Health and Environment

 

The environment influences human health in many ways — through exposures to physical, chemical and biological risk factors, and through related changes in behaviour in response to those factors. According to the WHO, 13 million deaths annually are due to preventable environmental causes. Mitigating environmental risk could save as many as four million lives a year in children alone, mostly in developing countries.

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The impact of the environment on health is a growing concern for the WMA and its members. Since 2007, the Association has been engaged in policy development and other activities, promoting the role of medical associations and individual physicians in preventing the damaging effects of the environment on health.

Health and Climate Change

“Climate change will affect, in profoundly adverse ways, some of the most fundamental determinants of health: food, air and water. The warming of the planet will be gradual, but the increasing frequency and severity of extreme weather events, such as intense storms, heat waves, droughts and floods, will be abrupt and the consequences will be acutely felt. The earliest and most severe threats are to developing countries, with negative implications for the achievement of the health-related Millennium Development Goals and for health equity. It is therefore essential to formulate a clear response in order to protect human health and ensure that it is placed at the centre of the climate debate.” WHO, report by the secretariat, January 2009

In May 2009, the World Health Assembly adopted a resolution on health protection from climate change, signaling a much higher level of engagement from the health sector. The resolution draws attention to the further strengthening of the evidence for human-induced climate change, and consequent risks to global health, the achievement of the Millennium Development Goals, and health equity.

At the global level, representatives of the world's government have been meeting several times over the last years to discuss climate change, in particular around the United Nations Climage Convention on climate change as well as the kyoto protocol.

WMA  Policy & Action

The WMA is committed to ensuring that the health sector is fully integrated in the current global debates and actions on climate change and to engaging physicians further for the protection of health from climate change.

On 1 of September 2009, the WMA held a seminar “Climate Change and Health Care” in Copenhagen to bring together physician leaders, other health actors and high-level experts from around the world in order to exchange experiences on the impact of climate change on health and to develop a global strategy, in particular in the context of the coming 15th Conference of the Parties to the UN Framework Convention on Climate Change.

At its annual General Assembly in New Delhi, India (17 October), the WMA approved a new Declaration setting out an action plan to bring health to the forefront of the climate change debate and to mitigate the serious health risks facing the world. WMA leaders insisted that physicians must be more involved in the development of policies to protect the health of all their patients.

The WMA follows the governmental talks in the context of the UN climate change negotiations. Physicians are concerned that the negotiations do not take fully into consideration the well-evidenced impact of climate change on health as well as  the public health benefits of climate change mitigation activities. Based on the skills, experience and knowledge of their members, medical associations acted to make health an inherent component of governmental talks in the context of Cancun's Summit in December 2010. In November 2010, WMA launched a lobbying action with its members. Based on a model letter , medical associations were invited to write to their governements asking to bring health to the forefront of the global warming debate. Together with environment & health NGOs, WMA  endorsed the Cancun statement "The time to act is now".

The recent Durban Summit (COP17 on climate change, December 2011) brought together a strong global health coalition, in which WMA was represented bringing forward physicians' concerns in this area. A Durban Climate and Health Declaration and Plan of Action were adopted in the parallel Climate and Health Summit.

The Climate and Health Declaration highlights that urgent replacement of fossil fuel-based energy with clean renewable energy is vital, as fossil fuels cause "immense harm" to both climate and health. It also urges governments to adopt an ambitious, fair and binding treaty by 2015, and to commit to equitable contributions to a green climate fund to assist adaptation and mitigation strategies to support human health.

In the Health Sector Call to Action, healthcare providers, professionals and health organizations commit to action themselves to cut emissions in the health sector, and urge health professionals worldwide to engage in advocacy for climate action, to help prevent unprecedented loss of life and human suffering.

The Climate and Health Summit was co-organized by the Climate & Health Council, Health Care Without Harm (HCWH) and the Nelson R. Mandela School of Medicine at the University of KwaZulu Natal, in partnership with the Health & Environment Alliance (HEAL), the World Health Organization (WHO), the World Medical Association, and the International Council of Nurses, among others, and brought over 250 health leaders from 30 countries. Active health representation at the UNFCCC COP 17 talks included HEAL, HCWH, the International Federation of Medical Students (IFMSA), World Medical Association, World Federation of Public Health Associations, Climate and Health Council and the WHO featured over a dozen side events, reports and briefings on health and climate.

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Chemicals

Some chemicals have been recognised or are suspected to cause serious health hazards. Advances in environmental health research including environmental and human sampling and measuring techniques, and better information about the potential of low dose human health effects have helped to underscore emerging concerns.

Several notable international agreements on chemicals exist. These were prompted by the first United Nations Conference on the Human Environment declaration in 1972 (Stockholm) on the discharge of toxic substances into the environment; These agreements include the 1989 Basel Convention to control/prevent trans-boundary movements of hazardous wastes, the 1992 Rio Declaration on Environment and Development, the 1998 Rotterdam Convention on informed consent and shipment of hazardous substances, and the 2001 Stockholm Convention on Persistent Organic Pollutants.

More recently, the UNEP developped a Strategic Approach to International Chemicals Management (SAICM). The SAICM, adopted in Dubai 2006 by the International Conference for Chemicals Management at its first session, is a multi-sectoral and multi-stakeholder policy framework aimed at promoting the sound management of chemicals and hazardous waste in the context of sustainable development. At its second session, in 2009, the International Conference on Chemicals Management requested the development of a strategy for strengthening the engagement of the health sector in the implementation of the Strategic Approach, in consultation with WHO. Special attention is required to protect those in society that are particularly vulnerable to risks from hazardous chemicals, children, and workers. 

Read more: Strategic Approach to International Chemical Management (SAICM)

WMA current policy and action

 The WMA is  involved in the development of the strategy for strengthening the engagement of the health sector in the implementation of the Strategic Approach.

At its General Assembly in Vancouver in October 2010, the WMA adopted a Statement on Environmental Degradation and Sound Management of Chemicals.

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Health and Mercury

Mercury, even in relatively low doses, can have serious adverse impacts on health, in particular in relation to neurodevelopment. Mercury has been an integral part of many medical devices, most prominently thermometers and sphygmomanometers. These devices break or leak with regularity, adding to the global burden of mercury in the environment and exposing health care personnel to the acute effects of the metal itself.

Read more on Mercury and Health Care (Health Care Without Harm)

An increasing number of health and environment organisations engage in advocacy and sponsor projects worldwide to reduce the over-exposure in mercury in children and adults and to explore the replacement of mercury-based medical devices by affordable, accurate and safer alternatives.

WMA Current Policy & Action

In October 2008, the WMA adopted a statement on Reducing the Global Burden of Mercury. Recognising the urgent need to reduce both the supply and demand of mercury in the health care sector, the WMA makes a range of recommendations, including that the National medical associations lobby their governments for the reduction of risks related to mercury in the environment and that physicians at the local level explore ways to eliminate mercury-containing products in their offices and clinical practices.

Further to this statement, the WMA joined the UNEP Global Mercury Partnership and in particular the “Mercury in products” area, sharing the partnership’s goal of protecting human health and the global environment from the release of mercury and its compounds.

At its  General Assembly in New Delhi (India) in October 2009, Mr A.K. Sengupta from WHO-India presented WHO Activities in the area of Mercury in Health Care with focus on Regional Perspective, including the Mercury Free Healthcare Initiative, co-lead by Health Care Without Harm (HCWH) and the WHO. This initiative is based on the 2005 WHO Policy Paper that calls for short, medium and long-term steps to achieve the gradual substitution of mercury-based medical devices. This initiative is a component of the UN Environment Programme’s Mercury Products Partnership.

The WMA is also involved in the negotiation of the UNEP (UN Environment Programme) for a legally binding instrument on mercury. The UNEP  convened an intergovernmental negotiating committee (INC) with the mandate to prepare the legally binding instrument. The first session of the committee was held in Stockholm, Sweden, from 7 to 11 June 2010. WMA was represented at the meeting, bringing forward its 2008 mercury resolution.

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Built environment

The term ‘built environment' refers to human-made resources and infrastructure designed to support human activity, such as buildings, roads, parks, and other facilities. The characteristics of the built environment can affect the health of residents in multiple ways. Studies have shown that people, particularly those in low income areas, can be negatively influenced by their built environment (for example, transportation, traffic noise, eating facilities...).

According to WHO, over the next thirty years, most of the world's population growth will occur in cities and towns of poor countries. Rapid, unplanned and unsustainable patterns of urban development are making developing cities focal points for many emerging environment and health hazards. As urban populations grow, the quality of the urban environment, will play an increasingly important role in public health with respect to issues ranging from solid waste disposal, provision of safe water and sanitation, and injury prevention, to the interface between urban poverty, environment and health.

The WMA working group on Health and the Environment together with the Canadian Medical Association commissioned a review on Health and the Built Environment to Urban Design 4 Health. The report provides a brief foundation on the connections between the built environment, health and wellbeing through a summary of key research and evidence. Read the report

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