Tag Archive for #post2015

Unhealthy investments

February 2, 2015 Environment and Health, Health and Wellness Promotion, Millennium Development Goals, Post-2015, Uncategorized No comments

I have been involved with the fossil fuel divestment movement over the past year, both with the University and through Healthy Planet UK, after coming to terms with the enormity of climate change and the need for urgent action. As a medical student I am compelled by a similar duty of care towards our ecosystem, on which our health depends, and am called to respond to its current symptoms of distress. Divestment offers a way to treat one of the root causes of these symptoms – the continued burning of fossil fuels – through moving investments away from the fossil fuel industry whose business model relies upon burning reserves which currently hold over five times that which is safe to burn if we are to stay below the 2 degrees celsius limit of global warming[1] Akin to the health sector leading divestment from the tobacco industry, there is a similar narrative in the response to the health threat of climate change further weighted by tactics utilised by the fossil fuel industry to thwart climate mitigation policy and mar public perception of the reality of climate science[2]. UK universities hold around £5.2 billion worth of investments through their endowment funds in the fossil fuel industry[3]. However, divestment is not simply a matter of money, most divestment decisions have been driven by a moral case. It rests on a simple principle -if it is wrong to wreck the planet, then it is wrong to profit from that wreckage. For the medical tradition investing in fossil fuels can be seen to contradict the fundamental principle to “first do no harm”. So far 21 universities, 35 cities, 65 religious organisations and numerous other organisations from around the world including the British Medical Association have committed to divesting from fossil fuels[4].

 

Medical institutions and the health community have a unique awareness of climate change through its current and future impacts on human health, but also through the potential immense health co-benefits of tackling climate change such as reducing the disease burden of air pollution, which has been attributed to 2000 premature deaths annually in Scotland[5], and encouraging active travel through reducing our reliance on fossil fuel guzzling cars. This gives an important dimension to the divestment dialogue and the engagement of medical schools and health organisations is sure to be very valuable. On the 3rd February, Healthy Planet are publishing their report “Unhealthy Investments”, co-authored with MedAct, The Climate and Health Council, Medsin and the Centre for Sustainable Healthcare. This will be a crucial step towards further engagement on fossil fuel divestment from the health sector. It will involve a panel of expert speakers to discuss the question of whether organisations which work to improve health should continue to invest in fossil fuel extraction and production companies. Should the health sector be taking more of a lead in this issue? There is certainly great potential in engaging with the process and evaluating how best our pension and endowment funds can be invested towards a healthier and more sustainable future.

 

More information on the report launch can be found here: http://www.eventbrite.co.uk/e/unhealthy-investmentsshould-health-organisations-divest-from-fossil-fuels-tickets-15237083527

 

References

[1] http://www.carbontracker.org/

[2] http://www.greenpeace.org/usa/en/campaigns/global-warming-and-energy/polluterwatch/Dealing-in-Doubt—the-Climate-Denial-Machine-vs-Climate-Science/

[3] http://peopleandplanet.org/fossil-free

[4] http://gofossilfree.org/commitments/

[5] http://www.foe-scotland.org.uk/air-pollution

 

 

Eleanor Dow – Medical student at the University of Edinburgh and coordinator of Healthy Planet UK, a network of students raising awareness of the links between climate change and health.

http://www.healthyplanetuk.org/

 

The health & environmental impact of global health research

August 19, 2014 Environment and Health, Health and Wellness Promotion, Uncategorized No comments

“How does one cross the Atlantic in an environmentally-friendly way?” I asked myself.* A few weeks earlier I had been challenged by a fellow student who had attended a university-run course “Carbon Conversations”. I then began to reflect on the health and environmental impact of my global health research and to consider ways in which I might reduce my climate change burden. Struggling to find a satisfactory answer to my question, I approached a local sustainability advisor who explained that the alternatives to “door-to-door” air travel were likely to involve significant time costs and/or financial costs. No feasible alternatives. It was a disappointing response, especially after reflecting on the potential global health cost of spending over 20 hours on aeroplanes for my research. Could a solution be found to minimise the global health impact of overseas travel which remains essential for many studying and working in global health with limited time and restricted budgets?

It is widely accepted that high carbon usage and emission contributes to global climate change. Studies have reported that the likely direct health impacts of global climate change include those associated with an increase in heatwaves and a rise in vector-borne diseases such as malaria. Indirect health impacts may include sanitation problems secondary water shortages and malnutrition due to a rise in food costs as a result of reduced food production. People living in less developed regions are predicted to experience the greatest direct and indirect health impacts of climate change.

Hard policies are already being implemented by national and global bodies to reduce carbon emissions through initiatives such as improving rail networks and increasing taxes on fuel and high-emission vehicles. Could “softer” approaches at a local level be effectively employed by individual members of the working and studying global health community in order to tackle the problem of climate change which threatens to have a negative health impact on many populations? It is certainly never too late to consider this suggestion. It was only in 2013 that the UN Development Programme for Europe and Asia for the first time assessed the carbon footprint of one of its global health projects. We know that travel and transportation are important contributors to the climate change problem, and that many staff and students in global health are likely to travel for work purposes. Perhaps responsible travel is an approach and practice that could be promoted more widely and emphasised more strongly within the global health community.

Practically speaking, adopting this approach might mean that within academic departments of global health, individuals who plan to travel would be encouraged to consider and attempt to address the issue of climate change when writing project proposals, funding applications, dissertations, and theses. For example, a postdoctoral researcher applying for funding to attend a global health conference in Brussels might choose to budget for the additional time and financial cost of travelling to Paris by ferry and train. At the same time she could be offset these extra costs against savings made by booking more modest accommodation. Similarly, a PhD student involved in global health data collection in Asia might include a reflective paragraph in his thesis acknowledging the health impact of climate change due to travel. He could also describe the challenges encountered and steps taken to reducing the travel-related carbon emissions associated with his research.

Finally, we need to consider not only the immediate costs of changing our travel habits, but also the longer-term global health costs of not taking action to promote a low carbon future worldwide. Time and money are important and even when both are limited, global health workers and students can still explore and consider more responsible ways of travelling. If we choose to spend years studying and working to improve global health today, let us also choose to leave a shrinking carbon footprint that will have not have a significant negative impact on global health tomorrow .

 

 

Dr Anne Aboaja

Dr Anne Aboaja, is a Global Health PhD Researcher, Psychiatrist and Member of the Global Health PhD Network at the University of Edinburgh

 

Foot note

*When I asked this question, I did not have in mind ticking a box during an online airline booking in order to offset my carbon emissions. Instead I entertained the idea of spending a couple of weeks on a low-cost transatlantic crossing followed by a scenic, and possibly bumpy, road trip on public transport to my destination, sensibly using the time to read and critically review journal articles, write papers for publication, practise language skills, and creatively think through research problems encountered. Unrealistic? Maybe. Maybe not. In the spirit of sustainable global health? Definitely.

 

 

Zoonotic diseases neglected for decades.

July 9, 2014 Cycles of Disease and Illness, Neglected Tropical Diseases, One World Health, Post-2015 No comments

As part of a study to analyse changes in global health priorities at the global level of the resolutions adopted at the World Health Assembly – the decision making body of the WHO – the relative neglect of endemic zoonotic diseases has been highlighted. This work has recently been published in PLOS NTDs, and has received widespread media attention.

The eight diseases of interest (anthrax, bovine tuberculosis, brucellosis, cysticercosis, echinococcosis, human African trypanosomiasis (HAT), leishmaniasis, rabies) are part of the group termed Neglected Zoonotic Diseases (NZDs) at an international meeting in 2005, so called as they are “not adequately addressed” at national and international levels. Zoonotic diseases are defined as diseases that are transmissible between humans and animals.

In the last decade, the Neglected Tropical Diseases (NTDs) have received increased global attention, and recent events celebrated the increased advocacy and control that has occurred. The research highlighted that these diseases have received relatively little attention at the global policy level, living up to their neglected title. In developing countries where these diseases remain endemic and resources are limited, the control of these diseases is limited as other high profile diseases are prioritised.

Some of the diseases have high fatality and cause a high number of deaths globally each year. For example, rabies causes an estimated 60,000 deaths worldwide, yet this disease remains neglected despite evidence that the disease can be effectively controlled through dog vaccination.

Neurocysticercosis is the greatest cause of preventable epilepsy worldwide, causing an estimated 30% of the 17 million cases of epilepsy in areas where the causative parasite is endemic. This disease can be controlled through sanitation and improved pig husbandry, and improved diagnosis of human infection, requiring a multi-sector approach.

Following the London Declaration on NTDs, there has been increased focus on NTD control. Of the NZDs, only leishmaniasis and HAT are included in the ten diseases which are the focus of the declaration, meaning that the other diseases are not benefitting from the increased Research and Development and drug donations that the other NTDs are experiencing as a result of the declaration. This study highlighted three diseases in particular that are not included in the WHO NTDs. Anthrax, brucellosis and bovine tuberculosis have therefore not received the increased attention that the other NTDs have seen. Upon the inception of the WHO in 1948, around twenty zoonotic diseases were determined to be diseases of priority in the WHO, including bovine tuberculosis and brucellosis. Despite this, there have not been any resolutions adopted for these diseases since 1950.  For these diseases, effective and simple control methods exist, meaning that they are no longer endemic in many developed countries. It is therefore astonishing to many that they remain neglected.

It seems that these diseases are particularly neglected due to the complexities of controlling diseases that affect both humans and animals, and the required communication and collaboration between human and animal health sectors, both at community and ministerial levels, that is sometimes lacking. This despite the dual benefits that would be received by both human and animal health sectors upon increased effective control methods.

The international attention that has been received following the publication of this research may be indicative that the neglect of these diseases – some of which are well known and well controlled in some countries – may be something which is surprising, but that there is desire to reduce this neglect and therefore the deaths that occur as a result. In order to reduce this neglect, we must see increased cooperation and communication between human and animal sectors at all levels, and efforts to increase the advocacy for the control of these diseases.

 

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Ms Hayley Mableson is in the final stages of completing a PhD from the University of Edinburgh.  Her research to date has focussed on global health advocacy and its application, with particular emphasis on the neglected tropical and zoonotic diseases. 

Shining a light on neglected tropical diseases

April 4, 2014 Millennium Development Goals, Neglected Tropical Diseases, Post-2015 No comments

The publication of the second report on Uniting to Combat Neglected Tropical Diseases entitled “delivering on promised and driving progress” marks remarkable progress that has been achieved in the last two years in this field.  In January 2012, the London Declaration on Neglected Tropical Diseases marked commitment from a wide range of organisations and industry to achieving the goals of the WHO roadmap to control, eliminate or eradicate ten of the NTDs.

To mark the launch of the report, on the 2nd April 2014 global leaders convened in Paris to discuss the progress that has been achieved so far.  In this “conversation on progress”, Director-General of the WHO Margaret Chan thanked endemic countries, organisations and industries for their commitment to this cause, and commented that these diseases are no longer neglected as they are “shining a light” on these diseases which shackle over 1.6 billion people worldwide.  Control of NTDs must be a priority in order to achieve the targets of the Millennium Development Goals as they affect the world’s poorest populations.  Since the establishment of the NTD department in the WHO in 2005, effective advocacy has increased the profile of these ancient diseases, and they have been described as a “rags to riches story”.

In the two years following the London Declaration, which was endorsed by thirteen pharmaceutical companies, the drug donation pledges made by these companies have been fulfilled and in some cases surpassed.  These donations allow countries to fulfil and increase the demand for treatment, and have resulted in the scaling up of control interventions as drug supply has been removed as a barrier to the control of a number of the NTDs.  Seventy four countries, representing around two thirds of all NTD endemic countries have now developed national plans for the control of NTDs.  This country ownership is an important factor in the increased commitment to control, eliminating and eradicating these diseases.  Coupled with capacity building and political commitment NTD control can be a success.  The adoption of a World Health Assembly resolution on all seventeen NTDs in May 2013 has been described as a “landmark” in NTD control.  Not only does this resolution confirm country commitment to NTDs, but it marks a change in the way the world is approaching NTD control.  Throughout the history of the WHO, there have been many resolutions adopted which focus on one or more of the NTDs, but the adoption of the 2013 resolution highlights the change to integrated approaches to NTD control.  When we consider the NTDs collectively, they represent an enormous burden on human health, and many opportunities exist to control several of these diseases in combination.

New funding was also announced in conjunction with the report representing increased commitment from a range of partners representing a new collaboration to control soil-transmitted helminths.  This collaboration and funding highlights how multi-partner and multi-sector collaboration is becoming increasingly important in NTD control.

The report highlights that commitment to NTDs has gained momentum since the London Declaration.  In addition, the 2013 resolution on NTDs marks a global pledge by Member States to the control of these diseases that in turn can leverage even more commitment.  In the last two years, the light has begun to shine brightly on these diseases that afflict the world’s poorest and most vulnerable populations.  The control and elimination of NTDs is now recognised as one of the best investments in development.  As the report states “much has been achieved, but much more work lies ahead”.  We must continue to increase commitments and activities to control NTDs.  The report highlights the success and fulfilment of commitments to the ten NTDs included in the London Declaration, but there remain seven of the defined NTDs without such multi-partner pledges of drug donations and increased funding.

World Health Day on the 7th April this year focusses on Vector Borne Diseases. This includes a number the NTDs such as leishmaniasis and sleeping sickness.  We must build on these recent success and increased momentum and continue to combat these ancient diseases while the light continues to shine.

 

 

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Ms Hayley Mableson is in the final stages of completing a PhD from the University of Edinburgh.  Her research to date has focussed on global health advocacy and its application, with particular emphasis on the neglected tropical and zoonotic diseases. 

Thinking about the post-MDG era

December 23, 2013 Measuring and prioritising health interventions and impact., Millennium Development Goals, Neglected Tropical Diseases, Post-2015 No comments

In 2015, the current eight Millennium Development Goals (MDGs) will expire. Results will be mixed, some will be met and some will not. What is clear, however, is that the MDGs have shaped the way we think about development, and our priorities and approaches to alleviating poverty.

The MDGs gave new prominence to the health issues affecting the poor; although their focus was restricted and derived from a top-down process of deliberation, rather than informed by inclusive analysis and a thorough prioritisation of development needs. Subsequently, the narrowly focused and largely sector-specific MDGs left gaps in coverage and failed to realise synergies between the foci covered by the goals (education, health, poverty, and gender). MDG 6 in particular—“combat HIV/AIDS, malaria and other diseases”—sidelined many of the communicable and non-communicable diseases that perpetuate the cycle of poverty in developing countries. And yet, the very act of naming HIV/AIDS and malaria raised the profile of these diseases immeasurably, stimulating increased funding, focused policy and dedicated institutions and programmes.

In response to the narrowness and specificity of the MDGs networks, alliances and lobby groups have emerged to argue for other priorities, perspectives and approaches. One of the most vocal examples – and the focus of the article – is the alliance arguing for Neglected Tropical Diseases (NTDs), a cluster of diseases of the bottom billion that are underserved with regards to research, treatment and control, to be included in the set of Goals that will replace the MDGs after 2015. At the moment it is looking increasingly likely that NTDs will be name-checked and specifically included in the “new” MDGs. This will be no mean feat.

The case for including NTDs in the post-2015 agenda has been building since their omission from MDG 6, which served as a call to arms for a group of concerned stakeholders, who have since contributed to a series of landmark initiatives that have placed NTDs firmly on the international agenda.

One “advantage” that the NTDs may have in a more enlightened and nuanced post-MDG era (with regards to development as well as to health), is that, by their very nature, they “undermine healthy lives” and cut across and threaten to undermine multiple silos of MDGs. This suggests a potentially fruitful bifurcated approach where focusing on NTDs can help make concrete inroads into reaffirmed or tweaked post-2015 MDGs, or NTDs can be used to articulate a set of goals that do not represent silos as targets to be met, but rather represent the strengthening of the institutions we need to manage the complex social, economic, environmental, and health systems that interact to shape future development.

Controlling NTDs in a post MDG era

MDGs and NTDs: Reshaping the Global Health Agenda

INZI Project (Investigating Networks of Zoonosis Innovation)

 

James Smith

Professor James Smith, Director, Global Development Academy, University of Edinburgh

Emma Michelle Taylor

Dr Emma Michelle Taylor, Research Fellow, INZI Project, Centre for African Studies, University of Edinburgh