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

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

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

  • Agriculture-Nutrition-Health From Framework to Action IFPRI Washington DC, 28 October 2010 Robert Bos, Coordinator Water, Sanitation, Hygiene and Health World Health Organization
  • Today’s presentation
    • Where were we four years ago?
    • Frameworks and models in the health sector
    • The local perspective: safe use of wastewater
    • New opportunities
  • Key messages for policy and programme change
    • Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • (2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies.
    • (3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development.
    • (4) Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework.
    • (5) Analyse and document the economics of joint agriculture and health actions as opposed to single sector approaches.
  • 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)
    • 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 …
    • What is prevention?
    • What are the economic dimensions of managing determinants of health rather than managing disease?
    • Do emerging diseases take prevalence over long-time health crises to which we have become accustomed?
    THE GLOBAL HEALTH PICTURE For other sectors: poor living standards, lost productivity, missed development opportunities
  • Linkages between agriculture and health: a conceptual framework
  • Development policy and health Social determinants Environmental determinants Health system Health Health Policy Development Policy Poverty
  • Development policy and health Social determinants Environmental determinants Health system Health Health Policy Agricultural Development Policy Poverty
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Water Safety Plans Integrated risk assessment & incremental risk management
  • Managing hazards and risks along agricultural value chains
    • Establish health-based targets for your outcome for vulnerable groups
    • Identify hazards and assess risks at each critical point along the chain
    • Design safeguards and risk mitigation measures along your chain that add up to achieve your health-based target
  • Wastewater use in agriculture: Situation and trends
    • Fresh water resources are rapidly becoming scarce.
    • Rapid urbanization is resulting in increasing outflows of domestic wastewater.
    • There is a growing market of urban workers looking for fast food with “green” ingredients
    • Fertilizers are a costly input into the agricultural production system.
    • 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.
    • 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.
  • Informal, shifting urban agriculture using wastewater in and around Accra, Ghana
  • Disposal of septic tank sludge at Lavender Hill, Accra Ghana
  • Cooperative peri-urban agriculture in Pikine, near Dakar, Senegal
  • Wastewater use in agriculture is extensive worldwide, and on the increase
    • Ten percent of the world’s population is thought to consume wastewater irrigated foods.
    • Twenty million hectares in 50 countries are irrigated with raw or partially treated wastewater.
    • The use of excreta (faeces, urine) is important worldwide, but the extent has not been quantified.
    • The use of greywater is growing in both developed and less-developed countries – it is culturally more acceptable in some societies.
  • Irrigation water use in cities around the world
    • Wastewater use is extensive worldwide, and increasing
    • Ten percent of the world’s population is thought to consume wastewater irrigated foods.
    • Twenty million hectares in 50 countries are irrigated with raw or partially treated wastewater.
    • The use of excreta (faeces, urine) is important worldwide, but the extent has not been quantified.
    • The use of greywater is growing in both developed and less-developed countries – it is culturally more acceptable in some societies.
    Source: IWMI 2007
  • Key messages for policy and programme change revisited
    • (1). Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • 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.
    • 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.
    • Mainstream health impact assessment in investment planning for the agriculture sector.
  • Key messages for policy and programme change revisited
    • Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • Initiate a process of joint review, reformulation and harmonization of agriculture and health policies.
    • Enlist a number of interested governments in an exercise of reviewing, reformulating and harmonizing agriculture, health and nutrition policies.
    • Develop ways to translate the harmonized policies into functional institutional arrangements between the different public sectors.
  • Key messages for policy and programme change revisited
    • Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • (2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies.
    • Anchor the methods and procedures for health impact assessment in the planning of agricultural development.
    • (Covered under 1 from a more effective resource allocation perspective).
    • Combine the creation of an enabling policy environment for HIA with institution strengthening and human resource development.
  • Key messages for policy and programme change revisited
    • Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • (2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies.
    • (3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development.
    • Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework.
    • Boost the environmental health and health promotion components in health sector programmes.
    • 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).
  • Key messages for policy and programme change revisited
    • Allocate resources to public health actions that, by independent criteria, are truly intersectoral.
    • (2) Initiate a process of joint review, reformulation and harmonization of agriculture and health policies.
    • (3) Anchor the methods and procedures for health impact assessment in the planning of agricultural development.
    • (4) Re-structure and strengthen the health sector to enable it to collaborate effectively in an agriculture/health framework.
    • Analyse and document the economics of joint agriculture and health actions as opposed to single sector approaches.
    • 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.
    • Promote the concept of Disability-Adjusted Life Years outside
    • of the health sector.
  • Thank you for your attention
    • For more information
    • www.who.int/phe