Human and Environmental Health
Context
Human and environmental health is inextricably linked with water quality. In the past, water quality has been considered only at the interfaces with human use, but now there is a considerable growth in understanding of the need to manage water quality to ensure ecosystem health as well. It is well known that unsafe water contributes to a large disease
burden. The second leading contributor to global disease is diarrhea which results in 2.2 million deaths, where the majority of cases are attributed to unsafe water, inadequate sanitation and hygiene. There is increasing evidence that water quality can significantly impact ecosystem health as well. Excessive nutrients into a water body, for instance, can lead to eutrophication – the over-productivity of organisms in water – leading to the creation of algal blooms and the depletion of oxygen concentrations, which threatens many animal and plant species (Carr and Neary 2008). One study on the extinction of freshwater fish found that water quality impacts contributed to 26 per cent of extinctions (in Revenga et al. 2000) Past failures to address the multiple drivers of water quality problems that affect human and ecosystem health have the potential to become more severe as they are compounded by population growth, water shortages, and climate change. Yet there is a need to continue striving for safe water for all (both human and aquatic systems), considering water quality’s pivotal role in human and economic development.Ensuring human and environmental health is a multi-faceted challenge, but progress in improving water quality will be a largestep in the right direction. This goal was the subject of several discussions during this year’s World Water Week.
Major insights
Throughout the week, cutting-edge research was presented that sheds light on the linkages between water quality, human health and environmental health. The 2010 Stockholm Water Prize Laureate Dr. Rita Colwell shared promising research which shows how changes in climate, adverse weather events, shifts in ocean circulation and other ecological processes can create conditions that allow infectious diseases such as cholera to spread. As a result of this and future work, scientists will be able to better predict and prevent infectious disease outbreaks with the use of environmental indicators. This research clearly shows the interconnectedness of the environment, water quality and human health. There is a growing concern about the potential effects of pharmaceuticals and other personal care products, xenobiotics and emerging pollutants on human and environmental health. Thesesubstances originate from a variety of activities, including from industrial, agricultural, medical and household activities. Several of these substances are known to have negative effects on human health and on the environment. Yet the exact extend of the effects and the behaviour of these substances, as well as their cumulative impacts, is not yet well understood and hard to predict. Another emerging area of research is related to regime shifts and tipping points concepts, where there is increasing evidence that there is a threshold in terms of amount of water abstracted/water quality degradation beyond which the ecological functioning is altered and or collapses irreversibly. However, there is still a lack of scientific understanding of these processes, yet there is a need to begin identifying indicators and developing management approaches to address this issue. Human and ecosystem health: The international community increasingly recognises the important links between environmental health, human health and overall well-being, and emerging research further supports these linkages. Yet in practice, integration between public health and environmental sciences rarely takes place. The lack of integrated strategies and perspectives in this area contributes to high incidences of waterrelated diseases, poor water quality, inadequate quality of food and low incomes from agriculture i.e. depletion of livelihoods and human wellbeing.
Environmental resources, fragile ecosystems and subsequently human health are in danger mainly because of inappropriate actions or inaction in many levels. During the week it has been highlighted that an important component of protecting waterquality for health is the building and enhancing of resilience at all levels, from the local to the national and international. By recognising the importance of protecting water quality for health, placing this within the context of an ecosystem management approaches, and developing and implementing policies andpractices now, it is possible to build community and ecosystem resilience to global environmental change.
Challenges and obstacles to progress
Information for decision making: A key obstacle to progress is the inherent difficulty in communicating scientific information in a manner that decision makers can understand and respond Ms. Jennifer De France and Dr. Thomas Chiramba highlight the linkages between water quality, human and environmental health and conclude that building resilience is imperative. 29 to. The science-policy gap is yet to be bridged, and this is perhaps one of the reasons why the MDG target on sanitation will not be met. For decision makers at all levels (household, municipal, national and international) to fully understand the need for and value of improved water quality, water supply, sanitation and ecosystem management, the benefits must be presented to them in compelling economic terms. Some progress has been made in conducting cost-benefit analyses of water supply and sanitation improvements, but more work needs to be conducted in this area. Furthermore, economic costing of ecosystem services is complex and difficult to achieve. Behavioural, cultural and equity factors: The socio-cultural dimensions of our interactions with the environment present ahost of obstacles. Behavioural change around such matters as sanitation and hygiene has been shown to be possible through interventions such as Community-Led Total Sanitation (CLTS). However, efforts to address behavioural and cultural change are often met with resistance or even outright opposition. An example raised during the World Water Week was the refusal of some ethnic groups to use chemical water treatment at household level, claiming that it is taboo. There is a need to betterunderstand the determinants of behaviour modification to initiate and support sustainable change. Equity also remains a continuing challenge – women, children, the disabled, the poor, and rural populations are still lagging behind in access to potable water and improved sanitation. This is supported by the 2010 report from the WHO/ UNICEF Joint Monitoring Programme (JMP) for water supply and sanitation. For example, the Report shows that the poorest quintile is 16 times more likely than the richest quintile to practice open defecation while the richest quintile is more than twice as likely than the poorest quintile to use an improveddrinking-water source. Enforcement mechanisms: While some progress has been made internationally in ensuring environmental health such as the adoption of the UN Convention on Shared Watercourses of 1997, international law enforcement mechanisms remain weak. Most countries have devised national legislation protecting water quality, but enforcement of these laws is also weak, particularly in poorer countries. Often, the immediate benefit obtained from activities that might impair water quality is valued above the cost to society from this impairment. Externalities are notadequately considered.
Human and environmental health is inextricably linked with water quality. In the past, water quality has been considered only at the interfaces with human use, but now there is a considerable growth in understanding of the need to manage water quality to ensure ecosystem health as well. It is well known that unsafe water contributes to a large disease
burden. The second leading contributor to global disease is diarrhea which results in 2.2 million deaths, where the majority of cases are attributed to unsafe water, inadequate sanitation and hygiene. There is increasing evidence that water quality can significantly impact ecosystem health as well. Excessive nutrients into a water body, for instance, can lead to eutrophication – the over-productivity of organisms in water – leading to the creation of algal blooms and the depletion of oxygen concentrations, which threatens many animal and plant species (Carr and Neary 2008). One study on the extinction of freshwater fish found that water quality impacts contributed to 26 per cent of extinctions (in Revenga et al. 2000) Past failures to address the multiple drivers of water quality problems that affect human and ecosystem health have the potential to become more severe as they are compounded by population growth, water shortages, and climate change. Yet there is a need to continue striving for safe water for all (both human and aquatic systems), considering water quality’s pivotal role in human and economic development.Ensuring human and environmental health is a multi-faceted challenge, but progress in improving water quality will be a largestep in the right direction. This goal was the subject of several discussions during this year’s World Water Week.
Major insights
Throughout the week, cutting-edge research was presented that sheds light on the linkages between water quality, human health and environmental health. The 2010 Stockholm Water Prize Laureate Dr. Rita Colwell shared promising research which shows how changes in climate, adverse weather events, shifts in ocean circulation and other ecological processes can create conditions that allow infectious diseases such as cholera to spread. As a result of this and future work, scientists will be able to better predict and prevent infectious disease outbreaks with the use of environmental indicators. This research clearly shows the interconnectedness of the environment, water quality and human health. There is a growing concern about the potential effects of pharmaceuticals and other personal care products, xenobiotics and emerging pollutants on human and environmental health. Thesesubstances originate from a variety of activities, including from industrial, agricultural, medical and household activities. Several of these substances are known to have negative effects on human health and on the environment. Yet the exact extend of the effects and the behaviour of these substances, as well as their cumulative impacts, is not yet well understood and hard to predict. Another emerging area of research is related to regime shifts and tipping points concepts, where there is increasing evidence that there is a threshold in terms of amount of water abstracted/water quality degradation beyond which the ecological functioning is altered and or collapses irreversibly. However, there is still a lack of scientific understanding of these processes, yet there is a need to begin identifying indicators and developing management approaches to address this issue. Human and ecosystem health: The international community increasingly recognises the important links between environmental health, human health and overall well-being, and emerging research further supports these linkages. Yet in practice, integration between public health and environmental sciences rarely takes place. The lack of integrated strategies and perspectives in this area contributes to high incidences of waterrelated diseases, poor water quality, inadequate quality of food and low incomes from agriculture i.e. depletion of livelihoods and human wellbeing.
Environmental resources, fragile ecosystems and subsequently human health are in danger mainly because of inappropriate actions or inaction in many levels. During the week it has been highlighted that an important component of protecting waterquality for health is the building and enhancing of resilience at all levels, from the local to the national and international. By recognising the importance of protecting water quality for health, placing this within the context of an ecosystem management approaches, and developing and implementing policies andpractices now, it is possible to build community and ecosystem resilience to global environmental change.
Challenges and obstacles to progress
Information for decision making: A key obstacle to progress is the inherent difficulty in communicating scientific information in a manner that decision makers can understand and respond Ms. Jennifer De France and Dr. Thomas Chiramba highlight the linkages between water quality, human and environmental health and conclude that building resilience is imperative. 29 to. The science-policy gap is yet to be bridged, and this is perhaps one of the reasons why the MDG target on sanitation will not be met. For decision makers at all levels (household, municipal, national and international) to fully understand the need for and value of improved water quality, water supply, sanitation and ecosystem management, the benefits must be presented to them in compelling economic terms. Some progress has been made in conducting cost-benefit analyses of water supply and sanitation improvements, but more work needs to be conducted in this area. Furthermore, economic costing of ecosystem services is complex and difficult to achieve. Behavioural, cultural and equity factors: The socio-cultural dimensions of our interactions with the environment present ahost of obstacles. Behavioural change around such matters as sanitation and hygiene has been shown to be possible through interventions such as Community-Led Total Sanitation (CLTS). However, efforts to address behavioural and cultural change are often met with resistance or even outright opposition. An example raised during the World Water Week was the refusal of some ethnic groups to use chemical water treatment at household level, claiming that it is taboo. There is a need to betterunderstand the determinants of behaviour modification to initiate and support sustainable change. Equity also remains a continuing challenge – women, children, the disabled, the poor, and rural populations are still lagging behind in access to potable water and improved sanitation. This is supported by the 2010 report from the WHO/ UNICEF Joint Monitoring Programme (JMP) for water supply and sanitation. For example, the Report shows that the poorest quintile is 16 times more likely than the richest quintile to practice open defecation while the richest quintile is more than twice as likely than the poorest quintile to use an improveddrinking-water source. Enforcement mechanisms: While some progress has been made internationally in ensuring environmental health such as the adoption of the UN Convention on Shared Watercourses of 1997, international law enforcement mechanisms remain weak. Most countries have devised national legislation protecting water quality, but enforcement of these laws is also weak, particularly in poorer countries. Often, the immediate benefit obtained from activities that might impair water quality is valued above the cost to society from this impairment. Externalities are notadequately considered.
Conclusions
The 2010 JMP Report indicates that the world is on track for
meeting the MDG target for drinking-water while the world is
off track to meet the sanitation target. However, the indicators
used for drinking-water (improved and unimproved sources)
do not adequately address the safety aspect of the source and
therefore, the actual situation is much more dire than portrayed
by the JMP numbers. Furthermore, as researchers and
practitioners in the fields of water supply, sanitation, health,
and environmental protection, we need to look beyond the
MDGs if sustainable solutions to the world’s current health
and environmental challenges are to be found. Meeting these
targets, while definitely commendable, should not be seen as
an end in itself. Holistic approaches that recognise human and
environmental health as interdependent will become increasingly
essential as the human population and our impact on the
environment continue to grow.
