Health-Environment and Sustainable

[OKKAR66129@xxxxxxx]

Subject: Health-Environment and Sustainable Development 

The New Light of Myanmar
Sunday, 26 December, 1999

Health-Environment and Sustainable Development 

Introduction

At the dawn of the 21" century, Myanmar, with the aim for the emergence of a 
peaceful, modern and developed Nation, is embarking on programmes for the all 
round national development and promoting the quality of life of the people. 
The State Peace and Development Council has laid down four Political 
objectives, four Economic objectives and four Social objectives. Myanmar is 
implementing market oriented economic system and taking appropriate measures 
for increasing participation of the private sector in economic activities and 
promoting efficiency of State Economic Enterprises.

In line with the four social objectives, the State Peace and Development 
Council has set up Myanmar Nain Ngan Education Committee for proper guidance 
towards development of education and the National Health-Committee which laid 
down the National Health Policy for health sector development. The Ministry 
of Health has taken the responsibility to implement the National Health Plans 
in line with the National Health Policy.

Myanmar has become a member country of Association of South-East Asian 
countries (ASEAN) and BIMSTEC (Bangladesh, India, Myanmar, Sri Lanka and Thai 
Economic Council) and therefore has opened the opportunities for the 
development of the country.

The National Health Committee has adopted the National Heal* Policy to 
achieve one of the social objectives which is "uplift of health, fitness and 
educational standards of the entire nation". Strong political commitment has 
been evident for the fundamental values of solidarity. social justice and 
self-determination. Myanmar is committed to achieving goals of HFA 2000 and 
has firmly adopted the primary health care approach since its inception at 
Alma-Ata in 1978. Successive health plans have been implemented over the last 
two decades and currently the National Health Plan (1996-2001) is being 
implemented. It is imperative that in order to have proper perspective for 
health development in the 21st century it is necessary to review and assess 
the past and on going programmes regarding the achievements and constraints 
i.e. successes and failures for developing effective plans for the 21st 
century.

Integration of Health Environment and Sustainable Development

Every parent hopes that their newborn child will enjoy a healthy, happy and 
long life, as good-health-has been a fundamental aim in every culture. The 
living environment is a cornerstone for good health. Almost all babies are 
born with the capacity to survive for at least seventy years. But a large 
percentage of them do not live long lives because of the poor quality of the 
environment into which they are born and in which' they are grown up. In some 
of the "least developed countries", more than 20% of children die before they 
reach the age of 5. In a typical "developed country", however, less than 1% 
of children will do so. If We all live in an environment that is supportive 
for health and if we enjoy good nutrition and housing, safe water and 
sanitation, receive vaccinations against key communicable diseases, and avoid 
unhealthy activities such as tobacco smoking, most of us would survive for at 
least 70 years. Protection of environment and health should therefore be 
understood as a constantly active and vigilant process, that needs to be 
integrated into economic development.

About 6000 million people living on Earth today, about 80% live in the 
developing countries (UN, 1995). Current annual population growth is about 90 
million, most of it occurring in developing countries. In many countries this 
increase is creating great difficulties in meeting the basic needs of 
populations and leading to pressure on environmental resources.

>From Stockholm To Rio And Beyond

The Earth Summit held in Rio de Janeiro, Brazil, in June 1992 heralded a new 
approach to national and international development, and environment planning. 
By adopting the principles of the Rio Declaration and Agenda 21 (UN, 1993) as 
the route to sustainable development in the 21st Century, the world's leaders 
recognized-the importance of investing in improvements to people's health and 
their environment as a prerequisite for sustainable deve10pment.

The Rio process has its roots in the 1972 Stockholm Conference, which was the 
first big UN conference on the environment. In the twenty years between 
Stockholm and Rio, global environmental threats and the link between 
environment add development and human well-being were recognized, and the 
concept of "sustainable development" made a mainstream issue by the 
Brundtland Commission (WCED, l987).

Sustainable development is defined by the Brundtland Commission as 
"development that meets the need of the present without compromising the 
ability of future generations to meet their own needs" (WCED, 1987). It 
incorporates many elements, and all sectors, including the "health sector" 
must contribute to achieving it.

Although policy makers and national planners have accepted the fact that the 
improvement in health and environment as social imperatives, the argument 
still erupts concerning the right balance between allocation of resources for 
protection of environment and health and allocation of resources for economic 
development.

Economic growth is being constrained countries by water shortages and land 
degradation, by an increasing number of environmental health problems caused 
or aggravated by crowded and squalid conditions in peri-urban settlements, 
and by increasing amounts of domestic and industrial waste (WHO,1992). More 
recently, awareness has increased of the links between economic growth and 
environmental protection, and of the need to adopt sustainable development 
strategies that both preserve the environment and enhance quality of life.

Since the Earth Summit, commitment to securing human health and a healthy 
environment has become widespread, as evidenced by a number of declarations 
and statement that have emanated from recent international conferences. At 
national level, many countries have formulated or are in the process of 
formulating sustainable development plans that give increase weight to 
health-and-environment concerns, However, these plans need to be supported 
and implemented by all sectors contributing to economic development and 
progress towards sustainable development needs to be monitored.

The Global environment outlook report (UNEP, 1997), contains progress on 
several fronts, particularly in the form of national and international 
awareness, and commitments to environmental protection. However it notes that 
"from a global perspective the environment has continued to degrade" (UNEP, 
1997). Similarly, the World Bank (1997) reports progress in the integration 
of the environmental concerns into all aspects of development programmes, but 
comments that "funding for environmental programmes remains inadequate". 
Furthermore, it remains to be seen whether the current trend towards 
"restructuring", "privatization" and "globalization" will be compatible with 
"sustainability". Universal declaration of human rights (UN, 1948) states 
that everyone has the right to a standard of living adequate to maintaining 
the health and well-being of themselves and their family, including food, 
clothing, housing, healthcare and the necessary social services.

Health is now a concern for almost every sector in society and not just the 
"health sector". Thus, it is understood that appropriate developments must 
occur in agriculture, industry and energy if sustainable health improvements 
are to be attained. At the same time, the health sector has an important role 
as advocate and guide for healthy development.

It will be appropriate to mention some of the key elements of declarations 
and statements of international conferences of particular relevance to human 
health.

?Rio Declaration, "Human beings are at the centre of concerns for sustainable 
development. They are entitled to a healthy and productive life in harmony 
with nature" (UNCED, Rio de Janeiro, Brazil, 1992)

?"All countries should give priority to measures' that improve the quality of 
life and health by ensuring a safe and sanitary living environment for all 
population groups through measures aimed at avoiding crowded h1using 
conditions, reducing air pollution, ensuring access to clean water and 
sanitation, improving waste management, and increasing the safety of the 
workplace." (International Conference on Population and Development, Cairo, 
Egypt, 1994)

?"In addressing inequalities in health status and unequal access to 
health-care services between women and men, governments and other actors 
should promote an active and visible policy of mainstreaming a gender 
perspective in all policies and programmes, so that...an analysis is made of 
the effects for women and men respectively". (Fourth World Conference Women, 
Beijing, People's Republic of China, 1995).

?"...to sustain our global environment -and improve the quality of living in 
our human settlements, we commit ourselves to sustainable patterns of 
production. consumption, transportation and settlements development; 
pollution prevention; respect for the carrying capacity of ecosystem; and the 
preservation of opportunities for future generations. In this connection, we 
shall cooperate in a spirit of global partnership to conserve, protect and 
restore the health and integrity of the Earth's ecosystem". (United Nations 
Conference on Human Settlements, HABITATII, Istanbul, Turkey, 1996).

?"...... a peaceful stable and enabling political, social and economic 
environments are the essential foundation which will enable states to give 
adequate priority to food security, poverty eradication and sustainable 
agriculture, fisheries, forestry and rural development". (World Food Summit 
Rome, Italy, 1996).

?"We decided to induce this issue (i.e. health and environment) for the first 
time in our agenda to emphasize that the protection of public health has been 
and remains a fundamental objective of environmental policies". (G7 meeting 
of Minister of Environment (Canada, France, Germany, Italy, Japan, UK and 
USA) Cabourg, France 1996).

Environmental Threats To Human Health

The word "environment" refers to whatever surrounds the humans beings. They 
are physical, chemical, biological, social, cultural and economic conditions. 
The environmental threats can be divided into "traditional hazards'' 
associated with lack of development, and "modern hazards" associated with 
unsustainable. development (WHO, 1992). One of the differences between 
traditional and modern environmental health hazards is that former are often 
rather quickly expressed as diseases. For example, a villager drinks polluted 
water today and tomorrow has severe diseases. For many modern environmental 
health hazards, however, a long period of time may pass before the health 
effects manifests itself. Similarly, environmental change may occur over 
several decades eg stratospheric ozone depletion due to chlorofluorocarbon 
emissions.

"Traditional hazards" are related to poverty and "insufficient" development. 
They include:

* lack of access to safe drinking-water
* inadequate basic sanitation in the house-hold and the community
* food contamination with pathogens
* indoor air pollution from cooking and heating using coal or biomass fuel
* inadequate solid waste disposal
* occupational injury and hazards in agriculture and cottage industries
* natural disasters, including floods, droughts and earthquakes
* disease vectors, mainly insects and rodents.

"Modern hazards" are related to rapid "development" that lacks 
health-and-environment safeguards, and to unsustainable consumption of 
natural resources. They include:

* water pollution from populated areas, industry and intensive agriculture
* urban air-pollution from motorcars, coal power stations and industry
* solid and hazardous waste accumulation
* chemical and radiation hazards following introduction of industrial and 
agricultural technologies
* emerging and re-emerging infectious disease hazards
* deforestation, land degradation and other major ecological change at local 
and regional levels
* climate change, stratospheric ozone depletion and transboundary pollution.

The Environmental Health Risk Transition

Traditional environmental health risks relating to unsafe food and drinking 
water, inadequate sanitation, poor housing, and infections transmitted by 
animals and vectors, have a major influence on health when countries are at 
early stages of development. Industrial development introduces "modern" 
environmental health risks relating to air pollution, chemical exposures and 
traffic accidents. The term "risk transition" is used to describe the 
reduction in "traditional risks" and increase in "modern risks" that take 
place as economic development progresses. However; when environmental health 
risks are poorly managed the "traditional risks" are not only eliminated but 
remain important health threats among the poor and disadvantaged, while the  
"modern risks" are increasing. But if environmental health risks are well 
managed, the "traditional risks" can be eliminated almost completely and 
"modern risks" reduced through effective prevention programmes.

A Health and Environment Cause-Effect Framework

The relationship between human health and the environment is evidently highly 
complex. Each of the traditional and modern hazards is associated with a 
variety of aspects of economic and social development.

Driving Forces

More generally, driving forces create the conditions in which environmental 
health hazards are generated by large numbers of people in their pursuit of 
the basics of life in terms of food and shelter, or in their appropriation 
and use of consumer goods. Driving forces include policies that determine 
trends in economic development, technological development, consumption 
patterns and population growth. 

Author: Mya Oo