Health and Environment: an unfinished agenda.
Challenges for action in the 21st centurywithin the SDG context
SDG in Europe
Bruxelles, 13 November 2015
Roberto Bertollini
Chief Scientist and WHO representative to the EU
Health in the context of the SDGs
Humans [are] the central concern of sustainable development […] living a healthy and productive life in harmony with nature –Principle 1 of the Rio Declaration (1992 ) • Health can be a contributor to sustainable
development • Health can benefit from sustainable
development• Health challenges can hamper sustainable
development
Health – a precious global good
• Higher on the political and social agenda of countries and internationally
• An important global economic and security issue
• A major investment sector for human, economic and social development
• A major economic sector in its own right
• A matter of human rights and social justice
SDG health goal 3 and its 13 targets
To ensure
healthy lives and
promote
wellbeing for all
at all ages
3.1 Reduce
maternal mortality
3.2 Reduce
child and neonatal
mortality
3.3 End epidemics of HIV, TB, malaria
and NTD, and combat hepatitis,
water-borne diseases and other
communicable diseases
3.4 Reduce
mortality due to NCD and
improve mental health
3.8 Achieve
universal health
coverage
3.7 Universal access to
sexual and reproductive
health-care services
3.6 Reduce mortality
due to road traffic
injuries
3.5 Strengthen prevention
and treatment of substance
abuse (narcotics, alcohol)
3.d Enhance capacity for early
warning, risk reduction and
management of national and global
health risks
3.c Increased health financing
and health workforce in
developing countries
3.a Strengthen
implementation FCTC
(tobacco)
3.9 Reduce deaths and illness
due to pollution and
contamination
3.b Access to affordable
essential medicines and
technologies
Goal 1: End poverty
Target 1.3: Implement social
protection systems for all
Goal 2: End hunger, achieve food
security and improved nutrition
Target 2.2: end malnutrition, achieve
targets for reductions child stunting
and wasting
Goal 6: Ensure availability
and sustainable management
of water and sanitation for all
Target 6.1: achieve universal
and equitable access to safe
and affordable drinking water
Goal 5: Achieve gender equality and empower all
women and girls
Target 5.2: end all forms of violence against all
women and girls ….
Goal 4: Ensure inclusive and
equitable education ………..
Target 4.2: ensure access to early
childhood development, care and pre-
primary education …
Goal 16: Promote peaceful and inclusive
societies for sustainable development, ……..
Target 16.1: reduce all forms of violence and
related death rates everywhere
Health
Health is linked to many other SDGs and
targets
Other goals and targets e.g. 10 (inequality), 11 (cities), 13 (climate change)
PHE Overview | May 20106 |
Health
Proximal causes
Air pollution
Water,sanitation
Chemicals
Vector breeding
sites
Radiation
etc.
Causes of the causes
Trade
Degraded ecosystems
MigrationDesertification
Climate change
Social factors not related to environment Genetic factors
Transport
Injuries
Physical inactivity
Respiratory diseases
Cardiovasc. diseases
Diabetes
Breast cancer
Malaria
Dengue
Leishmaniasisetc.
Malaria
Cardiovasc. diseases
Injuries
etc.
Malnutrition
Diarrhoea
Diarrhoea
MalnutritionDrownings
Intestinal parasites
etc.
Lung cancer
Respiratory infections
Lung cancer
COPD
Environment-society-individual interaction on healt h
Air pollution is a leading risk factor for disease –the Global Burden of Disease project
Lim et al. LANCET (2012)
Burden of Disease from Ambient Air Pollution, 2012
Total deaths 3.7 Million
PHE Overview | May 20109 |
“Environmental Health” Risks Widening our field of vision
“Environmental Health” Risks Widening our field of vision
Agriculture
Crop farming
Specific chemicalexposure
Livestockproduction
Use of chemicals
Cancer
Nitrous oxide
Nitrogenous fertiliser
Methane
Potent greenhouse gases
Climate change
Reduced farm yields
Impaired livelihoods
Nutritional status
Health impacts
Effects of temperature and soil moisture on plant growth
Health impacts
PHE Overview | May 201010 |
Evolution of human civilisation:
Obesity and diabetes are becoming more frequent, but the focus has been on diet and exercise
The mouse on the right was exposed in the womb to 1 ppb diethylstilbestrol (an experimental oestrogen).
Modern imagining methods show that children with high prenatal pollutant exposure must
activate brain regions not needed by controls
Increased prenatal exposure to MeHg + PCB (N = 3)
Controls(N = 3)
(D.A.Yurgelun-Todd, R.F.White et al., unpublished data)
Finger tapping with the left hand activates motor cortex on right AND left
In non-exposed controls, only the right motor cortex is activated
First High-level Meeting on NCDs (New York, 19-20 September 2011)
United Nations General AssemblyUnited Nations General AssemblyUnited Nations General AssemblyUnited Nations General Assembly
2011
Second high-level Meeting on NCDs (New York, 10-11 July 2014)
to take stock of the progress made since 20112014
Third High-level Meeting on NCDs to report on progress achieved since 20142018
Four common policy priorities for health
Investing in health through a life-
course approach and empowering
people
Tackling the Region’s major
health challenges of non-
communicable and communicable
diseases
Strengthening people-centred health
systems, public health
capacities and emergency
preparedness, surveillance and
response
Creating resilient communities and
supportive environments
Working to improve health for all and reducing the health
divide
Improving leadership, and participatory governance for
health
Two strategic objectives
Health Health Health Health 2020 2020 2020 2020 overarching policy frameworkoverarching policy frameworkoverarching policy frameworkoverarching policy framework
Thank You!
Health and SDGs
“Health has an obligatory place on any post-2015 development agenda. Better health is a good way to track the world’s true progress in poverty elimination, inclusive growth, and equity.”Dr Margaret ChanDirector-General of WHOAddress to the Sixty-seventh World Health Assembly, Geneva, Switzerland 19 May 2014
PHE Overview | May 201018 |
25% of disease could be prevented by modifying the environment
25% of disease could be prevented by modifying the environment
0 1% 2% 3% 4% 5% 6%
% of global disease burden in DALYs
Environmental fraction non-environmental
Diarrhoea
Lower resp. infections
Other unintentional inj.
Malaria
Road traffic injuries
COPD
Perinatal conditions
Ischaemic heart dis.
Childhood cluster
Lead-caused MMR
Drownings
HIV/AIDS
0 1% 2% 3% 4% 5% 6%
% of global disease burden in DALYs
Environmental fraction non-environmentalEnvironmental fraction non-environmental
Diarrhoea
Lower resp. infections
Other unintentional inj.
Malaria
Road traffic injuries
COPD
Perinatal conditions
Ischaemic heart dis.
Childhood cluster
Lead-caused MMR
Drownings
HIV/AIDS
