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New Paper: Sustainability Threatens Public Health In The Developing World

Mikko Paunio, Priorities Magazine

Current conservation policies often clash with public health initiatives in the developing world but they get little attention. There are real harms in advocating water and energy conservation over people.

We take sanitary practices for granted in wealthier countries but hygienic practices require water in quantity and uninterrupted power to supply that water and related sewage systems. Those really help countries that need it most yet those are two things that environmental groups and governments in Europe and North America often oppose. Reports from the World Health Organization and the World Bank have found that lack of water and energy affects 800 million people around the globe. Decentralized heating and cooking in homes in the urban areas of the developing world account for most ambient air pollution and perhaps 80-90 % of the WHO estimate of up to 6.5 million annual deaths linked to such air pollution.

Instead of addressing those issues in the most practical way possible, the US in 2013 declined multilateral (World Bank) aid to build centralized power plants in the poorest countries – because to be affordable they had to use coal. Instead, the US government sided with WHO and Dr. Margaret Chan and insisted on climate change mitigation for poor countries while giving China unlimited emissions until 2030.

Where did we go wrong? When guiding the “Our Common Future” report, Director General of the World Health Organization Dr. Gro Harlem Brundtland chose to deny crucial infrastructural urban development, such as the provision of fresh water supplies and the installation of sewerage systems, unless it could be done “sustainably”. But the countries that need such infrastructure are often unable to raise capital on their own and need multilateral assistance from rich countries. By mandating they could only have loans if they agreed to build things that would be too expensive, we doomed those countries to failure.

What has been little discussed is how those initiatives made western governments feel good while dooming developing nations. It has long been known that infectious diseases acquired before the age of one permanently affect the nutritional status of an infant, especially when the infections are frequent or virulent. Just over a decade ago, WHO and the World Bank attributed 50 percent of consequences of undernutrition to unhealthy environments. These are all easily solved – unless sustainability policies triumph over food and sanitation.

Direct human household consumption of water is only 11 percent of all total global consumption of water: this is small especially when compared to water consumption by the agricultural sector but the weight of evidence shows it is vitally important. Yet it is being left behind.

It wasn’t always this way. The WHO and its predecessors once emphasized the provision of fresh water and sewerage infrastructure in urban areas. These measures contributed greatly to the public health miracle that was mainly experienced by OECD-countries. Moreover, that agenda enabled the liberal per capita use of tap water by households, communities, hospitals and industries for a variety of hygiene purposes. Today, the current sustainable development agenda is dominated by conservation policies that pay little attention to the health protection needs of the poor.

This article appeared in the Fall 2017 Priorities magazine and was drawn from the longer paper below

Current sustainable development policies compromise public health in the developing world





Infections lower infant’s nutritional status. 7

Institutional environmental health – the forgotten agenda. 8

Water quantity is not mentioned in Sustainable Development policy texts. 9

Ecocentric Royal Society report 9

Misconceptions about the role of drinking water in diarrhoeal diseases. 10

Clean drinking water alone does not make a difference. 11

Hygiene practices have profound effects on disease burdens and help the management of infectious diseases. 12

Mills-Reincke phenomenon in the 21st Century. 13

Nutritionists ‘hijacked’ environmental health agenda. 15

Even the most knowledgeable can err as errare humanum est 16

A reliable power grid is needed to secure water supply and to clean indoor and ambient air 17

Final conclusions. 17


TABLE.. 28


Full paper