Environmental change and human health in countries of Africa, the Caribbean and the Pacific (ACP)

Aims to first briefly describe the broad global, economic, political, social, institutional context in which ACP countries currently find themselves. Describes the health status and key health threats in ACP countries in an environmental context and reviews environmental developments in the region and the ways in which they are influencing health. Finally, suggests environmental health priorities and measures which can be taken to improve environmental health in ACP countries are identified.While new environmental health risks dominate the World’s headlines, old diseases dominate the ACP health statistics. ACP residents are highly vulnerable to the health risks of global environmental change. But the poor majority are already at risk locally from inadequate water, poor sanitation, smoky dwellings, and a lack of food. Changes in the world economy pose a more obvious threat to these local environmental and health conditions than does global climate change.The environmental health priority for most ACP countries is to attend to old problems in a new world. This challenge deserves the best that science, governance, education and development assistance have to offer. To meet the challenge, the health and environment sectors will have to work together, and find a common agenda rooted in local concerns.While there is enormous variation among ACP countries, few contribute appreciably to global resource depletion and waste generation. On the other hand, the burden of disease in the ACP is among the highest in the world, and a particularly large share of this burden – about one third – is related to environmental conditions. Children are the worst affected.Report demonstrates that these environmental condition are, in turn, closely related to poverty, and the broader set of development challenges these countries face. However, what emerges is not an ‘old’ agenda, requiring ‘more of the same,’ but new challenges that call out for innovative forms of inter-sectoral collaboration, engagement with civil society, and an international agenda that responds to local concerns and priorities.A health perspective can make a major contribution to setting environmental priorities, especially in the low income settings. Demographic shifts are changing the health profiles in many countries, and shifting the environmental burden of disease. Socio-economic changes, such as structural adjustment and globalisation, are changing the very basis of local environment and health management. New technologies, such as genetic engineering, are creating new challenges, as well as opportunities. These are just a few of the changes that need to be taken into account.Report includes chapters relating health to demography, the environmental context, agricultural change, urbanization and global environmental change, concluding with a chapter on ‘Health and Environment: the Common Agenda.’ It can be read as a companion to the World Resource’s Institute’s World Resources Report, 1998-99, which focused on environmental change and human health, but at a global level.