Your Excellency, Mr Vice-President representing the President, Head of State of the Republic of Gabon,
Your Excellency Mr Vice-President of the Islamic Federal Republic of Comoros,
Your Excellency Deputy Prime Minister of the Republic of Gabon,
Chairpersons of Constitutional Institutions,
Members of the Government of the Republic of Gabon,
Honourable Ministers in Charge of Health and the Environment of participating countries,
Your Excellencies Ambassadors,
Members of the Diplomatic Corps,
Representatives of International Organizations,
Distinguished Experts and Participants
Distinguished Guests,
Ladies and Gentlemen,
On behalf of the Director-General of the World Health Organization, Dr Margaret Chan, I have the privilege and honour to address the first Interministerial Conference on Health and Environment in Africa.
I would like, first and foremost, to use this occasion to express my profound gratitude to President Omar Bongo Ondimba and the Government of Gabon for kindly accepting to host and co-organize this historic event with the World Health Organization and the United Nations Environment Programme.
I would like also to express my sincere thankfulness to France, Germany, Rockefeller Foundation and all other partners for the appreciable support they provided to make this event a reality.
May I also thank you all ministers of health and ministers in charge of environment for coming here in Libreville to discuss a subject of such great importance to Africa and to the world at large, and to agree on policies, strategies and actions that would lead to a more dynamic interface between the environment and health, for the benefit of the African populations.
We in WHO are convinced that this Interministerial Conference on Health and Environment in Africa reflects the commitment of Member States to initiate changes both in the development of policy and institutional frameworks and in making investments to reduce risks to health and environment and thereby promote sustainable development.
The need to preserve the environment and promote health has figured among global policy priorities for the past three decades as evidenced by the holding of several summits on this subject. The 1992 Rio de Janeiro Summit initiated the global process to control climate change, protect biodiversity and eliminate hazardous toxic products. It culminated in the adoption of the Rio Declaration which sets the lines of actions for better management of the climate and for taking forward the concept of the environmental rights and accountability of countries. The 2002 World Summit on Sustainable Development held in Johannesburg provided the world an opportunity to take stock of, and complement, the programme launched at the Rio Summit.
Excellencies,
Distinguished Guests,
Ladies and Gentlemen,
We now live in a world of unprecedented awakening of the consciousness of communities and civil society organizations in regard to environmental issues and their linkages to health. Governments must therefore provide adequate response to the health problems caused by environmental risks.
Latest WHO estimates show that nearly a quarter of the global burden of disease is attributable to avoidable environmental factors. That is the sad truth! In addition, the burden of disease attributable to the environment is not evenly distributed around the world. Developing countries, especially those in Africa, are the ones most seriously affected and the vulnerable and poor populations most hardly hit.
By talking about the disease burden, I am referring in particular to communicable diseases such as malaria, yellow fever, rift valley fever, chikungunya and tuberculosis, to mention but a few.
The persistence of malaria, a disease which is taking a very heavy toll on Africans, is caused largely by poor land use practices, deforestation, mismanagement of water resources and the natural environment of humans, in short irrational land use and territorial planning.
The WHO African Region has been experiencing, in recent years, repeated epidemics of mosquito-borne diseases including yellow fever, rift valley fever and chikungunya. In this regard, countries bordering the Indian Ocean have been particularly affected by chikungunya. In continental Africa, Gabon, our host country today, experienced a severe epidemic of this disease with over 13 000 cases in urban areas especially Libreville. With your permission, I would like to digress slightly by disclosing to you that in the course of that chikungunya outbreak, I happened to be on a visit to Gabon. I therefore discussed with the Gabonese authorities the expediency of organizing this conference, here in Libreville, under the high patronage of the Head of State who, in turn, consented, without hesitation, given the relevance of the subject.
I would also like to mention the growing risk of tuberculosis in highly overcrowded areas especially in slumps where poverty and disease are inextricably linked.
Excellencies,
Distinguished Guests,
Ladies and Gentlemen,
You are no doubt aware of the day-to-day sanitary conditions prevailing in public markets and in most of the eating places in our countries. The unhygienic conditions, coupled with the frequent lack of running water, have turned those places into hotbeds of microbial proliferation and contamination of foods sold to the large majority of the people. Schools where children spend a substantial part of their time are also in similar situations, with more schools lacking safe drinking water and adequate numbers of clean toilets.
The real challenge we face today is what we must do to remedy such a situation. It is not my intention here to defend the actions of WHO which is, after all, an organization of the Member States. Permit me, however, to mention the solutions that the Regional Office has tried, jointly with some countries, by initiating projects on healthy schools, healthy cities, healthy markets, healthy villages, and so on. Unfortunately, in most cases, the projects remained at the pilot phase. May I use this opportunity to appeal to local councils and communities of Member States to support these projects and replicate them countrywide.
Permit me also to address the issue of the unhygienic conditions prevailing in urban and peri-urban areas. African cities, with a few exceptions, are strewn with heaps of garbage lying uncollected for months or even years, hundreds of thousands of plastic sachets littering the ground, waste waters stagnant in gutters. In general, the coverage of communities with sanitation systems remains very low. This situation can only be addressed through adequate investment in the establishment and rational use of appropriate waste collection and treatment systems for most of our populations.
The use of sources of energy is also another area where health and environment converge. The majority of the world population still use biomass and charcoal for their energy needs, and that contributes to respiratory diseases such as lower respiratory-tract infections, chronic obstructive pulmonary diseases and lung cancers which claim 1.5 million lives globally, every year, with the majority occurring in Africa.
In the African Region, most people dwelling in rural areas or in slums use wood almost exclusively for cooking and heating. Children and the elderly are more vulnerable to the adverse impact of air pollution within households. The use of this low-quality and other similar fuels, coupled with poor ventilation, leads to high levels of indoor pollutants which are aggravating or contributory factors for diseases such as asthma, bronchitis, pneumonia, lung cancer and heart disease.
The use of a large number of second-hand cars and motor cycles that have a high capacity for exhaust gas emission and fail to meet new environmental protection standards is a major cause of concern considering the high degree of pollution occurring especially in our cities.
Another serious threat to public health is the transport, storage and dumping of toxic wastes. In the last two decades, we have learnt of huge quantities of toxic wastes dumped in Africa, sometimes even on the peripheries of major cities, in total disregard of all ethics. The magnitude of a recent incident prompted WHO to intervene to assess the extent of damage and help take appropriate measures. Such practices should bother the conscience of humankind as a whole. Adequate measures must be taken to protect the health of populations exposed to contamination risks.
The history of public health teaches us that substantial improvements in the supply of safe drinking water, in public hygiene and sanitation, and in access to clean environment, better education and safe and balanced diet and nutrition, among others, will lead to significant reduction of communicable diseases and improve the quality of life.
Excellencies,
Distinguished Guests,
Ladies and Gentlemen,
Climate change, another new challenge, is a very topical issue today. It is neither a mere figment of the imagination nor an abstract subject. In contrast, it is a real issue of concern because we are already experiencing its effects, specifically its adverse impact. Climate variability actually finds expression in occurrences of storms, flooding, drought with attendant destruction of infrastructures, dysfunction of health services and disorganization of agricultural production. That has led to a significant reduction of the availability and the quality of food commodities. That, in turn, exerts a direct impact on the nutritional status of the population and aggravates morbidity and mortality.
In the light of the numerous challenges, old and new, national health systems must strengthen their capacities and participate actively in assessing new risks and providing response. That would require actions including advocacy, continuing political commitment to sustainable development, continuing assessment of the environmental risks to human health, disease surveillance, institutional and human capacity building, establishment of mechanisms of close collaboration between the health sector and the environment sector, development of integrated policies especially policies focused on actions for ecosystems that are more conducive to human health.
Excellencies,
Distinguished Guests,
Ladies and Gentlemen,
In the past three days, experts have had in-depth discussions on these issues including issues we know since many years and those that we are just beginning to apprehend.
I am pleased to commend the quality of their work and to appreciate their huge contribution to the success of this Conference.
That is why I stand deeply convinced, Excellencies, Ladies and Gentlemen, that the Millennium Development Goals represent a shared vision and we should avoid considering them in isolation. They crystallize the main aspects of the intersectoral action of governments and development agencies. They reflect our renewed commitment and guide the effort that we are making to improve the quality of life of the populations. Being even more than a vision, the Millennium Development Goals are a real source of hope. If we in the health and environment sectors work together within a strategic alliance, we can and should make this hope a reality.
Excellencies,
Honourable Ministers,
I have no doubt whatsoever that we will rise to this occasion in the history of public health in Africa. By so doing, we will give hope and a real opportunity for a fresh start especially through the commitments and the actions that we need to set forth in the Libreville Declaration whose adoption will be the climax of this Conference.
May I reiterate my gratitude to the Ministers of Environment for taking this giant and historic step by teaming up with Ministers of Health to strengthen further the collaboration between the health sector and the environment sector.
May I also commend and thank the people and the Government of Gabon for the welcome and the kind hospitality that we have enjoyed during our stay in Libreville.
May you permit me to express our deep acknowledgements to the authorities of the Republic of Gabon especially the Deputy Prime Minister, the Minister of Environment, Sustainable Development and Nature Protection, and the Minister of Health and Public Hygiene, responsible for family affairs and women’s promotion, for all their efforts to make this historical event a success.
Last but not least, I would like to commend the exceptional quality of the cooperation between WHO and the Republic of Gabon, whose most recent fruits are the holding of the Regional Conference on avian influenza and the diverse forms of support for the establishment in Libreville of the WHO Intercountry Support Team for Central Africa.
Excellencies,
Ladies and Gentlemen,
“Now let the strategic alliance between Health and Environment begin!”
I thank you.