A HU­MAN RIGHT

New Straits Times - - News - The writer is a con­sul­tant re­s­pi­ra­tory physi­cian at Pan­tai Hos­pi­tal Kuala Lumpur and co-founder of Asthma Malaysia, Malaysia’s first asthma patient ad­vo­cacy plat­form

common trig­gers in­clude cock­roaches, dust mites, air con­di­tion­ers, to­bacco smoke and air pol­lu­tion.

The lat­ter two are ar­guably best ad­dressed at a higher pol­icy level. To­bacco smoke, which is es­sen­tially a form of air pol­lu­tion, is best ad­dressed by a holis­tic to­bacco con­trol pol­icy that re­duces the de­mand for to­bacco as well as that of pro­duc­tion, dis­tri­bu­tion, avail­abil­ity and sup­ply. To­bacco is unique in that when used as in­tended, the con­sumer dies. Add the hun­dreds of mil­lions of smok­ers world­wide and you get mass ex­ha­la­tion of thou­sands of chem­i­cals that not only ir­ri­tate the air­ways, but can cause coro­nary heart disease and em­phy­sema.

There are lo­cal fac­tors that con­trib­ute to poor air qual­ity, such as traffic con­ges­tion, which can also be ad­dressed by ap­pro­pri­ate ur­ban and de­vel­op­men­tal poli­cies. Mov­ing be­yond, one can be­gin to ap­pre­ci­ate the ne­ces­sity for ap­pro­pri­ate gov­ern­ment poli­cies when deal­ing with en­ergy mat­ters at a na­tional level and the need for in­ter­gov­ern­men­tal co­op­er­a­tion when ad­dress­ing pol­lu­tion at a global level.

One such is­sue that the world is strug­gling with is that of en­ergy pol­icy. Europe is com­mit­ted to mov­ing away from coal as a source of en­ergy. Al­though the cheap­est, coal is also the high­est emit­ter of car­bon diox­ide. This con­trasts with Ja­pan, which is in­creas­ing its coal use fol­low­ing the re­cent safety con­cerns about their nu­clear-de­rived en­ergy sources.

The En­ergy Com­mis­sion of Malaysia main­tains a pol­icy that pri­ori­tises af­ford­abil­ity for the peo­ple. Al­most 50 per cent of the to­tal fuel mix in Penin­su­lar Malaysia is from coal, with the com­mis­sion aim­ing to in­crease this to two-thirds by 2025. On pa­per, this makes sense as coal is both cheap and abun­dant, but this comes with added en­vi­ron­men­tal and health costs.

Gov­ern­ment poli­cies will not change if both the peo­ple and pol­i­cy­mak­ers fo­cus only on im­me­di­ate fi­nan­cial costs. We tend to for­get di­rect health-re­lated fi­nan­cial costs of poor air qual­ity, such as in­creased hos­pi­tal ad­mis­sions and use of medicine, as well as the in­di­rect costs to the econ­omy from loss of work pro­duc­tiv­ity and days off from school, which af­fect work­ing par­ents.

Poor air qual­ity also af­fects chil­dren’s growth, rob­bing them of their full po­ten­tial. And, we have not even touched on the cost to our en­vi­ron­ment and ef­fect on cli­mate change.

This il­lus­trates the need to think be­yond tra­di­tional si­los when deal­ing with our health and the fu­ture. How­ever, we have to start at a more ba­sic level. Poli­cies usu­ally re­flect so­ci­ety’s cur­rent think­ing and, as such, ed­u­ca­tion and aware­ness among the peo­ple need to be in­creased to in­duce a par­a­digm shift in our ap­proach.

This brings us full cir­cle back to the theme for this year’s World Asthma Day. As with any ad­vo­cacy ini­tia­tive, the goal is to create aware­ness and kick-start a dis­cus­sion that will hope­fully bear fruit. Al­though pa­tients with asthma will un­doubt­edly have more short-term com­pli­ca­tions from poor air qual­ity, the same is­sue af­fects all of us one way or an­other. It is high time we recog­nise clean air for what it is — a fun­da­men­tal hu­man right.

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