Presentation on theme: "Poverty, Health and the Environment"— Presentation transcript:
1Poverty, Health and the Environment Integrating environmental health into poverty reduction strategies11th PEP Meeting, June 2007Copenhagen, Denmark
2EH is important in poverty reduction. Burden of disease falls disproportionately on poorThe poor live where environmental conditions are worstDisease contributes to poverty (loss of income).The poor pay more for environmental health services (e.g. water)Other benefits to better EH: lower cost of living, gender equality, etc.Improved EH contributes to several MDGsPolluted environment Ill health Productivity Lost earnings
3Water, sanitation & hygiene and air pollution are important EH issues. Attributable mortality & DALY for selected environmental risk factorsSource: Adapted from WHO 2002 World Health Report, in Leitner 2005
4EH affects the poor of Africa and South Asia the most. Environmental disease burden in DALY per 1000 people (Source: WHO 2006)
5Costs associated with poor EH Economic burden associated with poor EH can account for between 2 and 5% of GDPCosts borne disproportionately by the poorSource: World Bank CEAs
6EH in poverty reduction goals, targets and strategies (I) Review of MDG Goal 7: Environmental sustainability (UNDP 2006) and Millennium Project Task Force Reports on MDG TargetsOverall weak reporting on MDG7; with only 8 out of 158 countries reporting on all global environmental indicatorsActual reporting of progress is even weaker: 116 countries have access to sanitation indicator but only 70 countries reported on it.Causal link between environment and poverty not well articulatedSlow progress on MDG7
7EH in poverty reduction goals, targets and strategies (II) Review of health (WHO 2004) and EH (WB 2006) in PRSPSEH is not systematically addressedWater & sanitation feature more often in PRSPs than any other EH issue; often independent of the health component; with sanitation remains secondaryOpportunities for multi-agency collaboration; however need to clarify EH related mandates of different agenciesNeed for better data and monitoring
9EH-Poverty Linkages in PRSPs EH ThemeExample of EH-poverty linkagesWater resource & sanitationLack of water supply and sewage system in rural areas leads to increased risk of water-related diseasesIndoor air pollutionBurning biomass in poor households for cooking and heating leads to increased risk of acute respiratory infectionsIndustrial & municipal wasteLeaching from unsanitary landfill sites located in poor areas contaminates water resources & causes health risksUrban Air PollutionEmissions from energy plants and transport are the main cause of air pollution related respiratory diseasesInstitutional developmentInadequate institutional capacity and legal framework underlie the specific EH-poverty issues described aboveSource: Adapted from Dale 2005
10Understanding Poverty Linkages and Prioritizing EH objectives What is the burden of disease from EH factors?What are the underlying environmental problems (poor sanitation and hygiene, indoor air pollution, etc.)?Who are the vulnerable groups (poor, children under five, etc.)?What are the subsequent economic costs and who bears these costs?What are the EH issues that matter most from a poverty reduction standpoint?
11Institutional Assessment Assessing institutional capacity & governance on EH issuesCross-sectoral collaborationVertical collaboration (national/local)Legal and regulatory frameworkEnforcementSocial accountability, particularly with respect to the vulnerable groupsResource allocation/PEER
12Selecting EH Interventions Cost-benefit analysisCost effectiveness studiesPoverty and health impactPolitical willSocial acceptability
13Multiple inputs and outcomes in EH Some InterventionsAnd examplesOutcomesMDG targetBehavior ChangeHealth promotionAdvocacyImproved healthMDG 4, 5, 6EnvironmentalHealth-global-national-local-householdGovernanceAir pollution codesEH legislationSaving timeMDG 3Improved quality of lifeMDG 2, 3, 4, 5Service deliveryWater supplyRefuse disposalEmpowering womenMDG 3Increased attendanceand better performanceat schoolMDG 2InfrastructureWater suppliesDrainageImproved housingMore sustainable livelihoodsMDG 7Finance and social marketingPromotionCreditSubsidy, if suitableSource: DFID 2003
14Monitoring progress and outcome indicators Monitoring of exposure, access to services, health improvementsSource of data: household surveysNational and sub-national level indicatorsDepends on: data, cost & ease of measurement, acceptance of indicators, etcSocial accountabilityCitizen monitoring of public services, access to information, participation in decision-making, access to justice
15Cross cutting themes Participation and stakeholder involvement Awareness-raising and communication strategiesSource: Tanzania’s Communication Strategy
16Moving towards action: Some Tools Data sources: Census, household surveys (DHS, LSMS), exposure/epidemiological studiesEconomic Assessment tools: cost-of-degradation studies, cost-benefit analysis, cost-effectivenessEnvironment & Health Assessment tools: EIA, SEA, HIA, CEAInstitutional Assessment tools: CEA, SEA, TAI, PEERsParticipatory Tools: PPA, beneficiary assessmentsOther Tools: poverty mapping (GIS)
17Moving towards action: stakeholder participation Paris Declaration: ‘increase the impact of aid in reducing poverty and inequality, increasing growth, building capacity & accelerating achievement of the MDGs’InternationalMultilateral institutionsBilateral institutionsInternational NGOsInternational FoundationsInternational Research InstitutesNationalFinance MinistryHealth MinistryEnvironment MinistryEducation MinistryInfrastructure MinistriesNational NGOsMediaCivil society organizationsUniversitiesThink tanksLocalGrassroots organizationsHealth workersPoor communitiesUniversities and research institutes
18Moving toward action: How can PEP help? Broadening the working concept of environment by incorporating the implications of the bio-physical and socio-economic environments on people and their health.Making the case for linking environmental health and poverty reduction by highlighting the economic importance of environmental health to poverty reduction and pro-poor growth.Incorporating environmental health into existing tools, programs, and investments by PEP members to move towards results on this important agenda and consequently a continuous improvement in the quality of life of the poor.
19Questions for PEP Members Content:Scope of paper: PRSPs or wider focus?Adequacy of approach/storylineWhat else can we include, e.g. tools?Finalization Process:Which agencies would like to sign off on it? Tell us by Sept 2007Level of sign-off (e.g. VP Sustainable Development, WB)Receipt of comments until September 15, 2007Final draft for agency review and sign-off, November 2007Publication costs (ADB and others?)Dissemination plan incl. different agency responsibilities – websites, existing forums, etc.