PHM-Exch> [PHM NEWS] WHO adopts global strategy on health, environment and climate change (and a plan of action for small island developing states)

[Claudio Schuftan]

From: David <dlegge at phmovement.org>


Widespread support for global strategy and plan of action (although the US
is somewhat irritated)

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<https://mailchi.mp/466497a739c1/who-global-strategy-on-health-environment-and-climate-change?e=916df65fd1>
WHO adopts global strategy on health, environment and climate change (and a
plan of action for small island developing states)

Climate change is central to the new Global Strategy (A72/15
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=0a7a8bd69c&e=916df65fd1>)
although the strategy also encompasses a range of other environmental
issues ranging from water and sanitation, chemical safety, vector control
to occupational health. The Strategy highlights the many health
‘co-benefits’, such as reduced air pollution, which would follow from
action on global warming.

The central ‘theory of change’ underlying the new Global Strategy relies
largely on advocacy and leadership from within national health systems. The
strategy envisages scaling up action around primary prevention (including
action on a range of environmental risks as well as on climate change);
strengthening the evidence and better communicating that evidence;
increasing capacity for intersectoral policy collaboration; and
strengthening health sector leadership generally. The strategy recognises
the need to build a social movement to drive political will and implies a
significant role of health care organisations and practitioners in building
that movement. In this respect it corresponds closely to the core logic of
comprehensive primary health care.

The global strategy envisages a role for WHO in policy leadership, evidence
synthesis and advocacy and country level support. WHO will engage in
regional and global policy platforms but it will also support national
health systems and partnerships for social movements.

The Plan of Action on climate change and health in small island developing
states (A72/16
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=d56bed7f6f&e=916df65fd1>)
addresses the building of climate resilient health systems, accumulating
evidence and mobilising funds for adaptation. However, the leading ‘line of
action’ is to support global advocacy by small island developing states
(SIDS) around the urgency of containing greenhouse gas emissions. (This was
the source of some irritation on the part of the USA.)
Widespread support

Interventions from member states and non-state actors were generally very
supportive.

The urgency of acting on global warming was emphasised in the Public
Services International (PSI) intervention which regretted the absence of
any reference to the Intergovernmental Panel on Climate Change’s special
report on Global Warming of 1.5oC. The representative of Colombia
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=205ab9ef4d&e=916df65fd1>
at the Executive Board in January had likewise urged that the draft global
strategy should incorporate the findings published by the Intergovernmental
Panel on Climate Change in 2018 on the impacts of global warming of 1.5 °C.

The co-benefits to health promotion from action on climate change were
highlighted by Romania
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=c0c5e51a78&e=916df65fd1>
speaking for the EU, by Tuvalu, speaking for Pacific Islands and
Territories; and by the International Federation of Medical Students.
Romania identified sustainable food systems as an “important area where we
can have major positive impacts on human health and the environment”.
Tuvalu and Suriname both pointed to the threats to food security associated
with climate change. Food systems were also mentioned in relation to
co-benefits by the UK, Belgium, the World Obesity Federation and the World
Medical Association. In most cases these speakers were pointing to the
health benefits of more sustainable food systems. Belgium for example spoke
about the value of a vegetarian diet in mitigating global warming.

A different perspective was evident in the remarks of the World Medical
Association
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=1b17c4110d&e=916df65fd1>
regarding the need for health impact assessments of new trade agreements
and the need to prioritise public health over commercial interests and
secure services in the public interest, including those impacting on health
and the environment. The World Heart Federation highlighted also the
co-benefits from reduced emissions from fossil fuelled transport and power
stations:

*Nineteen percent of all cardiovascular disease (CVD) deaths are caused by
air pollution - the equivalent of more than 3 million deaths every year.
Whilst you may not remember this figure by heart, you may remember that air
pollution is as big a risk factor for CVDs and stroke as tobacco use.*
Water

Several countries pointed to water issues, both droughts and floods, as
mediating the risks to health.
Zambia advised that in recent times they have experienced “droughts, floods
and extreme heat. Excess rainfall and floods, particularly in flood-prone
areas has increased the risk of water contamination thereby making the
country susceptible to water borne diseases”.

Namibia, also highlighted water supply issues, stating that the country is
currently facing a hepatitis epidemic due to limited access to clean water.
USA outraged by WHO’s encouragement of global mitigation advocacy by
leaders of small island developing states

The plan of action on climate change and health in small island developing
states (SIDS) includes (in para 14 of A72/16
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=f89879b914&e=916df65fd1>
):

*There is a need to ensure that the necessary information on the
connections between health and climate change is made available to Member
States, so that it can be considered in establishing the official positions
of relevant small island developing State groupings in the United Nations
Framework Convention on Climate Change and other relevant sustainable
development processes. Small island developing States constitute about one
fifth of United Nations and WHO Member States and could leverage their
strength in numbers to advocate more effectively for global action. The
strategic line of action on empowerment aims to promote the voice of health
leaders, on behalf of the most vulnerable populations, in support of
adaptation in small island developing States and mitigation by countries
around the world.*

Presumably it was this passage that the US delegate
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=b0abcde24f&e=916df65fd1>
was referring to when they said:

*We would like to reiterate our position that WHO not insert itself into
business of other fora by advocating for Member States to take specific
positions, or by shaping negotiating positions of Member States.*

This rather suggests that the US is concerned that advocacy by small island
developing states for global action to mitigate global warming has been too
effective. Their concern was not shared in the contributions of small
island developing states.

Barbados highlighted the emergence of zika and dengue as a consequence of
climate change and expressed concern regarding sustainable, safe and
reliable water supply.

Bahamas likewise spoke about the risk of entire nations being wiped out by
rising sea levels.

Tuvalu, speaking for the Pacific Islands group highlighted diarrhoeal
diseases, compromised food security and its impact on NCDs, injuries and
deaths from extreme weather.

Jamaica
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=60e246f89d&e=916df65fd1>
speaking at the Executive Board in January welcomed the opportunity for
small island developing states to adopt a leadership role on the issue of
climate change. Jamaica urged WHO to continue prioritizing the initiative,
as well as providing the necessary resources.

Several member states and three non-state actors highlighted WHO’s
precarious funding as a critical vulnerability in this strategy. Spain
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=fdfa69dc75&e=916df65fd1>,
speaking at the Executive Board in January commented that WHO’s work on
health, environment and climate change was chronically underfunded and was
crucial for the achievement of the objectives of the Thirteenth General
Programme of Work.

A similar concern was expressed in a statement by Medicus Mundi
International and PHM
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=77f6de4509&e=916df65fd1>,
who pointed out that only 74% of the approved Health and Environment budget
for the biennium (2018-19) for had been raised ($80m out of $108m). The
expenditure for 2018 of $36m was only 45% of what was available for the
biennium and only 33% of what had been approved. (See A72/45
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9c3e879041&e=916df65fd1>
.)

Clearly $108m for the biennium was not enough. However, the continued
freeze on assessed contributions and insistence of the donors on tight
earmarking (so they could avoid supporting particular programs) continues
to seriously limit the capacity of the Organisation.
Brazil rejects reference to ‘misuse of natural resources’

Several NGO speakers (World Obesity Federation and World Heart Foundation)
regretted the removal of a reference to ‘undue influence and vested
interests’ from the version which had been discussed at the Executive Board
in January.

*The commitment to tackling overuse of natural resources, large-scale waste
production, and undue influence and vested interests going against public
interests should allow more sustainable economic activities to be carried
out and the creation of public goods for health. (para 14 in **EB144/15*
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=2405888bf9&e=916df65fd1>*)
*

had been replaced by

*The commitment to sustainable patterns of consumption and production and
tackling misuse of natural resources and large-scale generation of waste
should allow more sustainable economic activities to be carried out and
progress to be made on global, cross-border goods for health, such as clean
air and a stable climate. (para 15 **A72/15*
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=f9bb102175&e=916df65fd1>
*)*

In fact it was not the food industry which had required this change but
Brazil
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=fbeeae9d1d&e=916df65fd1>
which during the Executive Board meeting in January had protested against
the use of the term ‘global public goods’. Brazil’s main concern appears to
have been the references to ‘misuse of natural resources’ and ‘large scale
generation of waste’. Brazil protested:

*There was no agreed multilateral definition of the term *[‘global public
goods’]*, which was at variance with the principle of international law –
set out in several multilateral agreements on the environment – that States
enjoyed the sovereign right to exploit their own resources pursuant to
their own environmental development policies.*

Presumably this is a reference to the accelerated deforestation of the
Amazon.
Limitations but a challenge worth taking up

In its comment before the World Health Assembly (here
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=bc7861ee39&e=916df65fd1>)
PHM was critical of the limited political analysis reflected in A72/15.

*Insofar as there is a political analysis underlying this strategy it is
structured around ‘sectors’. The ‘health sector’ needs to engage with
‘other sectors’ to emphasise the risks to health arising from continued
environmental pollution and global warming. This is a very limited frame of
analysis. *

*Where is the analysis of climate denialism, including both its corporate
sponsors and their political puppets?  WHO has named and excluded the
tobacco industry but makes only the most obscure references to the climate
hoodlums who are seeking to defer action on global warming in order to
maintain the profits of fossil fuel and related industries.*

*Where is the analysis of 21st Century transnational capitalism and its
dependence on producing and consuming stuff; externalising costs to the
environment (as in the two recent Brazil tailings dam disasters); and
avoiding regulation?*

*The global strategy correctly identifies the need for ‘partnerships for a
social movement for healthier environments’ and the need to mobilise public
support ‘for more sustainable and health-promoting development choices’. *

The strategy places some reliance, in terms of the drive to build such a
movement, on health care practitioners and agencies within countries. This
is to be achieved through a renewed emphasis on primary prevention and a
new leadership from within the health sector.

This is a challenge worth taking up and PHM is committed to playing its
part in building this movement. However, the challenge must extend beyond
‘cross sectoral collaboration’ to a broadly based engagement with the
political economy of neoliberal globalisation and the cultural
transformations needed to restore the relationship between humanity and
Mother Earth.
More

For full coverage of the WHA consideration of environment and climate
change refugee and migrant health see the PHM item page
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=21b49d3d32&e=916df65fd1>,
which includes: summary of issues in focus at the Assembly; background
notes; PHM commentary and the WHO watchers' notes of the debate.

Access all of the documents and debates from the World Health Assembly from
the WHO Tracker at who-track.phmovement.org/wha72
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=a4d1cadfcf&e=916df65fd1>.
Review previous Update Reports from WHA72 here
<https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=e15ccd811b&e=916df65fd1>
.
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