Health Improvement Essay

To address this challenge, the world’s governments committed themselves at the United Nations Millennium Summit to the Millennium Development Goals, including the overarching goal of halving extreme poverty by the year 2015. Yet, our planet’s capacity to sustain us is eroding. The problems are well-known – degrading agricultural lands, shrinking forests, diminishing supplies of clean water, dwindling fisheries, and the threat of growing social and ecological vulnerability from climate change and loss of biological diversity. While these threats are global, their impacts are most severe in the developing world – especially among people living in poverty who have the least means to cope. Is this environmental decline inevitable in order for poverty to be reduced? We argue not. Indeed, quite the opposite is true. If we do not successfully arrest and reverse these problems, the world will not be able to meet the Millennium Development Goals, particularly the goal of halving extreme poverty. As this paper demonstrates, tackling environmental degradation is an integral part of effective and lasting poverty reduction. The 2002 World Summit on Sustainable Development (WSSD) provides the international community with a pivotal opportunity to redirect the global debate, and to forge a more integrated and effective global response to poverty and environmental decline. To succeed, we need to focus on the most important links between poverty, the environment and sustainable development. For many, ensuring sound environmental management means curtailment of economic opportunities and growth, rather than their expansion †¦ too often; it is viewed as a cost rather than an investment. Prepared as a contribution to the 2002 World Summit on Sustainable Development focuses on ways to reduce poverty and sustain growth by improving management of the environment, broadly defined. It seeks to draw out the links between poverty and the environment, and to demonstrate that sound and equitable environmental management is integral to achieving the Millennium Development Goals, in particular eradicating extreme poverty and hunger, reducing child mortality, combating major diseases, and ensuring environmental sustainability. Four priority areas for sustained policy and institutional change are highlighted: ?Improving governance for pro-poor and pro-environment policies, institutions and services, with particular attention to the needs of women and children; ?Enhancing the assets of the poor and reducing their vulnerability to environment-related shocks and conflict; ?Improving the quality of growth to protect the asset base of the poor and expand opportunities for sustainable livelihoods; ?Reforming international and industrialized country policies related to trade, foreign direct investment, aid and debt. Policy opportunities exist to reduce poverty and improve the environment The environment matters greatly to people living in poverty. The poor often depend directly on natural resources and ecological services for their livelihoods; they are often the most affected by unclean water, indoor air pollution and exposure to toxic chemicals; and they are particularly vulnerable to environmental hazards such as floods and prolonged drought, and to environment-related conflict. Addressing these poverty-environment linkages must be at the core of national efforts to eradicate poverty. Many policy opportunities exist to reduce poverty by improving the environment – but there are significant and often deeply entrenched policy and institutional barriers to their widespread adoption. The past decade of experience since the 1992 Earth Summit in Rio reveals some important lessons that help point the way forward. Three broad lessons are highlighted here: ?First and foremost, poor people must be seen as part of the solution – rather than part of the problem. Efforts to improve environmental management in ways that contribute to sustainable growth and poverty reduction must begin with the poor themselves. Given the right incentives and support – including access to information and participation in decision-making – the poor will invest in environmental improvements to enhance their livelihoods and well-being. At the same time, however, it is essential to address the activities of the non-poor since they are the source of most environmental damage. The environmental quality of growth matters to the poor. Environmental improvement is not a luxury preoccupation that can wait until growth has alleviated income poverty, nor can it be assumed that growth itself will take care of environmental problems over the longer-term as a natural by-product of increasing affluence. First, this ignores the fundamental importance of environmental goods and services to the livelihoods and well-being of the rural and urban poor. Second, there are many examples of how bad environmental management is bad for growth, and of how the poor bear a disproportionate share of the costs of environmental degradation. Ignoring the environmental soundness of growth – even if this leads to short-run economic gains – can undermine long-run growth and its effectiveness in reducing poverty. ?Environmental management cannot be treated separately from other development concerns, but requires integration into poverty reduction and sustainable development efforts in order to achieve significant and lasting results. Improving environmental management in ways that benefit the poor requires policy and institutional changes that cut across sectors and lie mostly outside the control of environmental institutions – changes in governance, domestic economic policy, and in international policies. Improving governance ?Integrate poverty-environment issues into nationally-owned poverty reduction strategies, including macroeconomic and sect oral policy reforms and action programmes, so that they can become national sustainable development strategies. Engage poor and marginalized groups in policy and planning processes to ensure that the key environmental issues that affect them are adequately addressed, to build ownership, and to enhance the prospects for achieving lasting results. Address the poverty-environment concerns of poor women and children and ensure that they are given higher priority and fully integrated into poverty reduction strategies and policy reforms – for example, the growing burden of collecting scarce water and fuelwood supplies, and the effects of long-term exposure to polluted indoor air. Implement anti-corruption measures to counter the role of corruption in the misuse of natural resources and weak enforcement of environmental regulations – for example, the destructive impacts of illegal logging and unregulated mining, or the preference for construction of new power and water investments over increasing the efficiency of existing investments. ?Improve poverty-environment indicators to document environmental change and how it affects poor people, and integrate into national poverty monitoring systems. This should be complemented by measures to improve citizens’ access to environmental information. Enhancing the assets of the poor ?Strengthen resource rights of the poor by reforming the wider range of policies and institutions that influence resource access, control and benefit-sharing, with particular attention to resource rights for women. This includes central and sub-national government, traditional authorities, the legal system, and local land boards, commissions and tribunals. Support decentralization and local environmental management – land, water and forest resource management, and provision of water supply and sanitation services – by strengthening local management capacity and supporting women’s key roles in managing natural resources. ?Expand access to environmentally-sound and pro-poor technology, such as crop production technologies that conserve soil and water and minimize the use of pesticides, or appropriate renewable energy and energy e fficient technologies that also minimize air pollution. This includes support for indigenous technologies, and the need to address the social, cultural, financial and marketing aspects of technical change. ?Promote measures that reduce the environmental vulnerability of the poor by strengthening participatory disaster preparedness and prevention capacity, supporting the formal and informal coping strategies of vulnerable groups, and expanding access to insurance and other risk management mechanisms. Reduce the vulnerability of the poor to environment-related conflict by improving conflict resolution mechanisms in the management of natural resources and addressing the underlying political issues that affect resource access. Improving the quality of growth ?Integrate poverty-environment issues in economic policy and decision-making by strengthening the use of environmental assessment and poverty social impact analysis. Improve environmental valuation at both the macro and micro level, in order to highlight the full cost of environmental deg radation for the poor in particular and the economy in general, and to improve economic decision-making. ?Expand private sector involvement in pro-poor environmental management to maximize the efficiency gains from private sector participation, while safeguarding the interests of the poor. This requires capacity within government to negotiate with the private sector – for example, to ensure that utility privatization benefits the poor – and to forge effective public-private partnerships that enhance the poor’s access to environmental services. ?Implement pro-poor environmental fiscal reform including reform of environmentally-damaging subsidies, improved use of rent taxes to better capture and more effectively allocate resource revenues, and improved use of pollution charges to better reflect environmental costs in market prices. Reforming international and industrialized country policies ?Reform trade and industrialized country subsidy policies to open up markets to developing country imports while avoiding environmental protectionism, and to reduce subsidies that lead to unsustainable exploitation – such as subsidies for large-scale commercial fishing fleets that encourage over-harvesting in developing country fisheries. . Make foreign direct investment more pro-poor and pro-environment by encouraging multinational corporations to comply with the revised OECD Code of Conduct for Multinational Enterprises, and to report on the environmental impact of their activities in line with the UN Environment Programme’s Global Reporting Initiative. ?Increase funding for the Global Environment Facility as the major source of funding for global public goods in the environment, such as a stable climate, maintenance of biodiversity, clean international waters and the protective ozone layer. These benefit the whole world as well as the poor themselves – so the rich world must pay a fair share for their maintenance. ?Enhance the contribution of multilateral environmental agreements (MEAs) to national development objectives by strengthening developing country capacity to participate in the negotiation and implementation of MEAs (for example, to ensure that the Clean Development Mechanism promotes investments that benefit the poor). Also, improved coordination is needed between MEAs so that scarce developing country capacity is used most effectively. ?Encourage sustainable consumption and production – industrialized country consumers and producers through their trade, investment, pollution emissions and other activities affect the environmental conditions of developing countries. Making rich country consumption and production more sustainable will require a complex mix of institutional changes – addressing market and government failures as well as broad public attitudes. Enhance the effectiveness of development cooperation and debt relief with more priority for poverty-environment issues, particularly for the poorest countries where aid and debt relief continue to have a valuable role to play in helping governments to make many of the changes recommended above. Mainstream environment in donor agency operations through staff training, development and application of new skills, tools and approaches, and revisions to the way resources and budgets are allocated. Transparent monitoring of progress against stated objectives and targets is needed in order to hold development agencies accountable and to ensure that a commitment by senior management to addressing poverty-environment issues is put into practice throughout the organization. Conclusion This paper looks ahead with some degree of hope and optimism for the future – there are sometimes win-win opportunities, and there are rational ways of dealing with trade-offs. Environmental degradation is not inevitable, nor the unavoidable result of economic growth. On the contrary, sound and equitable environmental management is key to sustained poverty reduction and achievement of the Millennium Development Goals. There are significant policy opportunities to reduce poverty and improve the environment, but more integrated and pro-poor approaches are needed. The World Summit on Sustainable Development is an opportunity to focus on what is most important and to forge a coherent framework for action, with clear goals and achievable targets backed-up by adequate resources and effective and transparent monitoring mechanisms. There can be no more important goal than to reduce and ultimately eradicate poverty on our planet. PART 1 Why the Environment Matters to People Living in Poverty â€Å"Water is life and because we have no water, life is miserable† (Kenya) â€Å"We think the earth is generous; but what is the incentive to produce more than the family needs if there are no access roads to get produce to a market? † (Guatemala) â€Å"In the monsoons there is no difference between the land in front of our house and the public drain. You can see for yourself† (India) In their own words, the environment matters greatly to people living in poverty. Indeed, poor people’s perceptions of well-being are strongly related to the environment in terms of their livelihoods, health, vulnerability, and sense of empowerment and ability to control their lives. Figure 1 provides a simplified framework for understanding how environmental management relates to poverty reduction, and why these poverty-environment linkages must be at the core of action to achieve the Millennium Development Goals and related national poverty eradication and sustainable development objectives. Environmental management for poverty reductionDimensions of povertyDevelopment goals Part 1 of the paper focuses on the poverty-environment relationship by examining how environmental conditions in both rural and urban settings relate to three key dimensions of human poverty and well-being: ?Livelihoods – poor people tend to be most dependent upon the environment and the direct use of natural resources, and therefore are the most severely affected when the environment is degraded or their access to natural resources is limited or denied; Health – poor people suffer most when water, land and the air are polluted; ?Vulnerability – the poor are most often exposed to environmental hazards and environment-related conflict, and are least capable of coping when they occur. We also are concerned with the relationship between growth and the environment and how it affects the poor and efforts to reduce poverty. The environmental soundness of growth matters considerably to the poor, and countries with similar levels of income and growth can have quite different levels of environmental performance. While Figure 1 illustrates the main pathways between environmental conditions and dimensions of poverty, in reality these linkages are multi-dimensional, dynamic and often inter-connected: ?Poverty is now widely viewed as encompassing both income and non-income dimensions of deprivation – including lack of income and other material means; lack of access to basic social services such as education, health and safe water; lack of personal security; and lack of empowerment to participate in the political process and in decisions that influence one’s life. The dynamics of poverty also are better understood, and extreme vulnerability to external shocks is now seen as one of its major features. Environment refers to the biotic and abiotic components of the natural world that together support life on earth – as a provider of goods (natural resources) and ecosystem services utilized for food production, energy and as raw material; a recipient and partial recycler of waste products from the economy; and an important source of recreation, beauty, spiritual values and other amenities. The nature and dynamics of poverty-environment linkages are context-specific – reflecting both geographic location and economic, social and cultural characteristics of individuals, households and social groups. Different social groups can prioritize different environmental issues (Brocklesby and Hinshelwood, 2001). In rural areas, poor people are particularly concerned with their access to and the quality of natural resources, especially water, cro p and grazing land, forest products and biomass for fuel. For the urban poor, water, energy, sanitation and waste removal are key concerns. Poor women regard safe and physically close access to potable water, sanitation facilities and abundant energy supplies as crucial aspects of well-being, reflecting their primary role in managing the household. ?Environmental management, as used in this paper, extends well beyond the activities of public environmental institutions. In relation to poverty, environmental management is concerned fundamentally with sustaining the long-term capacity of the environment to provide the goods and services upon which people and economies depend. This means improving environmental conditions and ensuring equitable access to environmental assets – in particular land and biological resources, and safe and affordable water supply and sanitation – in order to expand poor people’s livelihood opportunities, protect their health and capacity to work, and reduce their vulnerability to environment-related risks. This broader conception of poverty and environment, and of environmental management, is essential to understanding the linkages between them and to identifying appropriate policy and institutional options for improving these linkages. There have been some impressive gains since the 1972 United Nations Conference on the Human Environment – the first global conference devoted to environment and development issues. There has been a proliferation of environmental policies and institutions at national and sub-national levels, and environmental issues are firmly placed on the agendas of governments, civil society and the private sector. Major global environmental agreements have been forged and global environmental organizations established. Environmental sustainability has become a core concern of bilateral and multilateral development cooperation, and billions of dollars have been spent on environment-related programmes and projects. Tangible progress also has been achieved ‘on the ground’, although the picture is usually mixed. For example, in the 1990s some 900 million people gained access to improved water sources. However, this was merely enough to keep pace with population growth, and about 1. 2 billion people are still without access to improved water sources, with rural populations particularly under-served (Devarajan et al, 2002). Another example is the productivity of soil used for cereal production, which increased on average in developing countries from 1979-81 to 1998-2000. However, it fell in some 25 countries, most of them in Africa, with land degradation being one factor behind the decline (World Bank, 2002c). Despite these gains, pressure on the environment continues to mount worldwide, posing major challenges to the prospects for poverty reduction and human development in developing countries, in particular the least developed countries.