Exploring the Link Between Health and Environment

By J.R. Pegg

May 28, 2003 (ENS) - The global environment is changing - with far reaching and complex consequences for human health - and the world's efforts to address global health issues will fall short unless policymakers embrace this link, say global health experts who have gathered in Washington for the 30th annual conference of the Global Health Council.

The theme of the four day conference, said the organization's president and CEO Nils Daulaire, is to bring the voice of the global health community "to the front lines of the ongoing dialogue about international environmental policy."

The interactions between health and the environment are complex, Daulaire said, but that should not tempt humanity to shy away from studying these important connections.

"We know our health depends on the air we breathe, the water we drink and the food we eat," Daulaire said

"Advocates for global health share common ground with the environmental movement, and the goals of both our movements are the same - the creation of a sustainable world where life can flourish and where justice is our common currency," Daulaire said. boy

About half the world's population relies on biomass to cook food or heat their homes, a statistic that has environmental and health implications. (Photo by R. Faidutti courtesy UN Food and Agriculture Organization(FAO))
But creating this sustainable world will be anything but easy.

The world seems distracted by issues of war and security, Daulaire said, even as the outbreak of SARS demonstrates the ability of an infectious disease to jump from the environment to humans and to rapidly spread across the world.

"Most of us do not see ourselves as environmental activists," Daulaire told attendees at today's opening session. "But each person in this room is an infectious agent for change."

Some 2,000 health and development professionals, policymakers and advocates from more than 60 nations have gathered at this week's conference to discuss the consequences of global environmental change on human health.

It is the lack of political will and financial commitment that undermines efforts to address global health and environmental issues and no crisis exposes this more than the fight against AIDS, said Stephen Lewis of Canada, United Nations Special Envoy on HIV/AIDS in Africa.

Lewis, in a rousing speech at this morning's plenary session, said that at first glance Africa seems to be "under some kind of otherworldly curse."

But upon closer examination, Lewis explained, it is clear that "Africa reaps what the world sows - and with a vengeance."

Lewis traveled to four nations in Southern Africa last year to explore the link between food shortages and HIV/AIDS. What he found was not only a link between these two, but an interconnection to destructive weather patterns that many believe are linked to climate change.

Populations weakened by AIDS/HIV are decimated by food shortages, Lewis explained, which in turn are heightened by unfriendly trade policies and increasing extreme weather.

"What we are dealing with in southern Africa, entwined with everything else - make no mistake about it - is the most ominous environmental threat on the planet: climate change," Lewis said. girl

The burdens of disease and food insecurity weigh heaviest on the world's poor children. (Photo by Peyton Johnson courtesy FAO)
Lewis noted that the concern that climate change would disproportionately affect the world's poor was identified by the first International Conference on Climate Change in 1988, but the industrialized world has not heard its own warnings.

The rich nations of the world are stuck in a "cycle of self centeredness," Lewis said.

"We are responsible for climate change," he said. "We are responsible for the extremes of weather. It is our greed which serves to compromise food security in Africa and stokes the pandemic in the process."

And climate change is occurring more rapidly than scientists thought, explained Paul Epstein, associate director at Harvard Medical School's Center for Health and the Global Environment.

Epstein cited evidence of decreasing polar ice, warming ocean waters, and increased rain at higher latitudes as well as decreased salinity in the North Atlantic, but he said the "most profound part of climate change" is the extreme weather events.

Yet it is perhaps the more subtle elements of climate change - warmer winters, warmer nights and shifts in the onset of spring and fall - that pose the greatest challenge for those focused on global health. Biological systems are responding to the warming of the climate, Epstein said, and this has implications for vectors of infectious diseases.

"We are seeing geographic shifts of vector borne diseases," he said, citing new findings of malaria at higher elevations and the rapid spread of West Nile virus in the United States.

Warmer weather gives insects, such as the spruce bark beetle, a much greater window for destruction on forests. A disease like West Nile, Epstein said, hits wildlife and could skew the predator prey relationship with implications for human health.

"We are in the midst of an emergence of new diseases," Epstein said. "How will we respond?"

The response of the international community to global health and environmental concerns is very much a target for this week's conference. Past promises of grand action have left many waiting for results, said Thais Corral, executive director and founder of REDEH, the Brazilian based Network for Human Development and a co-chair of the conference.

In her speech Corral detailed disappointment with the implementation of the lofty goals of sustainable development first explored at the Rio Summit in 1990.

The global community has stumbled in its effort to address the underlying issues of poverty that cause many of the world's health and environmental problems, Corral explained, and this failure falls hardest on the world's women and children.

"The road has been much more rough and complicated than expected," Corral said.

The impact of poverty on global health can not be understated, according to Corral and others at the conference. Some 25 percent of the world's population has 70 percent of the wealth and nearly half of the world lives on less than $2 a day.

Roughly 113 million primary school age children in the developing world are not in school, and 60 percent are girls. haitiflood

Increased torrential rains are an expected result of climate change. (Photo by C. Errath courtesy FAO)
Health, development and education programs are still not reaching those most in need, Corral said, and "women continue to be grossly invisible and under represented."

And the reason some 800 million people are malnourished is because of poverty, not because the world does not produce enough food, added Margaret Catley-Carlson, chair for the Global Water Partnership and former director of the Canadian International Development Agency.

"Poverty always makes environmental impact on health worse," said Catley-Carlson, who is a conference co-chair.

This link is perhaps most clear, Catley-Carlson said, when considering issue of water.

Access to clean water is the "single greatest health factor," she said, as some 29,000 people die daily because they do not have such access. The World Health Organization estimates that some 76 million people will die for lack of safe drinking water between now and 2025.

To reach the goals set out by the UN, some 280,000 people each day would have to be given access to clean water by 2025, she explained

"This is not going to happen under the current circumstances," Catley-Carlson said.

Providing individuals with a reliable and affordable supply of clean water is a vital step in improving the lives of the world's poor, explained Mike Muller, director general of South Africa's Watery and Forest Affairs Department.

Muller detailed how his nation has committed to ensuring all of its citizens have access to water and said this has helped lay the foundation for other positive change.

Convenient access to clean water and sanitation "is about much more than public health," he said. "It is about dignity, it is about human rights, it is about the right to have an environment protected for the benefit of present and future generations."

In 1994 some one third of South Africa's population did not have access to safe drinking water, but since then some nine million people have been provided with a stable and safe water supply.

"We have demonstrated in a very practical way that by addressing poverty, we could mobilize the social and political support we needed to protect our natural environment, a lesson with global implications," Muller said. waste

The industrialized world is largely ignoring its responsibility for environmental and economic policies that affect the health of the poor, says Stephen Lewis, UN Special Envoy on HIV/AIDS in Africa. (Photo courtesy Unitarian Universalist Association)
But the global implications of this are not so clear. South Africa, while a developing country, has much greater resources than many developing nations. And issues of global health and the environment always come back to poverty and to the industrialized world's willingness, or lack thereof, to support efforts to improve the conditions of the poor.

Speakers at the conference expressed dismay at the stalled efforts by the world's rich nations to address climate change. Pick a global health threat - malaria, HIV/AIDS, polluted water, industrial chemicals - and there is a legacy of under funding and blustery rhetoric.

Lewis noted that the international global fund to combat AIDS, tuberculosis and malaria is nearly out of funding. Even the latest pledge by the United States, which the Bush administration touted as $15 billion over three years, only amounts to $200 million in guaranteed funding per year for this fund.

The UN estimates that just to combat AIDS, the world needs some $15 billion a year by 2007.

"What is so intolerable about the continued funding crisis is not just the staggering loss of life, so much of it completely unnecessary, but what it says about us, the donor nations and our lamentable, incomprehensible behavior," Lewis said.

"We know what we are doing, but we do it anyway."