US embassy cable - 05AMMAN3533

UNCLAS SECTION 01 OF 02 AMMAN 003533 
 
SIPDIS 
 
ADDIS ABABA FOR ESTH HUB - BALZER 
 
E.O. 12958 N/A 
TAGS: SENV, TBIO, XF, JO 
SUBJECT: LINKING ENVIRONMENT AND HEALTH - EPA'S HELI PROGRAM 
 
1.  Summary: EPA's Children's Environmental Health Indicators 
(CEHI) program and the Health and Environment Linkage Initiative 
(HELI) program, co-chaired by UN Environment Program (UNEP) and 
the World Health Organization (WHO), seek to assess the health 
costs of environmental factors and ultimately to prevent 
environmentally-caused illness through more informed policy 
making.  WHO convened a Middle East regional HELI/CEHI 
consultation in Amman March 28-31 to assess progress and share 
information.  End Summary. 
 
EPA And Canada Launch Programs at WSSD 
-------------------------------------- 
2. US EPA, an early leader in linking health and environment, 
launched the Children's Environmental Health Indicators (CEHI) 
program at the 2002 Johannesburg World Summit on Sustainable 
Development (WSSD).  CEHI focuses specifically on environmental 
impacts on children's health.  At the same time, Canada launched 
the Health and Environment Linkage Initiative (HELI) program. 
HELI is now run in a unique "joint secretariat" relationship 
between UNEP and WHO.  WHO also runs EPA's CEHI program, and 
WHO's Eastern Mediterranean Regional Office (EMRO) is managing a 
CEHI pilot program.  EPA funds CEHI at $500,000 over 5 years, or 
$100,000 per year.  Canada funds HELI at $1 million per year for 
3 years. 
 
Attendees from Middle East, Maghreb, Gulf, Iran 
--------------------------------------------- -- 
3.  WHO's Eastern Mediterranean Regional Office (EMRO) held a 
regional HELI/CEHI consultation in Amman on March 28-31 to review 
Jordan's HELI pilot project, which looks at the relationship 
between water consumption and health.  Uganda and Thailand also 
have HELI pilot projects on other topics.  The intent is to scale 
up the programs after the appropriate tools and plans are 
developed.  In addition to regional consultations, there will be 
periodic global HELI/CEHI meetings.  Participants at the Amman 
HELI/CEHI consultation came from Saudi Arabia, Yemen, Oman, 
Syria, Iran, Morocco, Tunisia, Jordan, Lebanon, USA, Canada, 
Kuwait, Egypt, WHO, UNEP and Thailand.  (Note: Israel belongs to 
WHO's European Regional Office, and does not participate in WHO 
meetings under the Eastern Mediterranean Regional Office.) 
 
Prevention Cheaper Than Treatment 
--------------------------------- 
4.  According to Pierre Quiblier from UNEP, environmental factors 
cause 25 percent of all illness, primarily in developing 
countries.  HELI seeks to prove that environmentally sound 
policies contribute to income and development through better 
health, and that it is cheaper to prevent environmentally caused 
illnesses than to treat them.  The first job of the HELI group is 
to identify information tools to prove these assertions.  Each 
country defines its own agenda and needs, which are often multi- 
sectoral, using HELI tools.  Participants emphasized the need for 
practical, locally oriented results, not more studies. 
 
Health Impact Assessment - An Important New Tool 
--------------------------------------------- --- 
5.  HELI's strategy is to generate information for decision- 
makers that show the health costs of policy options so that those 
costs are considered at the policy planning phases, not ignored 
up front and managed later as side effects.  A "health impact 
assessment," similar to the environmental impact assessment, is 
one tool for identifying the health impacts of individual 
environmental actions and policies.  An economic approach to 
measuring the health outcomes of environmental factors seems to 
resonate best with policymakers, according to speakers at the 
meeting.  HELI seeks to tailor their processes and tools to fit 
decision-makers' needs. 
 
Wide Range of Factors Can Degrade Health 
---------------------------------------- 
6.  Environmental factors that can affect health include air 
pollution, smoking, chemicals in paints, household cleaners, 
pests and vermin, lead from paint and tailpipe emissions, car 
accidents, impure water, water scarcity, exposure to pesticides 
and fertilizers, noise, and proximity to solid waste.  For 
example, bad water makes kids sick with diarrhea, leading to 
fewer school days, higher medical expenses, lost household income 
as parents take time to care for sick children, and ultimately to 
developmentally stunted children and lost lives. 
 
Health-Environment Issue Lacks a Bureaucratic Champion 
--------------------------------------------- --------- 
7.  According to several meeting participants, governmental and 
policy-making bodies have been slow to link environment and 
health.  There has been a "not our problem" reaction to 
environmental health by both health departments and environment 
departments, leaving environmental health issues without a clear 
bureaucratic lead agency. HELI/CEHI participants are working hard 
to overcome this problem.  Even in the United States, according 
to EPA specialists, pediatricians receive only a few hours of 
training about environmental effects on children's health.  As a 
result, the Department of Health and Human Services (HHS) and EPA 
have developed a unique collaboration to create eleven 
Environmental Health Specialty Units in the United States.  The 
mission of these centers is to train pediatricians about health 
effects from environmental factors. 
 
Low-End Users Need to Use More Water, Not Less 
--------------------------------------------- - 
8.  Dr. Amer Jabarin, a HELI advisor from the University of 
Jordan, discussed Jordan's HELI pilot project on the relationship 
between water consumption and health.  He said that there is a 
minimum level of water consumption from a health viewpoint.  He 
said that people at the low end of the water consumption scale 
might not be using enough water to stay healthy (through such 
things as hand washing, bathing, waste disposal, washing 
vegetables and washing utensils).  While conservation at the high 
end of the consumption scale should be encouraged, he said, it 
might be useful, even in an arid country like Jordan, to 
encourage more water consumption among people with the lowest 
water consumption levels.  Consuming water among those people may 
make a net contribution to national income through better health, 
even though the water and the energy used to pump the water add 
costs. 
 
9.  Comment: The Health Impact Assessment may become an 
indispensable legal tool to protect public health, just as the 
Environmental Impact Assessment has become a standard tool for 
environmental protection. 
HALE