of environment and health issues in over 15 years.

UN Environment’s Solheim said: “There is an urgent need for our two agencies to work more closely together to address the critical threats to environmental sustainability and climate – which are the foundations for life on this planet. This new agreement recognizes that sober reality.”WHO’s Tedros said: “Our health is directly related to the health of the environment we live in. Together, air, water and chemical hazards kill more than 12.6 million people a year. This must not continue.”

He added: “Most of these deaths occur in developing countries in Asia, Africa and Latin America where environmental pollution takes its biggest health toll.”The new collaboration creates a more systematic framework for joint research, development of tools and guidance, capacity building, monitoring of Sustainable Development Goals, global and regional partnerships, and support to regional health and environment fora.

The two agencies will develop a joint work programme and hold an annual high-level meeting to evaluate progress and make recommendations for continued collaboration.The WHO-UN Environment collaboration follows a Ministerial Declaration on Health, Environment and Climate Change calling for the creation of a global “Health, Environment and Climate Change” Coalition, at the United Nations Framework Convention on Climate Change (UNFCCC) COP 22 in Marrakesh, Morocco in 2016.

Just last month, under the overarching topic “Towards a Pollution-Free Planet”, the United Nations Environment Assembly (UNEA), which convenes environment ministers worldwide, adopted a resolution on Environment and Health, called for expanded partnerships with relevant UN agencies and partners, and for an implementation plan to tackle pollution.

Priority areas of cooperation between WHO and UN Environment include:
*Air Quality – More effective air quality monitoring including guidance to countries on standard operating procedures; more accurate environment and health assessments, including economic assessment; and advocacy, including the BreatheLife campaign promoting air pollution reductions for climate and health benefits.

*Climate – Tackling vector-borne disease and other climate-related health risks, including through improved assessment of health benefits from climate mitigation and adaptation strategies.

*Water – Ensuring effective monitoring of data on water quality, including through data sharing and collaborative analysis of pollution risks to health.

*Waste and chemicals – Promotion of more sustainable waste and chemicals management, particularly in the area of pesticides, fertilizers, use of antimicrobials . The collaboration aims to advance the goal of sound lifecycle chemicals management by 2020, a target set out at the 2012 United Nations Conference on Sustainable Development.

Also, Maria Neira, Michaela Pfeiffer, Diarmid Campbell-Lendrum, and Annette Prüss-Ustün of the WHO Department of Public Health, Environmental and Social Determinants of Health in a commentary recommended how to achieve healthier and safer environment.Dr. Maria Neira is WHO’s Director, Department of Public Health, Environmental and Social Determinants of Health; Michaela Pfeiffer is the Technical Officer, Department of Public Health, Environmental and Social Determinants of Health while Dr. Diarmid Campbell-Lendrum is the WHO Climate Change Lead.

According to the commentary, The Lancet Commission on pollution and health by Philip Landrigan and colleagues is an immensely important piece of work highlighting the impact that environmental pollution has on death and disease and the related need to scale up political will if we are to effectively confront this issue.

WHO has long recognised the important influence that environmental integrity has on human health and development. We know from WHO’s most recent environmental burden of disease assessment that at least 12.6 million people die each year because of preventable environmental causes. This is almost a quarter of all annual deaths globally. Environmental risk factors—mainly due to the influence of air pollution on non-communicable diseases—are driving up healthcare costs, which consume nearly 10 per cent of global gross domestic product. Moreover, as highlighted by this Commission, it is vulnerable populations in low-income and middle-income countries (LMICs) that are most heavily affected. This is an unacceptable loss of lives and human development potential.

They wrote: “Today, we have more knowledge, evidence, and understanding than ever before about how and through what pathways climate and environmental change impact health. We know which sector policies and interventions effectively address environmental root causes of disease (example energy, transport, housing, and agriculture) and in which settings (example, cities, workplaces, and homes) these interventions will likely have the greatest impact. For instance, energy policies that facilitate or scale up household access to clean fuels for cooking, heating, and lighting in LMICs will help avert the 3.5 million deaths per year that result from exposure to household air pollution. We also know many of the co-benefits to health, the environment, and the economy that could accrue with a more integrated approach to development policy and planning.

According to the commentary, this is particularly the case in cities that are home to about four billion people—nearly half of the world’s population. People who live in cities are exposed to a range of environmental threats such as those arising from lack of adequate housing and transport and poor water, sanitation, and waste management. Nearly 90 per cent of the population living in cities worldwide is breathing air that fails to meet WHO air quality guideline limits.

Since most future population growth will take place in cities, urban expansion needs to be planned and designed in ways that make cities a centre of health and wellbeing. Specific sector policies such as energy, urban planning, transport, and infrastructure should be designed and implemented with clear and tangible health and environmental objectives in mind.

Governance of environmental threats to health is, however, also more challenging today than ever before. As argued persuasively in the Lancet Commission, environmental risk factors are changing in nature, origin, and influence. Some countries now face a combination of unresolved and new environmental and health challenges, where, for example, the poorest populations do not have access to clean water, clean household energy, and sanitation, and other populations are being increasingly exposed to chemicals, radiation, air pollution, and new and more complex occupational hazards. Conflict and natural disasters are adding further complexity to these governance challenges.

They added: “Simply put, the ways environmental threats to health are governed are no longer suited to today’s development context. We need a different approach. Although we do need more pollution control strategies to set and regulate environmental emission thresholds and to foster increased use of best available techniques and best environmental practices, pollution is not the root driver of ill health. Pollution is a symptom and unintended consequence of unhealthy and unsustainable development. If we want to substantially reduce the global environmental burden of disease, we need to act further upstream and address the drivers and sources of pollution to ensure that development policies and investments are healthy and sustainable by design and that the choices we make—at the government, private sector, and individual levels—cultivate a healthier and safer environment. In other words, we need to move beyond a “do-no-harm” approach and ensure that development actively and explicitly improves the environmental and social conditions that give rise to, and expose populations to, disease.

“The timing of this Lancet Commission could not be better given the clear need to scale up action in support of this agenda. There is growing global momentum around the Paris Agreement on Climate Change, arguably one of the most important treaties for public health in decades. This momentum, together with increased global demand for universal access to clean energy and more sustainable urban development, as reflected in the New Urban Agenda (8), provide a strategic opportunity for health actors to influence development policies and investments that can give rise to major environmental threats to health.

“For its part, WHO has prioritized such action, having placed particular focus on addressing the ‘health impacts of climate and environmental change’ (9) as one of four top health priorities for the next five years. WHO is also scaling up its programme of work on health and environment, placing greater focus on advocacy and awareness raising, the provision of technical support to countries, particularly those most vulnerable to climate and environmental change, and leveraging of key partnerships and constituencies such as in the energy, environment, water and sanitation, and urban planning sectors.”

Indeed, in this, and through greater alignment of its focus with the 2030 Agenda for Sustainable Development, WHO is reaffirming its commitment to reshape health and the determinants of health in today’s sustainable development context.

According to the commentary, the transition to a healthier and safer environment will require coordinated action and inputs from a range of actors from within and outside of the health sector. This action needs to be underpinned by scientifically sound and compelling evidence. WHO applauds and welcomes the timely Lancet Commission on pollution and health for its contribution to this global effort on both fronts.