Tripler le gain dans la santé, la lutte contre la pauvreté et le changement climatique

09/12/2011
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UK medical journal The Lancet recently headlined climate change as “the biggest global health threat of the 21st century.” Yet this presents a triple-win opportunity for Africa with three development agendas. With just 12.3 percent of the world’s population but 25 percent of the global disease burden, harnessing health and poverty reduction goals to climate-change mitigation and adaptation strategies makes financial and logistical sense. “In Africa, we have an opportunity to win on several fronts at once against climate change, health challenges and poverty,” said Dr. Lucien Manga, Regional Advisor, Protection of the Human Environment, in the WHO Regional Office for Africa, in opening the session.

“Sub-Saharan Africa, excluding South Africa, is well behind on the health outcomes of the Millennium Development Goals (MDGs), so we can progress better with this joint strategy,” pointed out Dr. Agnès Soucat, Director, Human Development Department, African Development Bank.

For example, only seven countries are on track for MDG4, reducing child mortality by two-thirds; and only two for MDG5, reducing maternal mortality by three-quarters.

“MDG progress can’t be isolated from other factors affecting health, disease incidence and treatment – or response capabilities,” she noted. “A broad spectrum of socio-economic factors affects progress, including food, water and sanitation quality, employment levels, workforce health and education and training readiness. Public-health service delivery is affected directly by diagnostic and treatment services and by demographic changes.”

Already the youngest region in the world, Africa is currently second most populous after Asia. By 2050, its population will more than double to 2.3 billion, mostly urbanised, making it harder and more vital to address health challenges.  

This was foreseen when 52 African governments committed themselves in 2008 to the 11 priority actions of the Libreville Declaration on Health and Environment Linkages, said Emily Ojoo-Massawa of the United Nations Environment Programme. At the Luanda 2010 Second Inter-Ministerial Conference on Health and Environment, African ministers of health and environment issued their strongest pronouncement ever on climate change and health in the region.

Implementation proves how goals interlink, noted Mali’s Minister of Environment, H.E. Tiémoko Sangaré, citing how extending potable water, created more wastewater, increasing disease, necessitating improved sanitation services. Increased focus on public health, added Mali National Director of Health, Boubacar Abida Maiga, showed existing statistics for malaria incidence, for example, are understated at 82 per 1,000.

“Hence the World Health Organisation (WHO) plan of action emphasises a comprehensive, evidence-based, coordinated health-sector response to African countries’ climate change adaptation needs and commitments,” explained Dr. Matshidiso Moeti, Deputy Regional Director, WHO Regional Office for Africa. “It both establishes a common platform for comparability and progress assessment and provides a basis for standardised resource requirement estimates.”

Those estimates demonstrate responses can be cost-effective when integrated with existing programmes – essential as the changing aid landscape means they will generally be funded by African countries from their own budgets and growth. Total 2012-2016 country costs are estimated at US$751,000,000, against US$250,000,000 to be raised from international assistance.

Applauding these programmes, Dr. Maria Neira, Director of Public Health and Environment, WHO, underlined how an everyday change, such as improving cooking-stoves, which contribute to black-carbon warming and cause indoor air pollution, could prevent about a million deaths over 10 years in Africa, mostly of women. Reducing external air pollution and incorporating more activity through sustainable urban transport could cut heart disease and stroke by up to 20 percent.

“Africa is particularly vulnerable but also has great capacity to respond. We already have sufficient mandates, frameworks, technical knowledge and pilot experience. It’s now time to take this forward.”