Health Impact Assessment (HIA)

Launch of Health in the Green Economy: Global Health Council 2011

14 June 2011, Washington, DC

Dr Mohammed Akhter, Director, Washington DC Department of Health

The health sector needs to take action on key urban environmental policies, housing, transport, and nutrition that stimulate major health risks and also contribute to climate change.
"These linked issues of health, climate and sustainability are about the future. But we haven't really owned this issue as our issue,” said Dr Mohammed Akhter, director of the Washington DC Department of Health. “This is what we need to do first of all." Dr Akhter, who is also a former director of the American Public Health Association, was speaking at an event on "Health in the green economy - leveraging big gains for chronic disease prevention" at the annual meeting of the Global Health Council, on June 14.

Dr Jon Andrus, PAHO Deputy Director

The event was co-sponsored by WHO's Geneva headquarters and the Washington, DCbased Pan American Health Organization (PAHO/WHO) which is the Regional Office for the Americas of the WHO.
PAHO deputy director Dr Jon Andrus convened the gathering that also launched a new series of WHO-sponsored reviews systematically examining health co-benefit opportunities from proposed climate change mitigation measures. The series also looks at potential health risks and needs for further analysis.
Expert presentations made at the event illustrated how more climate-friendly investments in key economic sectors could prevent significant obesity-related diseases; cardiovascular and respiratory diseases including asthmas and allergies; traffic injuries; and illnesses related to excessive exposure to heat waves and winter cold.

Moderator Dr Maria Neira, Director of WHO's Department of Public Health and Environment (PHE), said that the series shows that "we need a new alliance of policymakers in climate, health and key sectors such as housing and transport."

Dr Carlos Dora, WHO; Dr Maria Neira, WHO; Dr M. Akhter, Washington DC Department of Health

Dr Carlos Dora, PHE coordinator of the Health in the Green Economy series initiative, said that this was the "first systematic look at how we could gain major health benefits, and also avoid some significant risks from more energy efficient policies and investments in sectors such as transport, housing, home energy, and agriculture."
He described how the series examined specific mitigation strategies that had been reviewed by the Intergovernmental Panel on Climate Change (IPCC), the most authoritative global scientific body on climate change science. The series reviews the IPCC mitigation measures in light of three categories of health impacts: 1) environmental health risks; 2) environmentally-related diseases, e.g. asthmas and allergies from poor indoor air quality, or cardiovascular disease from air pollution; and 3) health equity.
While most climate change policies have been found to yield large co-benefits for health, there were some risks that needed to be addressed as well, Dora noted. These include the need for assuring adequate fresh air ventilation in more thermally-insulated houses so as to prevent indoor-air pollution related respiratory diseases, asthmas and allergies.
Also gaps in IPCC transport analysis received attention. Notably, there is a lack of IPCC emphasis on more sustainable public transit, walking and cycling as a health and mitigation measure for the transport sector. In the housing analysis, IPCC does not systematically address the opportunities for more climate friendly and healthier housing in rapidly growing low-income cities, or for developing cleaner household energy in poor homes highly dependent on wood and coal stoves.
The review also covers the health sector. Preliminary findings identified how "greening" health sector activities could improve access to renewable energy sources and low-energy medical devices for 170,000 clinics in the developing world that currently lack any reliable source of energy - and that in turn would improve health.

Dr Carlos Dora, Public Health and Environment, WHO

Even in Washington DC, however, unsustainable patterns of transport, housing, energy and agriculture can leave many urban dwellers with unhealthy home environments, few outlets for healthy physical activity as part of daily travel routines, and inadequate access to nutritious and diverse local food sources, Dr Akhter observed.
Dr Akhter described how the Washington DC Department of Health, under his leadership, had been investing more than ever before in support for better walking and cycling infrastructures, including expanded bike paths and a bike rental system and, in collaboration with the city's transport department, improved rapid transit.
The Department has also established over two dozen farmers’ markets in the city to improve access to fresh fruits and vegetables, he noted, saying, "I can show you places in our nation's capitol where you can't get fresh fruits and vegetables."
He echoed findings from the WHO series that such investments are often "easier and cheaper, and more sustainable" than traditional health sector interventions, "but just needs more political support."
"In the past, health involved a focus on a single discipline," Dr Akhter said. "But in the future, it will be multi-disciplined. We in the health sector have been sleeping, but the world is changing. We need to put health on the table."

In addition to Dr Akhter, four other presenters from India, Thailand, Latin America and the USA illustrated the application of "health in the green economy" concepts in a range of developing country settings:

Mili Majumdar, Energy and Resources Institute

• Mili Majumdar, of the Energy and Resources Institute (TERI), described India's increased promotion of climate-friendly and naturally ventilated buildings that reduce indoor air pollution risks as well as improving thermal comfort in hot climates.



Dr Sumi Mehta, Global Alliance for Clean Cookstoves

• Dr Sumi Mehta, of the Global Alliance for Clean Cookstoves, on the new UN Foundation initiative, in which WHO is a key partner, which is striving to reduce COPD in adults, pneumonia in children and a range of other diseases through better access to modern energy and fuels, including improved biomass stoves.


Claudia Adriazola, EMBARQ/World Resources Institute

• Claudia Adriazola of an EMBARQ/World Resources Institute Initiative that is supporting the introduction of bus rapid transit and pedestrians/cycle networks in several Latin American cities as well as assessing impacts on a range of transportrelated health risks including: air pollution concentrations along the bus routes; injury risks to pedestrians and cyclists; and overall patterns of healthy physical activity/active travel in the areas that are the focus of the transport interventions.

Dr Twisuk Punpeng, Thai Ministry of Health

• Dr Twisuk Punpeng, Director for the Bureau of Technical Advisors at the Thai Ministry of Health, spoke about Thailand's new Clean and Green Hospitals initiative, which is introducing more environmentally sustainable management practices into health care facilities, from better management of sanitation and waste to the promotion of healthy local foods in hospital kitchens.

Share