Health sec­tor must join de­bate on cli­mate change

It must am­plify mes­sage after re­ports that global air pol­lu­tion is be­hind many deaths


THE time is now for the health sec­tor to join the en­vi­ron­men­tal and cli­mate de­bate!

For com­mu­nity peo­ple air pol­lu­tion has since the 1990s been a fram­ing for en­vi­ron­men­tal jus­tice, es­pe­cially those liv­ing next to oil re­finer­ies, as in south Dur­ban, Sa­sol­burg and Ta­ble View, Cape Town.

To­day, the World Health Or­gan­i­sa­tion (WHO), and our very own Pub­lic Health As­so­ci­a­tion and the Acad­emy of Science of South Africa have come out and pub­licly chal­lenged poor gov­er­nance that leads to air pol­lu­tion. We are fac­ing a cri­sis!

Air pol­lu­tion has be­come a greater health risk than cig­a­rette smok­ing; 90% of the global pop­u­la­tion breathes pol­luted air. Air pol­lu­tion has the same driv­ers as cli­mate change – pol­lut­ing in­dus­try and the burn­ing of fos­sil fu­els.

This is widely con­sid­ered the great­est pub­lic health chal­lenge of the 21st cen­tury, threat­en­ing all as­pects of so­ci­ety. The WHO has de­clared air pol­lu­tion as a “global pub­lic health emer­gency”, and along with cli­mate change, the num­ber 1 threat to pub­lic health.

The Global Bur­den of Dis­ease, an in­ter­na­tional pro­gramme which mea­sures and as­sesses mor­tal­ity from ma­jor dis­eases shows that for the African re­gion the com­bined deaths from house­hold air pol­lu­tion in Africa amounts to ap­prox­i­mately 1 mil­lion deaths a year (am­bi­ent air pol­lu­tion 439 000 deaths, house­hold air pol­lu­tion 791 000 deaths).

Am­bi­ent air is the air we breathe daily. Air pol­lu­tion is known to cause pre­ma­ture deaths from lung can­cer, is­chaemic heart dis­ease, chronic ob­struc­tive pul­monary dis­ease, strokes, and lower res­pi­ra­tory in­fec­tion.

This bur­den of dis­ease and dis­abil­ity is es­ti­mated to cost us up to 3.8% of Africa’s GDP.

A 2017 re­port, by Dr Michael Hol­land, ti­tled “Health im­pacts of coal-fired power plants in South Africa”, as­sessed the health im­pacts and as­so­ci­ated eco­nomic costs of emis­sions from Eskom’s coal-fired power sta­tions.

This re­port con­firms that the health im­pact of coal-fired power plants in South Africa cre­ates a sub­stan­tial bur­den on hu­man health, lead­ing to 2 239 equiv­a­lent at­trib­ut­able deaths an­nu­ally, as well as 2 781 cases of bron­chi­tis in adults, and 9 533 episodes in chil­dren, to­gether with other re­lated res­pi­ra­tory re­lated dis­eases in adults and chil­dren each year.

These neg­a­tive health im­pacts are likely to be mostly ex­pe­ri­enced by dis­ad­van­taged mem­bers of so­ci­ety.

Linked to this are the high costs as­so­ci­ated with the health im­pacts of coal-fired power sta­tions and mines in South Africa.

The study by Hol­land finds that the to­tal quan­tifi­able eco­nomic cost of air pol­lu­tion from coal­fired gen­er­a­tion in South Africa is in the re­gion of R34.9 bil­lion a year.

This is made up of im­pacts in terms of early death, chronic bron­chi­tis, hos­pi­tal ad­mis­sions for res­pi­ra­tory and car­dio­vas­cu­lar dis­ease, and a va­ri­ety of mi­nor con­di­tions lead­ing to re­stric­tions on daily ac­tiv­ity, in­clud­ing lost eco­nomic pro­duc­tiv­ity.

Hol­land’s re­port ex­cluded the sig­nif­i­cant im­pacts on air pol­lu­tion from min­ing (such as coal dust), trans­port of coal and con­tam­i­na­tion of wa­ter. Health pro­fes­sion­als, es­pe­cially those in the pub­lic sphere, have a duty of care to­wards cur­rent and fu­ture gen­er­a­tions.

Cli­mate change will only ex­ac­er­bate this man­made health epi­demic, in ad­di­tion to its own health im­pacts. This is more than an en­vi­ron­men­tal prob­lem. This is a pub­lic health cri­sis that re­quires the pub­lic health com­mu­nity to be part of the so­lu­tion – and it has the power to do so.

The time is now for the health sec­tor to join the en­vi­ron­men­tal and cli­mate de­bate! Health must take over­sight of air pol­lu­tion for South Africa be­cause the en­vi­ron­men­tal min­istry has failed over the past 15 years!

This is ac­cord­ing to a re­cent as­sess­ment of the Na­tional En­vi­ron­men­tal Man­age­ment Air Qual­ity Act after im­ple­men­ta­tion by weather and pub­lic health sci­en­tists. The im­pli­ca­tion is that the leg­is­la­tion is fail­ing to re­duce air pol­lu­tion!

Ad­vo­cated by dirty in­dus­try and con­strained en­vi­ron­men­tal min­istries, we of­ten en­counter the ar­gu­ment that en­vi­ron­men­tal degra­da­tion and pol­lu­tion are in­evitable con­se­quences of de­vel­op­ment in our re­gion.

De­vel­op­ment and pol­lu­tion go hand in hand. How­ever, ad­dress­ing ex­ist­ing en­vi­ron­men­tal degra­da­tion and em­bark­ing on a just tran­si­tion through rein­vest­ment in re­new­able en­ergy and pro­vid­ing bet­ter ser­vices and houses for peo­ple, of­fers us a unique op­por­tu­nity to ad­dress health and so­cial in­equal­ity.

This has also shown to be a suc­cess­ful global strat­egy to help slow cli­mate change and re­duce the pub­lic health and eco­nomic risks of fos­sil fuel in­vest­ments. In ef­fect a re­turn on in­vest­ment, through mea­sur­able en­vi­ron­men­tal im­prove­ments and re­duced health costs.

In con­trast, a busi­ness as usual sce­nario will con­tinue to place our way of life at risk, marginalis­e work­ers who are in­evitably los­ing their coal sec­tor jobs and ex­clude the poor from “de­vel­op­ment” who can’t af­ford elec­tric­ity at cur­rent prices any way.

In South Africa, it’s not that we lack reg­u­la­tions on air pol­lu­tion, it’s the po­lit­i­cal will and fore­sight to im­ple­ment these poli­cies that is se­verely con­strained by those who hold the reins of power.

Air qual­ity mon­i­tor­ing and re­port­ing is of­ten de­lib­er­ately left to de­te­ri­o­rate through wil­ful ne­glect, and our en­vi­ron­men­tal min­istry plays sec­ond fid­dle to the po­lit­i­cally con­nected within the de­part­ments of min­er­als and en­ergy along en­trenched party pa­tron­age sup­ply lines.

Nurses, doc­tors and phar­ma­cists con­sis­tently rank among the most trusted pro­fes­sions glob­ally.

How­ever, it is not suf­fi­cient to treat peo­ple’s ill­nesses with­out chang­ing the con­di­tions which make them sick in the first place. The en­vi­ron­ment is re­spon­si­ble for 23% of the global bur­den of dis­eases – this is from the WHO and the call to ac­tion is for the health sec­tor to be­come more vested and ar­tic­u­late the health im­pacts to ad­dress the cli­mate and global air pol­lu­tion cri­sis. There is an ur­gent and im­me­di­ate need for health voices to am­plify health mes­sages and join the cli­mate and health move­ment!

Euripi­dou is an en­vi­ron­men­tal epi­demi­ol­o­gist at the Lon­don School of Hy­giene and Trop­i­cal Medicine in the UK. Euripi­dou’s in­ter­ests lie in work­ing on is­sues of en­ergy and chem­i­cals pol­icy, cli­mate change and pub­lic health.

A RE­PORT HAS con­firmed that the health im­pacts of coal-fired power plants in South Africa cre­ate a sub­stan­tial bur­den on hu­man health, lead­ing to 2 239 equiv­a­lent at­trib­ut­able deaths an­nu­ally. | African News Agency

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