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Health and environment.

Human beings are entitled to a healthy and productive life and should be able to live in harmony with nature. This calls for proper linkage of health aspects with environmental health protection an emerging subject of intense debate and discussion at local, national, and international forums.

In his keynote address during the Third International Conference on Health and Environment: Global Partners for Global Solutions, The Honorable Dato' Mohd Farid Ariffin, Deputy Minister of Health of Malaysia, emphasized that the causes of environmental degradation are numerous. Activities in the name of development, aimed to elevate the quality of life, have resulted in the deterioration of the very resources that are needed for sustaining life, such as food, water, air, and soil. Rapid population growth and increasing poverty, two major factors affecting environment, development, and health in the world, are exerting heavy pressures on natural resources and the capacity of natural resources and the capacity of natural ecosystems to support human activity. He continued that it must be realized that the capacity of the natural environment is limited and this fact cannot be ignored if the goal is to enhance and improve the health and well being of world citizens. It must also be realized that health is closely related to development and the environment. However in many parts of the world, very little attention is paid to health aspects when environment and development are considered.

The warning bells have been sounded from as far back as 1913 when arsenic poisoning was reported in Argentina to as recent as the deaths in South Africa caused by drowning in toxic sludge.

In developing countries, the major environmental health concerns are still those environmental factors contributing to the spread of infectious diseases, all of which require provision of safe water, basic sanitation, adequate shelter, availability of food and handling practices, controlling disease vectors, and agricultural hazards.

In contrasts, the environmental health problems in developed countries are related to hazards that are related to environmental pollution and lifestyles which are based on higher consumption of natural resources, some of which include emissions from motor vehicles, industrial and municipal waste discharges, toxic and hazardous waste, unhealthy diet, alcohols, smoking, and drug abuse.

Both the public sector and the private sectors in many countries are spending large sums of money to solve environmental problems, but not enough is targeted towards preventing these problems. There is a great deal of disagreement and confusion regarding the environmental health protection priorities, goals, and the allocation of resources.

Without a comprehensive and coordinated approach to environmental health protection, it will be impossible to properly balance the risks and the resources needed to address the risks. Talking of risks, I may say that the most critical environmental problem of today and in the future is and will be how we identify risks, assess these risks, define them, thoroughly understand these risks, prioritize them, and communicate these risks to all citizens. In doing so it becomes very critical also on how we handle the gap between scientific and public perception of environmental health risks.

The actions of the past are irreversible, and the release of more than three and a half billion pounds of toxic chemicals into the environment, as estimated by the United States Environmental Protection Agency, has resulted in various adverse health impacts. Two-thirds of cancers, for example, have been attributed to environmental problems which could have been prevented. Other adverse health impacts are seen in the damage to the developing nervous system of children from lead contamination, decreased male sterility from debromochloropropane, as well as the largest cholera epidemic ever recorded which occurred in Peru in 1991.

Healthy environments and healthy populations are closely linked, and to ensure that environmental degradation does not adversely affect public health, appropriate planning decisions have to be made which more than just prevent or counter the problem of environmental pollution. It requires an active maintenance and promotion of health through improved social amenities and living and working environments.

Environmental health is by its nature an area which can draw considerable public interest. Therefore, it is necessary to formulate environmental health protection programs which identify vulnerable groups and their health risks and also to ensure that social factors which underlie these risks are taken into account in development policies and decisions.

Environmental health impact assessments should specifically report and comment on potential effects on human health rather than just providing data on point source emissions and ambient levels of pollutants. This then calls for the development of indicators of community health which can be derived from public health surveillance activities or pollution incidents and epidemiologic studies of disease clusters, which should all be integrated into a national environmental health database. Public health authorities could play a major role in constantly developing indicators of environment health and refining these indicators to improve the predictive availability of health impact assessments where such indicators are used.

It is important to maintain as a principle, that environmental health impact assessment is not considered a parallel process but rather an integral part of the environmental impact assessment process. This can be achieved through legislation which requires health impacts to be addressed explicitly in EIAs, development of health impact guidelines, development of avenues impact guidelines, development of avenues for access to health expertise and community input at different stages of the EIA process, and the clarification of roles between agencies.

As any other developing country, Malaysia has to balance its development priorities against effective environmental and health management. The impact of environmental measures on national economy will have to be considered along with the implications of affecting foreign investment as against a well-regulated environment.

Nevertheless, in achieving this economic growth. Malaysia recognizes that the well being of the people cannot be ignored or compromised since their health is fundamental to a nation's development and progress. Also, recognizing the fact that the health of the people is inextricably linked to a sound environment, Malaysia strives to strike a balance between economic growth and sustainable development.

Towards the achievement of sustainable development, health and socio-economic objectives, such as eradication of poverty and equity of benefits, have been incorporated as development priorities. Hence, Malaysia has integrated the main themes of Agenda 21 into its national policies and continues to pursue the integration of other Agenda 21 themes.

Malaysia is also taking steps to be a party to the Based Convention and currently observes and complies with the recommended guidelines on toxic and hazardous waste. Steps are also being taken to plan and design permanent treatment and disposal sites for toxic and hazardous waste derived from electronic industries, metal electroplating industries, and other industries related to chemicals, rubber, plastics, printing, packaging, tanneries, and pharmaceuticals.

While Malaysia promotes cooperation, involvement, and consultation with various groups including NGO's, a legislative framework has been set in place in order to achieve the goals of sustainable development principle. Among these is the Environmental Quality Act of 1974, amended in 1984, and its 17 subsidiary regulations which collectively aim to prevent, abate, and control pollution. The Environmental Impact Assessment Order of 1987 requires EIA studies to be conducted for any proposed development falling under the definition of prescribed activities. This very move has set in motion awareness in preventing and mitigating environmental problems. This is a holistic legislation to ensure that there are adequate and effective environmental considerations. During planning of development activities and projects, 19 categories of development activities require that EIA reports be submitted. These include agricultural land reclamation, housing, industry, infrastructure, waste treatment and disposal, and water supply. The EIA order is a legislative procedure for approving or rejecting the report about the project, not the project itself. It acts as a mechanism for improving planning of redevelopment projects, determining when effects are unacceptable and deciding methods for avoiding some effects and mitigating the remainder.

Apart from these, Malaysia has geared itself towards the improvement of environmental health as is evidenced by the incentives announced in the 1994 budget which among other things provide for tax exemptions for investment in timber plantations, catalytic converters, and other pollution control equipment, as well as the 2.7% reduction in the price of unleaded fuel. An extensive healthcare system is in place which not only provides basic healthcare services and promotion of hygienic practices among the rural population but is able to control, prevent, and treat tropical disease, as well as disease of modern living, such as cardiovascular disease and cancer.

Eighty nine percent of Malaysians will have access to piped, treated public water by 1996. In 1988, a national action plan was developed for municipal solid waste management which identified the scope for combining recycling incineration, and sanitary landfilling coupled with efficient collection systems as important components for improving cleanliness in the urban areas. Currently, the privatization of solid waste management services is being implemented which will then provide extensive and efficient waste management services throughout the country.

In pursuit of implementing Agenda 21, three functions are seen as necessary: capacity building to provide the human resource and the skills, technology transfer to provide the facilities and techniques, and the financial resources to support sustainable development and promote environmental health. Since environmental health issues are multisectorial and transboundary in nature, international partnerships and commitments in terms of adequate financing, appropriate trade conditions, and technology transfer become essential.

In the partnerships that are developed, it must be borne in mind that the poorer developing countries face a more difficult challenge where in they have to combat both the traditional health problems of diarrheal diseases, vector-borne diseases, and parasitic infections, as well as the emerging environmental health problems resulting from development. Thus the standard for environmental health must be realistic so as not to preclude resources essential for addressing more pressing problems.

It must also be borne in mind that developing countries need to continually strive for development. The challenge they face is that it cannot be done at the expense of the environment. In addition, a large number for developing countries are not equipped and prepared to integrate health into their development planning or even to deal with the most pressing environmental problems confronting them.

This issue is even more critical in rapidly industrializing countries where capability building falls far short of the increasing impact of pollution on the environment and the depletion of natural resources. In many countries, I must point out, there have not been active involvement of health authorities in development and environmental management, and I hope that the WHO's Global Strategy for Health and Environment will seek increased health intervention of all future developmental activities.

Standards must be set in the spirit of global partnership to solve global problems such as global warming, ozone depletion, and acid rain which cannot be solved singularly by any one nation. There must be recognition of shared, albeit differentiated responsibilities among all nations and a strong commitment towards sustainable development for the benefit of all peoples today and tomorrow.

This sense of responsibility and commitment may perhaps be strengthened by remembering that "the world was not bequeathed to us by our parents but rather entrusted to us by our children."
COPYRIGHT 1995 National Environmental Health Association
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Copyright 1995, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:International Perspectives; excerpt from speech by the Malaysian Deputy Minister for Health Dato' Mohd Farid Ariffin
Publication:Journal of Environmental Health
Date:Apr 1, 1995
Previous Article:Proposed method for isolation of Escherichia coli 0157:H7 from environmental samples.
Next Article:Plague in India posed little threat to U.S. public health.

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