PHM-Exch> An opportunity to put climate change and occupational health onto a social justice agenda for health

[Claudio Schuftan]

The People’s Health Movement:

*An opportunity to put climate*

*change and occupational health*

*onto a social justice agenda for*

*health*

Leslie London, Louis Reynolds, James Irlam

On behalf of the People’s Health Movement

Photo by PHM

Afr Newslett on Occup Health and Safety 2011;21:55–6 • 55



The People’s Health Movement (PHM) is a

global network of civil society groups, researchers,

and activists in health advocacy

that works toward the revitalization of Primary

Health Care and seeks to address the

social determinants of health, including, in

particular, the growing inequity within and

between nations. Nowhere is the need for this

approach starker than in the challenge that

climate change poses for global health equity.

The World Health Organization (WHO)

estimates that human-induced climate change

already claims over 150,000 lives every year

(1). The health impacts of climate change include

the dire consequences of more extreme

weather events such as hurricanes, heat waves,

droughts and floods; and the spread of infectious

diseases with high mortality, including

cholera and gastroenteritis, particularly in water-

stressed communities.

In countries already classified as ‘waterstressed’,

such as South Africa, demand for

water exceeds the available supply, or use is

limited by the poor quality of potable water.

With climate change, hotter and drier conditions

will increase water shortages, with a

consequent increase in food insecurity, hunger

and malnutrition (2). In addition, an increasing

number of very hot days each year

will affect the ability of people to carry out

daily tasks, including their capacity for income-

generating work. This will mean a disproportionate

economic burden on already

marginal populations (3).

With regard to malaria, already one of the

main causes of infant and maternal mortality,

climate change will alter the breeding environments

of the anopheles vector, resulting in

drying of some areas with reduced transmission,

but simultaneously rendering previously

unaffected areas more suitable environments

for these organisms. As a result, malaria control

programmes will be more difficult to plan,

posing particular challenges to countries in

sub-Saharan Africa (4).

The above considerations illustrate how the

impacts of climate change will be felt disproportionately

in vulnerable populations, such as the

very young, the elderly, the sick, the poor and

those required to work in the hot sun or other

hot settings. These impacts will be particularly

severe in developing countries struggling to

meet the Millennium Development Goals and

particularly in sub-Saharan Africa, where more

people already die from the effects of climate

change than anywhere else (1).

The environmental impacts of climate

change will be impossible to reverse in the

coming decades, yet many of the health effects

can be avoided or controlled right now

by means of tried and tested public health

measures. These measures include prioritiz-

ing, above commercial or leisure purposes,

the provision of clean water and sanitation for

human use; widespread immunization; effective

disease surveillance and control; disaster

preparedness; effective occupational health

programmes; and access to safe and adequate

food from locally-grown crops suited to waterscarce

conditions.

Moreover, many of the measures needed

to prevent climate change have public health

benefits. For example, reducing the use of private

vehicles in favour of public transport, cycling

and walking will not only reduce greenhouse

gas (GHG) emissions, but also improve

air quality, increase physical activity levels and

reduce obesity, leading to better respiratory

health, fewer obesity-related illnesses, and

fewer premature deaths.

Environmental justice is a key element of

the Right to Health (5, 6). Many civil society

organizations campaigning for environmental

justice have found a base in the Right to

Health programmes of the PHM, which has

its roots in grassroots community movements

and owes its genesis to many health networks

and activists who have been concerned by the

growing inequities in health over the past 25

years.

PHM believes that the promise of the

Right to Health will only be effectively realized

if civil society is active in pursuing its

health rights. These rights include a range of

socio-economic entitlements beyond access to

health care services, such as adequate housing,

clean water, safe sanitation, good nutrition,

and a safe and sustainable environment.

As an alternative to the assemblies held by

the WHO, PHM convenes a periodic gathering

of civil society organizations and movements

under the banner of a People’s Health

Assembly (PHA). The 3rd PHA (PHA3),

scheduled to take place in South Africa in July

2012, will be a global event bringing together

health activists from across the world

to share experiences, analyse the global health

situation, and develop civil society strategies

to advance health for all. It is an opportunity

to reassess, redirect and re-inspire.

The PHA3 programme will include both

first-hand testimonies from communities affected

by threats to their health and analyses of

health situations across the globe. It will focus

on moving from analysis to action, with sufficient

time and process to facilitate discussions

on strategy, future activities and movement

building. Themes provisionally identified for

the PHA include the Social Determinants of

Health, Economic and Political Architecture,

Building Sustainable Health Systems, Voices of

Resistance, Actions and Change, and Watching

Global Processes and Institution.

However, with the growing recognition

that climate change poses very real and substantial

threats to health, particularly for populations

in developing countries, the organizers

have identified the impact of climate

change on health as a key issue on the agendas

of health activists in PHM. We therefore

would like to invite readers of the newsletter

to participate in pre-assembly mobilization

activities currently underway in the African

region under PHM’s auspices, with a view to

organizing nationally and regionally around

climate change and health. PHA3 offers an

opportunity to gather and present testimonies

and first-hand experiences as a basis for

learning and joint action; to discuss and suggest

amendments to the People’s Charter for

Health; and to link workplace health, climate

change, and the right to health. The main objectives

of pre-assembly mobilization are to

strengthen collaboration and encourage inspiring

exchange amongst PHM activists and

to increase participation and grassroots voices

on themes such as climate change at PHA3.

Occupational health practitioners are familiar

with the hazards posed by unsafe environments

to working populations. Climate

change is likely to exacerbate many of these

threats. We need to extend our occupational

health practice to make the links between

occupational and environmental health hazards

on the one hand, and, on the other hand,

broader advocacy for the health of populations

living in the global south who will bear the

brunt of climate change. For example, there

is already work in civil society groups lobbying

for improved ‘bicycle-friendly’ cities,

but much more could be done legislatively

to strengthen public transport and discourage

the use of motor cars. Weaning the public

(and government) off their carbon dependency

should not be seen as simply a cost to local

coffers but as an investment for a healthier,

more sustainable and just society (7).

PHM is also aware that health systems

themselves, particularly in wealthy industrialized

countries such as the UK, contribute substantially

to climate change through their own

GHG emissions., Unless health systems become

greener themselves, not only will they be

unsustainable, but they will add to the burden

of disease. One key aspect of making health

systems greener and more sustainable would

be to shift the emphasis away from hospitalbased,

doctor-centered models to community-

based models that incorporate more community

and mid-level health workers. With

the necessary political will and a participative

multisectoral approach, massive reductions in

GHG emissions can be achieved and a large

number of jobs created simultaneously.

WHO recognizes that in order to meet

the threats posed by climate change, partner

ships

are needed between international agencies,

government departments, non-governmental

organizations, industry, professional

groups and local communities. Knowledge

and information need to be shared and people

need to be empowered with choices that

will benefit their own health and that of their

communities in the long run. PHA3 provides

an opportunity for PHM and other health and

social advocacy groups in the African region

to reflect on the public health threats posed

by climate change, and to identify opportunities

for comprehensively addressing an issue

that affects us all.

PHM welcomes any interested individuals

and organizations to get involved by contacting

Anneleen De Keukelaere from the global

secretariat at pha3 at phmovement.org or by

seeking more information at www.phmovement.

org. For more information on the processes

taking place in Africa, please contact Linda

Mashingaidze at linda at phmovement.org.

*References*

1. The Health and Environment Linkages Initiative

(HELI). World Health Organization. See http://

www.who.int/heli/risks/climate/climatechange/

en/ (accessed 15-09-2011).

2. Patz JA, Campbell-Lendrum D, Holloway T, Foley

JA. Impact of regional climate change on human

health. Nature 2005;438(17):310–7.

3. Kjellstrom T, Holmer I, Lemke B: Workplace heat

stress, health and productivity - an increasing

challenge for low and middle-income countries

during climate change. Global Health Action

2009;2:10.3402/gha.v2i0.2047.

4. Tanser FC, Sharp B, le Sueur D. Potential effect of

climate change on malaria transmission in Africa.

Lancet 2003;362:1792–8.

*Leslie London, Louis Reynolds, James Irlam *-

On behalf of the People’s Health Movement

People’s Health Movement South Africa

129 Rochester Road

Observatory 7925

Cape Town

South Africa

tel: +27 21 447 5770

email: coordinator at phmsouthafrica.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20120109/aa9ff7fc/attachment.html>