South Africa | Health sector must join debate on climate change

It must amplify message after reports that global air pollution is behind many deaths

Op-ed by Rico Euripidou, groundWork, Healthy Energy Initiative partner in South Africa, published in The Mercury, October 14, 2019

The time is now for the health sector to join the environmental and climate debate!

A report has confirmed that the health impacts of coal-fired power plants in South Africa create a substantial burden on human health, leading to 2 239 equivalent attributable deaths annually. | African News Agency

For community people air pollution has since the 1990s been a framing for environmental justice, especially those living next to oil refineries, as in south Durban, Sasolburg and Table View, Cape Town.

Today, the World Health Organisation (WHO), and our very own Public Health Association and the Academy of Science of South Africa have come out and publicly challenged poor governance that leads to air pollution. We are facing a crisis!

Air pollution has become a greater health risk than cigarette smoking; 90% of the global population breathes polluted air. Air pollution has the same drivers as climate change – polluting industry and the burning of fossil fuels.

This is widely considered the greatest public health challenge of the 21st century, threatening all aspects of society. The WHO has declared air pollution as a “global public health emergency”, and along with climate change, the number 1 threat to public health.

The Global Burden of Disease, an international programme which measures and assesses mortality from major diseases shows that for the African region the combined deaths from household air pollution in Africa amounts to over 1 million deaths a year (ambient air pollution 439 000 deaths, household air pollution 791 000 deaths).

Ambient air is the air we breathe daily. Air pollution is known to cause premature deaths from lung cancer, ischaemic heart disease, chronic obstructive pulmonary disease, strokes, and lower respiratory infection.

This burden of disease and disability is estimated to cost us up to 3.8% of Africa’s GDP.

A 2017 report, by Dr Michael Holland, titled “Health impacts of coal-fired power plants in South Africa”, assessed the health impacts and associated economic costs of emissions from Eskom’s coal-fired power stations.

This report confirms that the health impact of coal-fired power plants in South Africa creates a substantial burden on human health, leading to 2 239 equivalent attributable deaths annually, as well as 2 781 cases of bronchitis in adults, and 9 533 episodes in children, together with other related respiratory related diseases in adults and children each year.

These negative health impacts are likely to be mostly experienced by disadvantaged members of society.

Linked to this are the high costs associated with the health impacts of coal-fired power stations and mines in South Africa.

The study by Holland finds that the total quantifiable economic cost of air pollution from coalfired generation in South Africa is in the region of R34.9 billion a year.

This is made up of impacts in terms of early death, chronic bronchitis, hospital admissions for respiratory and cardiovascular disease, and a variety of minor conditions leading to restrictions on daily activity, including lost economic productivity.

Holland’s report excluded the significant impacts on air pollution from mining (such as coal dust), transport of coal and contamination of water. Health professionals, especially those in the public sphere, have a duty of care towards current and future generations.

Climate change will only exacerbate this manmade health epidemic, in addition to its own health impacts. This is more than an environmental problem. This is a public health crisis that requires the public health community to be part of the solution – and it has the power to do so.

The time is now for the health sector to join the environmental and climate debate! Health must take oversight of air pollution for South Africa because the environmental ministry has failed over the past 15 years!

This is according to a recent assessment of the National Environmental Management Air Quality Act after implementation by weather and public health scientists. The implication is that the legislation is failing to reduce air pollution!

Advocated by dirty industry and constrained environmental ministries, we often encounter the argument that environmental degradation and pollution are inevitable consequences of development in our region.

Development and pollution go hand in hand. However, addressing existing environmental degradation and embarking on a just transition through reinvestment in renewable energy and providing better services and houses for people, offers us a unique opportunity to address health and social inequality.

This has also shown to be a successful global strategy to help slow climate change and reduce the public health and economic risks of fossil fuel investments. In effect a return on investment, through measurable environmental improvements and reduced health costs.

In contrast, a business as usual scenario will continue to place our way of life at risk, marginalise workers who are inevitably losing their coal sector jobs and exclude the poor from “development” who can’t afford electricity at current prices any way.

In South Africa, it’s not that we lack regulations on air pollution, it’s the political will and foresight to implement these policies that is severely constrained by those who hold the reins of power.

Air quality monitoring and reporting is often deliberately left to deteriorate through wilful neglect, and our environmental ministry plays second fiddle to the politically connected within the departments of minerals and energy along entrenched party patronage supply lines.

Nurses, doctors and pharmacists consistently rank among the most trusted professions globally.

However, it is not sufficient to treat people’s illnesses without changing the conditions which make them sick in the first place. The environment is responsible for 23% of the global burden of diseases – this is from the WHO and the call to action is for the health sector to become more vested and articulate the health impacts to address the climate and global air pollution crisis. There is an urgent and immediate need for health voices to amplify health messages and join the climate and health movement!

Euripidou trained as an environmental epidemiologist at the London School of Hygiene and Tropical Medicine in the UK. Euripidou’s interests lie in working on issues of energy and chemicals policy, climate change and public health.

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