Water for Health - Taking Charge
5. It can be done
Getting Health Back Into The Water Agenda - Better Planning For Water And Health - The Role Of Research - Living In One World
People who are in good health are better able to take advantage of economic opportunities. It is also true that an improvement in standards of living contributes to better health. Society is generally accustomed to look at the contribution of development to health; whereas the contribution of health to development has been largely ignored. It is time to reverse this formula. Putting health at the centre of economic and human development instead of viewing it as a by-product of development could create new possibilities for poverty alleviation.
Getting Health Back Into The Water Agenda
In the second half of the 20th century there was a greater emphasis on medical interventions which tended to push safe water supply, adequate sanitation and environmental management to the back-seat. After years of reliance on strictly medical interventions, the health sector is now increasingly faced with the limitations of this approach. For several of the water-associated diseases, resistance to standard drugs is increasing. Bacterial resistance to antibiotics, parasite resistance, and resistance to insecticides by insects that carry diseases (vectors) all follow this trend.
Better Planning For Water And Health
The environmental movement has made enormous progress in highlighting the impact of development projects on people and their surroundings. Most countries now have legislation that requires an environmental impact assessment before a project can go ahead. Awareness is growing that health, like the environment, needs to be addressed at the early stages of planning to ensure that proper safeguards to protect health, particularly in water projects, are taken into account. For maximum benefit and durability, developers must not transfer hidden costs to the health sector and they must give priority consideration to the health and well-being of people affected by development projects, especially large-scale water management schemes.
What Science Has To Offer - The Role Of Research
Less than 10% of the world's health research budget is spent on conditions that account for 90% of global disease. In 2000, the Global Forum for Health Research called for a reallocation of the estimated US$ 56 billion spent annually on health research by the public and private sectors. While pneumonia and diarrhoea represent around 11% of worldwide illness, only around one fifth of 1% of research funding is spent on them.
Although major new funds are unlikely to appear for water and health research much can be learned by integrating what is already known in different areas of concern. That agricultural productivity is reduced when farmers fall ill may appear to be obvious, but the connections are not always made between agriculture and health because they are treated as separate issues. Were health and agriculture researchers to work together, they could enlarge their knowledge of the environmental and social conditions which determine health. An example of this is work carried out on surveying insect ecology in rice ecosystems.
Pressures on diminishing water resources are acting as a spur to technological innovation. Faced by absolute freshwater shortages, the sea has stirred the inventive spirit of many in the direction of modern desalination technologies. Although dropping, their cost still remains too high to provide a viable solution to the world's inadequate supply of drinking-water.
The health sector could benefit from better use of advances made in information collection and management. It has been slow to embrace new devices such as remote sensing and geographic information systems which could, for instance, detect and analyse links between water resources and the distribution and intensity of water-associated diseases.
Living In One World
Globalization has taken root, doing away with the old-fashioned notion that countries can live in “splendid isolation.” The rich cannot ignore the poor. Even if moral and human rights considerations play no part in their thinking, for purely selfish reasons, rich countries must assist the poor in obtaining a better life. High-speed travel, instant information through the wonders of satellite technology and the internet have brought every corner of the earth closer together. The ramifications of this more integrated world are both good and bad.
Infectious diseases know no borders. Travellers vacationing in exotic places may be stricken with illnesses such as malaria, schistosomiasis and cholera. Malaria-bearing mosquitos have been known to hitch rides on airplanes departing from Africa or Asia and unwittingly infecting an individual from a non-endemic country. Since the wild polio-virus can travel from one country to another, the global campaign to eradicate this crippling disease will not succeed until polio has been eliminated in every country of the world. These are some of the grim realities of a more integrated world. But, pressures created by forces such as the multibillion dollar tourist industry for a safer and cleaner environment could, if effectively channeled, contribute also to development for the benefit of the poor.
Dams and HealthThe development potential of dams includes irrigation, power generation, drinking-water supply, flood control, navigation, fisheries and recreation. Dam construction has a chequered past because of adverse environmental and health impacts. The impacts of dams on environmental and social determinants often worsen the health status of vulnerable communities; they transfer hidden costs to the health sector and they undermine the project's sustainability. For example, in Ethiopia the cumulative effect of microdams translated into a seven-fold increase of malaria transmission in the nearby communities. Health impact assessment (HIA) provides a well-tested method and procedure for minimizing health risks and maximizing the health benefits of development projects. HIA fits in with prospective environmental and economic assessments. It is an effective decision-support tool, provided recommended mitigating health measures are included in the resulting environmental management and resettlement plans. Scaling up HIA will ensure improved equity of health benefits of dams and other water-resource projects. It will prevent the transfer of hidden costs to the health sector and it will contribute a great deal to its sustainability. |
While the internet is still mainly the purview of the rich, access is rapidly accelerating worldwide. The digital divide between the haves and have-nots is enormous and will not be easily bridged. But, slowly, more opportunities for development through the global information network are becoming available. An example of this in the water and health field is Sanitation Connection, an internet-based information clearing-house led by WHO with the United Nations Environment Programme, the Water and Sanitation Programme, International Water Association and Water Supply and Sanitation Collaborative Council (http://www.sanicon.net)
Vector ControlVector control can render whole areas of productive land habitable. While insect populations important for plant protection are well studied, agricultural entomologists simply throw out species of medical interest because they don't fit into their field of study. By pooling these surveys with medical entomologists, data vital for good health can be collected at little extra cost. |