As countries gathered at the United Nations’ biodiversity conference, or COP15, to agree on the post-2020 global biodiversity framework, policymakers, scientists, and rights advocates reaffirmed nature’s vital role in supporting human health and called for stronger and more integrated action to safeguard nature and overall human well-being.
Biodiversity loss and climate change create immense risks for people’s health and well-being in Asia and the Pacific. Our health is threatened by extreme weather events such as drought and floods, poor air quality, unsafe food and diseases emerging and spreading because of environmental change, such as dengue fever. The WHO estimated that almost one quarter of the global environmental burden of disease arises from 14 South-East and East Asian countries alone. The combined costs of these different natural and biological hazards may well cost the Asia-Pacific region over US$ 7 trillion per year in the next decades.
Given the interconnected nature of these risks, it is only logical for the environment and the health sectors to join hands to address them more effectively. An integrated approach to the environment-health nexus is not only cost-effective and improve risk-management but can also deliver co-benefits and allow the Asia-Pacific region to accelerate progress towards the 2030 Agenda for Sustainable Development, including the Sustainable Development Goals, the post-2020 global biodiversity framework and the Paris Agreement on Climate Change.
Figure: An overview of health risks associated with climate change and biodiversity loss and their exposure pathways (Source: ESCAP, adapted from WHO)
But what does this mean in practice? How can we operationalize the environment-health nexus and support more integrated policy making? A starting point is to evaluate the state of policy coherence of national environment and health plans and mainstream the nexus into these plans.
In our recent review of 15 national health plans in the Asia-Pacific region, currently less than half reference ‘environmental determinants of health’. A parallel review of 15 National Biodiversity Strategies and Action Plans (NBSAPs) found that while nine countries have at least one target related to health and well-being, only six referred to working with a ministry of health; and only three plans included a reference to food systems or healthy diets, despite a direct and strong link between food and health. As countries agree on the post-2020 global biodiversity framework, this is an opportune moment to update national plans and integrate a stronger reference to health.
In comparison, the climate change-health nexus is relatively better mainstreamed, however, there is room to better involve the health sector in reporting frameworks under the UNFCCC. Among 53 ESCAP member States, the health sector has been included in the climate strategies of 43 countries, nationally determined contributions (NDCs) of 24 countries, and national adaptation plans (NAPs) of 16 countries.
Multisectoral collaboration is important for strengthening policy coherence and ensuring alignment of values, perspectives, investments and technical capacities. During the COVID-19 pandemic most countries in Asia and the Pacific established multisectoral health committees to provide integrated and timely recommendations. These committees or other existing multisectoral initiatives can be expanded to include the environment sector in planning and assessment. Likewise, some countries have One Health coordination bodies and action plans – engaging the environment sector as equal partner into these platforms is a low-hanging fruit to deliver both health and environment outcomes.
Investment in integrated data collection, analysis, and interpretation supports the development of prevention strategies for environment-health threats, including by identifying priority interventions and by identifying the most vulnerable population.
Integrated environment-health funding streams brings different sectors together. Financial mechanisms and institutions, including the World Bank and the Global Environment Facility have begun to prioritize projects with co-benefits. Nature-based solutions should be part of the portfolios and investments could target ecosystem functions critical for reducing health risks and improving health outcomes.
Earlier this year, the UN General Assembly adopted a landmark resolution that recognizes the human right to a clean, healthy, and sustainable environment. This resolution provides an internationally recognized legal foundation for the environment-health nexus, meaning that countries should protect people from environmental harms, ensure access to environmental-health information and remedies; and encourage participatory processes in environmental decision-making, including by ensuring the participation of communities at risk, women, youth, disabled people, and indigenous communities.
The environment-health nexus is receiving increasing attention in the political agenda of the Asia-Pacific region, including in the Bangkok Declaration on A Common Agenda to Advance Sustainable Development in Asia and the Pacific. Following the integration of the environment dimension in the an updated definition of One Health in 2021, as well as the launch of the global One Health Joint Plan of Action in October 2022, there have been calls to operationalize a comprehensive One Health approach. ESCAP supports governments at local and national levels to strengthen skills, knowledge and tools, as well as to improve knowledge-sharing on the environment-health nexus and One Health.
Figure: The new definition of One Health (as of 2021)
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This article presents some key messages of a policy guide “Operationalize the environment-health nexus in Asia and the Pacific” recently published by ESCAP and IISD. For detailed analysis, recommendations and case studies, please refer to the policy guide. Additionally, in collaboration with IISD, FAO, UNEP, and WHO, an interactive policy dialogue and a side event were organized to promote understanding of an environmentally-comprehensive One Health approach and facilitate cross-sectoral exchanges on best practices. We invite you to take a look at these resources.