IFPRI 2020 Panel Discussion "Understanding the Interactions Between Agriculture & Health"

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IFPRI 2020 Panel Discussion "Understanding the Interactions Between Agriculture & Health" by Robert Bos 28 October 2010

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  • One barrier to evaluating EH services was the fact that they are traditionally administered by several agencies such as health, environment, agriculture, industry, transport. (WHO EURO about 1997). A study of EH in the Pacific concluded Much EH protection is under jurisdiction of Environment ministries. Delineation of responsibility between environment and health is not clear.
  • One barrier to evaluating EH services was the fact that they are traditionally administered by several agencies such as health, environment, agriculture, industry, transport. (WHO EURO about 1997). A study of EH in the Pacific concluded Much EH protection is under jurisdiction of Environment ministries. Delineation of responsibility between environment and health is not clear.
  • One barrier to evaluating EH services was the fact that they are traditionally administered by several agencies such as health, environment, agriculture, industry, transport. (WHO EURO about 1997). A study of EH in the Pacific concluded Much EH protection is under jurisdiction of Environment ministries. Delineation of responsibility between environment and health is not clear.
  • One barrier to evaluating EH services was the fact that they are traditionally administered by several agencies such as health, environment, agriculture, industry, transport. (WHO EURO about 1997). A study of EH in the Pacific concluded Much EH protection is under jurisdiction of Environment ministries. Delineation of responsibility between environment and health is not clear.
  • IAIA 07 HIA Screening - P. Furu
  • IAIA 07 HIA Screening - P. Furu
  • IFPRI 2020 Panel Discussion "Understanding the Interactions Between Agriculture & Health"

    1. 1. Agriculture-Nutrition-Health From Framework to Action IFPRI Washington DC, 28 October 2010 Robert Bos, Coordinator Water, Sanitation, Hygiene and Health World Health Organization
    2. 2. Today’s presentation <ul><li>Where were we four years ago? </li></ul><ul><li>Frameworks and models in the health sector </li></ul><ul><li>The local perspective: safe use of wastewater </li></ul><ul><li>New opportunities </li></ul>
    3. 3. Key messages for policy and programme change <ul><li>Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>(2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies. </li></ul><ul><li>(3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development. </li></ul><ul><li>(4) Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework. </li></ul><ul><li>(5) Analyse and document the economics of joint agriculture and health actions as opposed to single sector approaches. </li></ul>
    4. 4. THE GLOBAL HEALTH PICTURE Global mortality rates from water-, sanitation- and hygiene-related diseases 90% of the toll of diarrhoeal disease is borne by children under five (WHO 2000, 2006, 2007 and Prüss-Üstün et al. 2008) WHO/Carolos Gaggero Disease Cases per year Deaths per year (year) Cholera 131 943 2 272 (2005) Typhoid fever 16 million 600 000 (2000) Diarrhoeal disease 4.6 billion 2.2 million (2004)
    5. 5. <ul><li>The insidious impact of morbidity: billions of diarrhoeal disease and malaria episodes; hyper-endemic intestinal worm infections; chronic under- and malnutrition; chronic effect of exposure to arsenic or pesticides … </li></ul><ul><li>What is prevention? </li></ul><ul><li>What are the economic dimensions of managing determinants of health rather than managing disease? </li></ul><ul><li>Do emerging diseases take prevalence over long-time health crises to which we have become accustomed? </li></ul>THE GLOBAL HEALTH PICTURE For other sectors: poor living standards, lost productivity, missed development opportunities
    6. 6. Linkages between agriculture and health: a conceptual framework
    7. 7. Development policy and health Social determinants Environmental determinants Health system Health Health Policy Development Policy Poverty
    8. 8. Development policy and health Social determinants Environmental determinants Health system Health Health Policy Agricultural Development Policy Poverty
    9. 9. Development policy and health Improved land tenure; Increased income; Enhanced farmer education; Intensified and expanded irrigation; changed livestock management; increased chemical inputs; introduction new crop varieties; mechanization Health system Health Health Policy Agricultural Development Policy Poverty
    10. 10. Development policy and health Improved land tenure; Increased income; Enhanced farmer education; Intensified and expanded irrigation; changed livestock management; increased chemical inputs; introduction new crop varieties; mechanization Health system Communicable diseases Non-communicable diseases Malnutrition Injuries and accidents Psycho-social disorders Health Policy Agricultural Development Policy Poverty
    11. 11. We change the world Environmental P ressure Environmental S tate Human E xposure Development D riving forces A ction Health E ffect The DPSEEA model Modified from WHO, 1997
    12. 12. Environmental P ressure D riving Forces Environmental S tate We change the world Consumption patterns Production manufacturing Waste release Population growth Economic development Technology Natural hazards Resource availability Pollution levels DPSEEA Development
    13. 13. Human E xposure Health E ffect A ction Level of external exposure to hazards Level of hazards absorbed Target organ dose Well-being Morbidity Mortality To reduce burden of disease and increase well-being DPSEEA
    14. 14. Environmental P ressure Environmental S tat e Human E xposure Environmental improvement, pollution monitoring and control Education, awareness raising Treatment, rehabilitation Economics, social policies, clean technology Hazard management Modified from WHO, 1997 Development D riving forces A ction Health E ffect
    15. 15. Water Safety Plans Integrated risk assessment & incremental risk management
    16. 16. Managing hazards and risks along agricultural value chains <ul><li>Establish health-based targets for your outcome for vulnerable groups </li></ul><ul><li>Identify hazards and assess risks at each critical point along the chain </li></ul><ul><li>Design safeguards and risk mitigation measures along your chain that add up to achieve your health-based target </li></ul>
    17. 17. Wastewater use in agriculture: Situation and trends <ul><li>Fresh water resources are rapidly becoming scarce. </li></ul><ul><li>Rapid urbanization is resulting in increasing outflows of domestic wastewater. </li></ul><ul><li>There is a growing market of urban workers looking for fast food with “green” ingredients </li></ul><ul><li>Fertilizers are a costly input into the agricultural production system. </li></ul><ul><li>Result: Farmers in rural and peri-urban areas are turning to the use of wastewater, excreta and greywater in agriculture and aquaculture in increasing numbers. </li></ul><ul><li>Without effective risk assessment and management, such use incurs important health hazards. The associated water-borne disease risks affect farmers and their families, those who market the produce and consumers. </li></ul>
    18. 18. Informal, shifting urban agriculture using wastewater in and around Accra, Ghana
    19. 19. Disposal of septic tank sludge at Lavender Hill, Accra Ghana
    20. 20. Cooperative peri-urban agriculture in Pikine, near Dakar, Senegal
    21. 21. Wastewater use in agriculture is extensive worldwide, and on the increase <ul><li>Ten percent of the world’s population is thought to consume wastewater irrigated foods. </li></ul><ul><li>Twenty million hectares in 50 countries are irrigated with raw or partially treated wastewater. </li></ul><ul><li>The use of excreta (faeces, urine) is important worldwide, but the extent has not been quantified. </li></ul><ul><li>The use of greywater is growing in both developed and less-developed countries – it is culturally more acceptable in some societies. </li></ul>
    22. 22. Irrigation water use in cities around the world <ul><li>Wastewater use is extensive worldwide, and increasing </li></ul><ul><li>Ten percent of the world’s population is thought to consume wastewater irrigated foods. </li></ul><ul><li>Twenty million hectares in 50 countries are irrigated with raw or partially treated wastewater. </li></ul><ul><li>The use of excreta (faeces, urine) is important worldwide, but the extent has not been quantified. </li></ul><ul><li>The use of greywater is growing in both developed and less-developed countries – it is culturally more acceptable in some societies. </li></ul>Source: IWMI 2007
    23. 23. Key messages for policy and programme change revisited <ul><li>(1). Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>Explore whether recent re-structuring in bilateral donor agencies (from sectoral to thematic approaches) offers new opportunities to put multidisciplinary/intersectoral issues on the agenda. </li></ul><ul><li>Generate new and more compelling evidence for ministers of planning and of finance about the potential to improve agriculture-associated health status through targeted investment in agriculture. </li></ul><ul><li>Mainstream health impact assessment in investment planning for the agriculture sector. </li></ul>
    24. 24. Key messages for policy and programme change revisited <ul><li>Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>Initiate a process of joint review, reformulation and harmonization of agriculture and health policies. </li></ul><ul><li>Enlist a number of interested governments in an exercise of reviewing, reformulating and harmonizing agriculture, health and nutrition policies. </li></ul><ul><li>Develop ways to translate the harmonized policies into functional institutional arrangements between the different public sectors. </li></ul>
    25. 25. Key messages for policy and programme change revisited <ul><li>Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>(2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies. </li></ul><ul><li>Anchor the methods and procedures for health impact assessment in the planning of agricultural development. </li></ul><ul><li>(Covered under 1 from a more effective resource allocation perspective). </li></ul><ul><li>Combine the creation of an enabling policy environment for HIA with institution strengthening and human resource development. </li></ul>
    26. 26. Key messages for policy and programme change revisited <ul><li>Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>(2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies. </li></ul><ul><li>(3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development. </li></ul><ul><li>Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework. </li></ul><ul><li>Boost the environmental health and health promotion components in health sector programmes. </li></ul><ul><li>Generate evidence of how other sectors can assist in overcoming health sector constraints (drug resistance, insecticide resistance, infrastructure and human resource deficiencies, outbreak and crisis pressures). </li></ul>
    27. 27. Key messages for policy and programme change revisited <ul><li>Allocate resources to public health actions that, by independent criteria, are truly intersectoral. </li></ul><ul><li>(2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies. </li></ul><ul><li>(3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development. </li></ul><ul><li>(4) Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework. </li></ul><ul><li>Analyse and document the economics of joint agriculture and health actions as opposed to single sector approaches. </li></ul><ul><li>Implement economic evaluations in a number of settings and for a range of agriculture/nutrition/health issues, comparing singular and integrated interventions in terms of their efficiency. </li></ul><ul><li>Promote the concept of Disability-Adjusted Life Years outside </li></ul><ul><li>of the health sector. </li></ul>
    28. 28. Thank you for your attention <ul><li>For more information </li></ul><ul><li>www.who.int/phe </li></ul>

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