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078 HEALTH                                                                                                                                                                                                                            HEALTH 079

                                                                                                                                             study published last year in The Lancet, carried out     indeed help combat air pollution. But some experts

GREEN ECONOMIC                                                                                                                               with WHO participation, modelled effects on health in
                                                                                                                                             London and Delhi from low-emission vehicles and
                                                                                                                                             policies to increase “active travel” and reduce car
                                                                                                                                                                                                      contend that improved public transport, walking and
                                                                                                                                                                                                      cycling systems could potentially do much more – by
                                                                                                                                                                                                      attacking air pollution, obesity and traffic injury in


DEVELOPMENT CAN BE                                                                                                                           travel. A combination of active travel and lower-
                                                                                                                                             emission motor vehicles was projected to reduce the
                                                                                                                                             number of years of life lost from ischaemic heart
                                                                                                                                                                                                      an integrated and cost-effective way (Wright and
                                                                                                                                                                                                      Fulton, 2005; Kahn Ribeiro et al, 2007; Woodcock et
                                                                                                                                                                                                      al, 2009).


GOOD FOR HEALTH
DR MARIA NEIRA, DIRECTOR OF THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,
                                                                                                                                             disease by 10-19 per cent in London and 11-25 per
                                                                                                                                             cent in Delhi (Woodcock et al, 2009). In many cases,
                                                                                                                                             the health and health care cost savings resulting
                                                                                                                                             from climate change mitigation actions can also cover
                                                                                                                                                                                                      Sometimes, tradeoffs also need to be considered.
                                                                                                                                                                                                      For instance, improving the insulation quality of
                                                                                                                                                                                                      homes in developed countries offers one very
WORLD HEALTH ORGANISATION (WHO)                                                                                                              much of the cost of the interventions (Metz B, et al     major climate change mitigation opportunity,
                                                                                                                                             eds., 2007).                                             according to the reviews of the Intergovernmental
                                                                                                                                                                                                      Panel on Climate Change. Better insulation can
                                                                                                                                                                                                      also help protect against extreme heat and cold
                                                                                                                                              FINE-TUNING MITIGATION POLICIES TO                      waves that become more frequent with climate
                                                                                                                                              CONSIDER HEALTH                                         change. However, in health terms, adequate provision
                                                                                                                                                                                                      for ventilation must also be assured to keep
                                                                                                                                             Significantly, some mitigation policies may be better    down levels of indoor air pollution from dust and
                                                                                                                                             than others, in health terms. For instance, mitigation   mould and chemicals that otherwise might build up in
                                                                                                                                             policies to encourage lower-emission vehicles can        closed spaces.

                                                                                                                                                                                                      This is why more careful health assessment and
             s concerns mount over the long-term                                                                   Right: Dr Maria Neira,                                                             analysis of mitigation policies is required in order to


  A          risks of climate change to the planet’s
             health, there is a wave of interest in
             “green” economic development among
UN and multi-lateral aid agencies, national
                                                          THE HEALTH COST OF GREY, THE
                                                          SAVINGS OF GREEN
                                                         Overall, WHO estimates that nearly one-quarter
                                                                                                                   Director, Department of
                                                                                                                   Public Health and
                                                                                                                   Environment, WHO,
                                                                                                                   Geneva
                                                                                                                                                                                                      explore what combination of climate change mitigation
                                                                                                                                                                                                      policies can yield the most optimal health benefits in
                                                                                                                                                                                                      any given economic sector. Relative costs and benefits
                                                                                                                                                                                                      also need to be examined by diverse economies
governments and industry. But can “green” economic       of the global disease burden is attributable to                                                                                              and regions.
initiatives also yield more immediate public             environmental pollution and degradation, which could
health benefits?                                         be readily addressed by available technologies in
                                                         various economic sectors (WHO, 2009). For instance,                                                                                            LEADING BY DOING
Early findings emerging from a new series of global      most deaths from indoor air pollution (2 million
reviews by WHO of climate change mitigation policies     annually) are due to leaky and inefficient household                                                                                         Mitigation policies can and should also be applied
in key economic sectors say “yes”, health can be a       energy systems that burn biomass fuels and coal,                                                                                             in the health sector itself to obtain better use
winner in greener development strategies.                and upon which 3 billion people still rely for fuel                                                                                          of health system resources. Currently, hundreds of
                                                         (WHO, 2009).                                                                                                                                 thousands of health clinics in Africa, Asia and
Well-designed initiatives that curb greenhouse gas                                                                                                                                                    Latin America have no power at all. If such clinics
emissions in energy, residential construction,           However, much of this burden of disease could                                                                                                could be supplied with renewable electricity for basic
transport, and agricultural systems can not only         potentially be reduced or eliminated through improved                                                                                        needs from solar panels, the quality of health care
enhance global public health, but also improve health    access to cleaner-burning cookstoves or fuels now                                                                                            could potentially be improved, at little long term cost
among poor populations and save scarce health            becoming available in developing countries (Wilkinson                                                                                        to the planet.
resources – in a relatively short time frame.            P et al, 2009; WHO 2006). Concurrent reductions in
                                                         stove emissions could also reduce the climate impacts                                                                                        In developing world cities, where power outages
Better understanding of the multiple “win-win”           of black carbon (USAID/RDMA, 2010; Ramanathan                                                                                                are often common, expanded hospital access to
health and climate benefits that could be                and Carmichael, 2008).                                                                                                                       renewable energy sources and on-site co-generation
obtained from mitigation could help build support                                                                                                                                                     of heat and electricity could potentially provide
for existing and future climate change agreements,       The burden of disease from urban outdoor air pollution                                                                                       health facilities with more efficient, reliable and
such as the one being negotiated in the talks            (1.2 million deaths annually) and traffic injury (1.3                                                                                        independent sources of energy for emergencies.
in Cancún.                                               million deaths annually) could similarly be addressed                                                                                        Building energy efficiencies into construction and
                                                         by policies that promote more compact urban                                                                                                  the use of medical devices can help hospitals, large
Embracing “health-enhancing” low-carbon strategies       development around public transport corridors as well                                                                                        or small, and in developing or developed countries,
can allow policy-makers to demonstrate positive health   as “active” transport by walking and cycling. An ever                                                                                        better rationalise resources.
and wealth-generating results within a period of years   growing body of literature indicates that active
– while averting devastating long-term impacts to        transport to work, school and shopping can also                                                                                              Recognising these realities, the health sector is already
the planet.                                              address obesity-related diseases caused by physical                                                                                          “leading” with its own “greening” initiatives. Hospitals
                                                         inactivity (3.2 million deaths annually) (Aytur, et al,                                                                                      in a number of Chinese cities recently launched
The general public can potentially be motivated to       2008; WHO, 2006; WHO, 2008).                                                                                                                 programmes to promote “green and safe” hospitals –
adopt more sustainable lifestyles when there is better                                                                                                                                                that can function better in emergencies. From the UK’s
understanding of how such measures also improve          Recent modeling of cities in developed and developing                                                                                        National Health Service to small NGOs at the grass
personal health and well-being in tangible ways.         countries indicated that the potential is huge. A major                                                                                      roots, health facilities are launching energy audits and
080 HEALTH                                                                                                                                                                                                                                                                                    HEALTH 081

examining how carbon efficiencies can benefit both          partners and stakeholders, is a key aim of WHO’s                                                                                                                                              believe, can revitalise climate change processes
the planet and health.                                      climate change adaptation and mitigation efforts.                                                                                                                                             and lead to future climate change agreements that
                                                                                                                                                                                                                                                          take the biggest step yet towards global health in
                                                            Such efforts can help strengthen the global                                                                                                                                                   human history.
  “ADAPTIVE” MITIGATION                                     community’s capacity to protect health from climate
                                                            change and thus reap more immediate and wider
Initiatives for “green and safe” hospitals recognise that   benefits from strong mitigation polices.                                                                                                                                                        ABOUT THE AUTHOR
many measures that “mitigate” against future climate
change can also be integrated with measures that                                                                                                                                                                                                          Dr Maria P. Neira was appointed Director of the
improve adaptation to the impacts of climate change           GETTING HEALTH ON THE CLIMATE                                                                                                                                                               Department of Public Health and Environment at
already being felt. Other such “adaptive mitigation”          CHANGE AGENDA                                                                                                                                                                               the World Health Organisation, Geneva, Switzerland
measures could include:                                                                                                                                                                                                                                   in September 2005. Prior to that, she was Vice-
                                                            To date, health issues have been marginal in the                                                                                                                                              Minister of Health and President of the Spanish
Integrated vector management, which combines                climate talks – even though “adverse effects of climate                                                                                                                                       Food Safety Agency.
environmental management with wise use of                   change on the economy, public health and the quality
chemicals, can help combat climate change-induced           of the environment” were noted in the first United                                                                                                                                            She had previously held senior positions in WHO as
changes in vector borne disease transmission, while         Nations Framework Convention on Climate Change as                                                                                                                                             Director of the Control, Prevention and Eradication
also reducing long-term environmental impact of             the three critical arenas of global climate-related                                                                                                                                           Programme on Communicable Diseases and as
chemicals (van den Berg et al, 2007; Campbell-              commitment (UN,1992).                                                                                                                                                                         Coordinator of the Global Task Force on Cholera Control.
Lendrum, et al, 2005).
                                                            Less than 2 per cent of the international funding on                                                                                                                                          Dr Neira began her career as a field physician and
Improved home and hospital design to facilitate             climate change adaptation goes to protect health, and                                                                                                                                         medical coordinator working with refugees in El
natural ventilation can improve air flows for better        there has been no systematic quantification of                                                                                                                                                Salvador and Honduras and later as a public health
infection control and heat wave resilience while            potential health opportunities and funding in the                                                                                                                                             adviser in Mozambique and Rwanda.
reducing reliance on air-conditioning (Atkinson et          context of IPCC mitigation reviews. Out of the 323 side
al, 2009).                                                  events at the COP15 conference in 2009 in                                                                                                                                                     Dr Neira is a Spanish national, and a medical doctor
                                                            Copenhagen, only one focused on health.                                                                                                                                                       by training. She specialised in Endocrinology and
Greener urban development could improve home siting                                                                                                                                                                                                       Metabolic Diseases and also obtained an
and construction to better protect from heat waves,         The very significant health gains and cost savings that                                                                                                                                       International Diploma in Emergency Preparedness
flooding and mudslides that may be caused by climate        can be realised through climate change mitigation                                                                                                                                             and Crisis Management.
change – while also improving access to public              policies are not typically considered in economic
transport, walking and cycling, to mitigate against         models that aim to guide decision-making on                                                                                                                                                   Among her many distinctions, Dr Neira has been
future climate change.                                      greenhouse gas emission reduction. This, in fact,                                                                                                                                             awarded the Médaille de l’Ordre national du Mérite by
                                                            can lead to incomplete evidence and a bias against                                                                                                                                            the Government of France and is a member of the
                                                            more sustainable and greener decisions! Finally,                                                                                                                                              Academy of Medicine, Asturias, Spain.
  “KNOCK-ON” BENEFITS                                       quantifiable health gains are not typically considered

Greening initiatives in one sector also can have other
indirect “knock-on” health benefits in other areas.
                                                            in the context of UNFCCC clean development
                                                            mechanisms used to finance many types of low-
                                                            carbon development.
                                                                                                                         “ INITIATIVESAND
                                                                                                                         FOR ‘GREEN
                                                                                                                         SAFE’ HOSPITALS
                                                                                                                                            REFERENCES
                                                                                                                                            Acharya J, Bajgain MS, Subedi PS,           Edwards P, Tsouros AD. A healthy city is     Development’s Regional Development           Remais J, Chen L, Seto, E. Leveraging
                                                                                                                                            “Scaling up biogas in Nepal, what else is   an active city: a physical activity          Mission for Asia (USAID/RDMA),               rural energy investment for parasitic
                                                                                                                         RECOGNISE          needed.” Boiling Point, 50;2005.            planning guide. Copenhagen: World            Bangkok, Thailand, April 2010.               disease control: shistosome ova
For instance, new programmes in China and Nepal to          WHO believes this can change. Initial findings from          THAT MANY OF                                                   Health Organization; 2008.                                                                inactivation and energy co-benefits of
develop household biogas installations for home             WHO’s series of reviews on Health in the Green               THE CARBON-        Atkinson J , Chartier Y , Pessoa-Silva                                                   Metz B, Davidson OR, Bosch PR, Dave          anaerobic digestors in rural China. PLoS

cooking not only provide people with a more efficient       Economy to be presented at the Cancun conference             EFFICIENT          C , Jensen P , Li Y and Seto WH ,           Fuel for life: household energy and          R, Meyer LA (eds). Contribution of           ONE, March 2009; 4:3: e4856.

and less-polluting source of home energy, but               cover the potential co-benefits to health of mitigation
                                                                                                                         MEASURES THAT      eds. Natural Ventilation for Infection
                                                                                                                                            Control in Health-Care Settings, World
                                                                                                                                                                                        health. Geneva, World Health
                                                                                                                                                                                        Organization, 2006.
                                                                                                                                                                                                                                     Working Group III to the Fourth
                                                                                                                                                                                                                                     Assessment Report of the                     Van den Ber, H. Reducing vector-borne
encourage the building of latrines to provide the fuel      action in: agriculture, transport, household energy,
                                                                                                                         ‘MITIGATE’         Health Organization, 2009.                                                               Intergovernmental Panel on Climate           disease by empowering farmers in
                                                                                                                         AGAINST FUTURE                                                 Global health risks, mortality and           Change, Cambridge University                 integrated vector management. Bulletin
source (Remais, 2009; Acharya, 2005).                       residential construction and health care facilities.         CLIMATE CHANGE     Aytur SA, Rodriguez DA, Evenson KR,         burden of disease attributable to            Press, 2007.                                 of the World Health Organization, Vol.
                                                                                                                         CAN ALSO BE        Catellier DJ. “Urban containment            selected major risks. Geneva, World                                                       85;7 (2007), pp. 561-566.
That is of considerable importance in light of the          These reviews will summarise current knowledge and           INTEGRATED WITH    policies and physical activity: A time-
                                                                                                                                            series analysis of metropolitan areas,
                                                                                                                                                                                        Health Organization, 2009.                   Pruss-Ustun A, et al, Preventing disease
                                                                                                                                                                                                                                     through healthy environments, towards        Wilkinson P, et al., “Public health
fact that some 2.6 billion people worldwide had             evidence of the health impacts of climate change             MEASURES THAT      1990-2002.” American Journal of             Kahn Ribeiro S, Kobayashi S, Beuthe M,       an estimate of the environmental burden      benefits of strategies to reduce
no access to a hygienic toilet or safe latrine in           mitigation strategies in different sectors and identify      IMPROVE            Preventive Medicine. 2008; 34: 320-332.     et al. “Transport and its infrastructure.”   of disease (2004 update of global            greenhouse gas emissions, household
2008 (WHO/UNICEF, 2010). Improved sanitation                opportunities for fine-tuning and strengthening              ADAPTATION TO                                                  In: Metz B, Davidson OR, Bosch PR,           statistics. Annex 2 tables). Geneva, World   energy.” The Lancet, 374 (9705):1917-
is a critical means of reducing deaths (1.9 million         existing policies to both enhance health and reduce          THE IMPACTS OF     Campbell-Lendrum D, Molyneux D, et al.      Dave R, Meyer LA, editors. Climate           Health Organization, 2009.                   1929.

people annually) from unsafe water and sanitation           our global carbon footprint. But this is only a first step   CLIMATE CHANGE     “Ecosystems and vector borne disease        Change 2007: Mitigation Contribution of
                                                                                                                                            control”, In: Ecosystems and human          Working Group III to the Fourth              Pruss-Ustun A, et al, Safer water, better     Woodcock J, Edwards P, Tonne C, et al.
(WHO, 2009).                                                towards ongoing, global and systematic reviews of the
                                                                                                                         ALREADY BEING      well-being: policy responses, Vol. 3.       Assessment Report of the                     health - Costs, benefits and                 “Public health benefits of strategies to
                                                                                                                         FELT               Findings of the Responses Working           Intergovernmental Panel on Climate           sustainability of interventions to protect   reduce greenhouse-gas emissions:

Despite their enormous potential, the health impacts
of climate change mitigation are not measured
                                                            evidence on climate change mitigation and health.

                                                            Our aim is to make the strategic, political and scientific
                                                                                                                             ”              Group, Millennium Ecosystem
                                                                                                                                            Assessment, London, 2005, pp.353-374.
                                                                                                                                                                                        Change. Cambridge University Press;
                                                                                                                                                                                        2007.
                                                                                                                                                                                                                                     and promote health. Geneva, World
                                                                                                                                                                                                                                     Health Organization, 2008.
                                                                                                                                                                                                                                                                                  urban land transport.” The Lancet.
                                                                                                                                                                                                                                                                                  2009 Dec 5;374(9705):1930-43.

systematically enough today. But it is possible to          case for placing greater emphasis on the health                                 Cavill N, Kahlmeier S, Racioppi F, eds.     Kroeger et al, Black carbon emissions in     Ramanathan V, Carmichael G. Global           Wright L, Fulton L. “Climate Change
                                                                                                                                            Physical activity and health in Europe:     Asia: sources, impacts and abatement         and regional climate changes due to          Mitigation and Transport in Developing
develop that knowledge with more health sector              dimension at COP16 as a way to improve public                                   evidence for action. Copenhagen: World      opportunities, report prepared for the       black carbon. Nature Geoscience.             Nations.” Transport Reviews.
research and involvement overall. Reviewing and             engagement, relevance, and effectiveness of climate                             Health Organization; 2006.                  US Agency for International                  2008; 1:221-227.                             2005;25(6):691-717.
consolidating such evidence, together with our              policy. A new and strengthened health focus, we

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Green Economic Development can be Good for Health

  • 1. 078 HEALTH HEALTH 079 study published last year in The Lancet, carried out indeed help combat air pollution. But some experts GREEN ECONOMIC with WHO participation, modelled effects on health in London and Delhi from low-emission vehicles and policies to increase “active travel” and reduce car contend that improved public transport, walking and cycling systems could potentially do much more – by attacking air pollution, obesity and traffic injury in DEVELOPMENT CAN BE travel. A combination of active travel and lower- emission motor vehicles was projected to reduce the number of years of life lost from ischaemic heart an integrated and cost-effective way (Wright and Fulton, 2005; Kahn Ribeiro et al, 2007; Woodcock et al, 2009). GOOD FOR HEALTH DR MARIA NEIRA, DIRECTOR OF THE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, disease by 10-19 per cent in London and 11-25 per cent in Delhi (Woodcock et al, 2009). In many cases, the health and health care cost savings resulting from climate change mitigation actions can also cover Sometimes, tradeoffs also need to be considered. For instance, improving the insulation quality of homes in developed countries offers one very WORLD HEALTH ORGANISATION (WHO) much of the cost of the interventions (Metz B, et al major climate change mitigation opportunity, eds., 2007). according to the reviews of the Intergovernmental Panel on Climate Change. Better insulation can also help protect against extreme heat and cold FINE-TUNING MITIGATION POLICIES TO waves that become more frequent with climate CONSIDER HEALTH change. However, in health terms, adequate provision for ventilation must also be assured to keep Significantly, some mitigation policies may be better down levels of indoor air pollution from dust and than others, in health terms. For instance, mitigation mould and chemicals that otherwise might build up in policies to encourage lower-emission vehicles can closed spaces. This is why more careful health assessment and s concerns mount over the long-term Right: Dr Maria Neira, analysis of mitigation policies is required in order to A risks of climate change to the planet’s health, there is a wave of interest in “green” economic development among UN and multi-lateral aid agencies, national THE HEALTH COST OF GREY, THE SAVINGS OF GREEN Overall, WHO estimates that nearly one-quarter Director, Department of Public Health and Environment, WHO, Geneva explore what combination of climate change mitigation policies can yield the most optimal health benefits in any given economic sector. Relative costs and benefits also need to be examined by diverse economies governments and industry. But can “green” economic of the global disease burden is attributable to and regions. initiatives also yield more immediate public environmental pollution and degradation, which could health benefits? be readily addressed by available technologies in various economic sectors (WHO, 2009). For instance, LEADING BY DOING Early findings emerging from a new series of global most deaths from indoor air pollution (2 million reviews by WHO of climate change mitigation policies annually) are due to leaky and inefficient household Mitigation policies can and should also be applied in key economic sectors say “yes”, health can be a energy systems that burn biomass fuels and coal, in the health sector itself to obtain better use winner in greener development strategies. and upon which 3 billion people still rely for fuel of health system resources. Currently, hundreds of (WHO, 2009). thousands of health clinics in Africa, Asia and Well-designed initiatives that curb greenhouse gas Latin America have no power at all. If such clinics emissions in energy, residential construction, However, much of this burden of disease could could be supplied with renewable electricity for basic transport, and agricultural systems can not only potentially be reduced or eliminated through improved needs from solar panels, the quality of health care enhance global public health, but also improve health access to cleaner-burning cookstoves or fuels now could potentially be improved, at little long term cost among poor populations and save scarce health becoming available in developing countries (Wilkinson to the planet. resources – in a relatively short time frame. P et al, 2009; WHO 2006). Concurrent reductions in stove emissions could also reduce the climate impacts In developing world cities, where power outages Better understanding of the multiple “win-win” of black carbon (USAID/RDMA, 2010; Ramanathan are often common, expanded hospital access to health and climate benefits that could be and Carmichael, 2008). renewable energy sources and on-site co-generation obtained from mitigation could help build support of heat and electricity could potentially provide for existing and future climate change agreements, The burden of disease from urban outdoor air pollution health facilities with more efficient, reliable and such as the one being negotiated in the talks (1.2 million deaths annually) and traffic injury (1.3 independent sources of energy for emergencies. in Cancún. million deaths annually) could similarly be addressed Building energy efficiencies into construction and by policies that promote more compact urban the use of medical devices can help hospitals, large Embracing “health-enhancing” low-carbon strategies development around public transport corridors as well or small, and in developing or developed countries, can allow policy-makers to demonstrate positive health as “active” transport by walking and cycling. An ever better rationalise resources. and wealth-generating results within a period of years growing body of literature indicates that active – while averting devastating long-term impacts to transport to work, school and shopping can also Recognising these realities, the health sector is already the planet. address obesity-related diseases caused by physical “leading” with its own “greening” initiatives. Hospitals inactivity (3.2 million deaths annually) (Aytur, et al, in a number of Chinese cities recently launched The general public can potentially be motivated to 2008; WHO, 2006; WHO, 2008). programmes to promote “green and safe” hospitals – adopt more sustainable lifestyles when there is better that can function better in emergencies. From the UK’s understanding of how such measures also improve Recent modeling of cities in developed and developing National Health Service to small NGOs at the grass personal health and well-being in tangible ways. countries indicated that the potential is huge. A major roots, health facilities are launching energy audits and
  • 2. 080 HEALTH HEALTH 081 examining how carbon efficiencies can benefit both partners and stakeholders, is a key aim of WHO’s believe, can revitalise climate change processes the planet and health. climate change adaptation and mitigation efforts. and lead to future climate change agreements that take the biggest step yet towards global health in Such efforts can help strengthen the global human history. “ADAPTIVE” MITIGATION community’s capacity to protect health from climate change and thus reap more immediate and wider Initiatives for “green and safe” hospitals recognise that benefits from strong mitigation polices. ABOUT THE AUTHOR many measures that “mitigate” against future climate change can also be integrated with measures that Dr Maria P. Neira was appointed Director of the improve adaptation to the impacts of climate change GETTING HEALTH ON THE CLIMATE Department of Public Health and Environment at already being felt. Other such “adaptive mitigation” CHANGE AGENDA the World Health Organisation, Geneva, Switzerland measures could include: in September 2005. Prior to that, she was Vice- To date, health issues have been marginal in the Minister of Health and President of the Spanish Integrated vector management, which combines climate talks – even though “adverse effects of climate Food Safety Agency. environmental management with wise use of change on the economy, public health and the quality chemicals, can help combat climate change-induced of the environment” were noted in the first United She had previously held senior positions in WHO as changes in vector borne disease transmission, while Nations Framework Convention on Climate Change as Director of the Control, Prevention and Eradication also reducing long-term environmental impact of the three critical arenas of global climate-related Programme on Communicable Diseases and as chemicals (van den Berg et al, 2007; Campbell- commitment (UN,1992). Coordinator of the Global Task Force on Cholera Control. Lendrum, et al, 2005). Less than 2 per cent of the international funding on Dr Neira began her career as a field physician and Improved home and hospital design to facilitate climate change adaptation goes to protect health, and medical coordinator working with refugees in El natural ventilation can improve air flows for better there has been no systematic quantification of Salvador and Honduras and later as a public health infection control and heat wave resilience while potential health opportunities and funding in the adviser in Mozambique and Rwanda. reducing reliance on air-conditioning (Atkinson et context of IPCC mitigation reviews. Out of the 323 side al, 2009). events at the COP15 conference in 2009 in Dr Neira is a Spanish national, and a medical doctor Copenhagen, only one focused on health. by training. She specialised in Endocrinology and Greener urban development could improve home siting Metabolic Diseases and also obtained an and construction to better protect from heat waves, The very significant health gains and cost savings that International Diploma in Emergency Preparedness flooding and mudslides that may be caused by climate can be realised through climate change mitigation and Crisis Management. change – while also improving access to public policies are not typically considered in economic transport, walking and cycling, to mitigate against models that aim to guide decision-making on Among her many distinctions, Dr Neira has been future climate change. greenhouse gas emission reduction. This, in fact, awarded the Médaille de l’Ordre national du Mérite by can lead to incomplete evidence and a bias against the Government of France and is a member of the more sustainable and greener decisions! Finally, Academy of Medicine, Asturias, Spain. “KNOCK-ON” BENEFITS quantifiable health gains are not typically considered Greening initiatives in one sector also can have other indirect “knock-on” health benefits in other areas. in the context of UNFCCC clean development mechanisms used to finance many types of low- carbon development. “ INITIATIVESAND FOR ‘GREEN SAFE’ HOSPITALS REFERENCES Acharya J, Bajgain MS, Subedi PS, Edwards P, Tsouros AD. A healthy city is Development’s Regional Development Remais J, Chen L, Seto, E. Leveraging “Scaling up biogas in Nepal, what else is an active city: a physical activity Mission for Asia (USAID/RDMA), rural energy investment for parasitic RECOGNISE needed.” Boiling Point, 50;2005. planning guide. Copenhagen: World Bangkok, Thailand, April 2010. disease control: shistosome ova For instance, new programmes in China and Nepal to WHO believes this can change. Initial findings from THAT MANY OF Health Organization; 2008. inactivation and energy co-benefits of develop household biogas installations for home WHO’s series of reviews on Health in the Green THE CARBON- Atkinson J , Chartier Y , Pessoa-Silva Metz B, Davidson OR, Bosch PR, Dave anaerobic digestors in rural China. PLoS cooking not only provide people with a more efficient Economy to be presented at the Cancun conference EFFICIENT C , Jensen P , Li Y and Seto WH , Fuel for life: household energy and R, Meyer LA (eds). Contribution of ONE, March 2009; 4:3: e4856. and less-polluting source of home energy, but cover the potential co-benefits to health of mitigation MEASURES THAT eds. Natural Ventilation for Infection Control in Health-Care Settings, World health. Geneva, World Health Organization, 2006. Working Group III to the Fourth Assessment Report of the Van den Ber, H. Reducing vector-borne encourage the building of latrines to provide the fuel action in: agriculture, transport, household energy, ‘MITIGATE’ Health Organization, 2009. Intergovernmental Panel on Climate disease by empowering farmers in AGAINST FUTURE Global health risks, mortality and Change, Cambridge University integrated vector management. Bulletin source (Remais, 2009; Acharya, 2005). residential construction and health care facilities. CLIMATE CHANGE Aytur SA, Rodriguez DA, Evenson KR, burden of disease attributable to Press, 2007. of the World Health Organization, Vol. CAN ALSO BE Catellier DJ. “Urban containment selected major risks. Geneva, World 85;7 (2007), pp. 561-566. That is of considerable importance in light of the These reviews will summarise current knowledge and INTEGRATED WITH policies and physical activity: A time- series analysis of metropolitan areas, Health Organization, 2009. Pruss-Ustun A, et al, Preventing disease through healthy environments, towards Wilkinson P, et al., “Public health fact that some 2.6 billion people worldwide had evidence of the health impacts of climate change MEASURES THAT 1990-2002.” American Journal of Kahn Ribeiro S, Kobayashi S, Beuthe M, an estimate of the environmental burden benefits of strategies to reduce no access to a hygienic toilet or safe latrine in mitigation strategies in different sectors and identify IMPROVE Preventive Medicine. 2008; 34: 320-332. et al. “Transport and its infrastructure.” of disease (2004 update of global greenhouse gas emissions, household 2008 (WHO/UNICEF, 2010). Improved sanitation opportunities for fine-tuning and strengthening ADAPTATION TO In: Metz B, Davidson OR, Bosch PR, statistics. Annex 2 tables). Geneva, World energy.” The Lancet, 374 (9705):1917- is a critical means of reducing deaths (1.9 million existing policies to both enhance health and reduce THE IMPACTS OF Campbell-Lendrum D, Molyneux D, et al. Dave R, Meyer LA, editors. Climate Health Organization, 2009. 1929. people annually) from unsafe water and sanitation our global carbon footprint. But this is only a first step CLIMATE CHANGE “Ecosystems and vector borne disease Change 2007: Mitigation Contribution of control”, In: Ecosystems and human Working Group III to the Fourth Pruss-Ustun A, et al, Safer water, better Woodcock J, Edwards P, Tonne C, et al. (WHO, 2009). towards ongoing, global and systematic reviews of the ALREADY BEING well-being: policy responses, Vol. 3. Assessment Report of the health - Costs, benefits and “Public health benefits of strategies to FELT Findings of the Responses Working Intergovernmental Panel on Climate sustainability of interventions to protect reduce greenhouse-gas emissions: Despite their enormous potential, the health impacts of climate change mitigation are not measured evidence on climate change mitigation and health. Our aim is to make the strategic, political and scientific ” Group, Millennium Ecosystem Assessment, London, 2005, pp.353-374. Change. Cambridge University Press; 2007. and promote health. Geneva, World Health Organization, 2008. urban land transport.” The Lancet. 2009 Dec 5;374(9705):1930-43. systematically enough today. But it is possible to case for placing greater emphasis on the health Cavill N, Kahlmeier S, Racioppi F, eds. Kroeger et al, Black carbon emissions in Ramanathan V, Carmichael G. Global Wright L, Fulton L. “Climate Change Physical activity and health in Europe: Asia: sources, impacts and abatement and regional climate changes due to Mitigation and Transport in Developing develop that knowledge with more health sector dimension at COP16 as a way to improve public evidence for action. Copenhagen: World opportunities, report prepared for the black carbon. Nature Geoscience. Nations.” Transport Reviews. research and involvement overall. Reviewing and engagement, relevance, and effectiveness of climate Health Organization; 2006. US Agency for International 2008; 1:221-227. 2005;25(6):691-717. consolidating such evidence, together with our policy. A new and strengthened health focus, we