PAPER ON: POVERTY ENVIRONMENT AND HEALTH

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PAPER ON POVERTY ENVIRONMENT AND HEALTH

• Kulsum Ahmed (WB)
• On behalf of Carlos Dora (WHO)
• and the PEP EH Subgroup
• PEP Meeting, Ottawa,
• October 13, 2005

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PROCESS UPDATE

• Behind schedule
• Second draft is still work-in-progress
• Collected information on burden of disease
• Gathered some information on cases,
  interventions, tools but still more to do
• Aim To have a draft paper ready for wider
  comment from PEP Group at next meeting in
  Washington DC

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AUDIENCE

• Country level (bilateral/multilateral) agencies
  and their interlocutors

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OUTLINE

• Why environmental health matters to poverty
  reduction?
• What are key environmental health challenges?
• Opportunities for tackling environmental health
  issues
• Poverty reduction processes as an entry point for
  addressing environmental health

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1. Why EH matters to poverty reduction?

• 1.1. What is EH? Links between environment,
  health, vulnerability and livelihoods
• 1.2. The burden of disease due to environment
• over a quarter of total burden of disease (WHO
  estimates)
• Over 40 of this BOD falls on children under 5
  years
• 1.3. Determinants of EH disease burden and paths
  to poverty alleviation
• Agriculture, pesticides, vectors, diets,
• Urbanization, slums, injuries, WatSan
• 1.4. Economic benefits from addressing EH
• Costs of degradation studies
• Historical studies

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Environmental Health is top-of-mind concern
Environmental issues Very Serious, High vs Low
GDP per capita
Source Globescan, 2003
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2. Key EH challenges

• 2.1. Main EH risks
• Traditional risks Indoor air, disease vectors,
  WatSan
• Modern risks injuries, slums, pesticides,
  toxic waste
• Emerging risks climate change, biodiversity
  loss
• Groups at risk - children, indigenous groups,
  women
• 2.2. Technical challenges
• Affordability, cost effectiveness
• 2.3. Institutional challenges
• EH a multi-stakeholder, inter-sectoral issue

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3. Opportunities for tackling environmental
health issues

• Examples of inter-sectoral action and how
  agencies contributed to solving EH issues
• Agriculture
• Water management
• Slums
• Indoor air
• Environment management
• Need more case studies from you!

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4. PRSPs as an entry point for addressing
environmental health

• Opportunities (to integrate EH) within
  governments own development policies and plans,
  drawing on experience
• What is the coverage of EH in PRSPs?
• WHO preliminary analysis
• WB study (underway)
• Approaches and tools to address EH challenges
• Strengths and weaknesses

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Exiting coverage of EH in 21 PRSPs

• All contain wat/san strategies, and 17 contain
  some kind of pro-poor targeting (eg a focus on
  rural areas)
• 16 contain Nutrition strategies, of which 9
  target the poor
• 11 PRSPs will monitor the impact of their wat/san
  strategies in a disaggregated way (eg poor-
  non-poor, rural/urban) but only 3 will do so for
  nutrition
• Few PRSPs address indoor air pollution even
  fewer link food security and nutrition/health
• Overall conclusion PRSPs are not realising their
  full potential for cross-sectoral collaboration
• No insight into constraints on the ground
• WHO analysis 2004

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Approaches and tools to address EH challenges

• Understanding EH links
• Raising awareness, building constituencies
• Prioritizing
• Size of impacts
• Economic analysis / cost of degradation
• EH impact assessment, SEA
• Participation/stakeholder involvement
• Designing interventions to maximize health
  outcomes
• Building capacity for inter-sectoral action
• Governance institutions
• Monitoring processes and indicators

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E.g. showing the links between a neglected EH
hazard such as Indoor Smoke and the Millennium
Development Goals
"We will spare no effort to free our fellow men,
women and children from the abject and
dehumanizing conditions of extreme poverty, to
which more than a billion of them are currently
subjected." United Nations Millennium Development
Declaration, signed by all 191 Member States of
the United Nations in September 2000