Challenges in decision-making
|Every minute, five children in developing countries die from malaria or diarrhoea. Every hour, 100 children die as a result of exposure to indoor smoke from solid fuels.
Every day, nearly 1800 people in developing cities die as a result of exposure to urban air pollution. Every month, nearly 19 000 people in developing countries die from unintentional poisonings.|
– Health and Environment: Tools for Effective Decision-Making: the WHO/UNEP Health and Environment Linkages Initiative Review of Initial Findings, 2004.
Policy-makers in the developing world face a range of pressing health impacts from environmentally-related hazards. And along with the human toll, developing countries bear the economic cost of lost productivity, the burden on the health sector, a burden from degraded resources and long-term social consequences.
At the same time, developing countries are coping with a rapid rate of modernization and change. Environment and health issues, then, need to be high on policy agendas. Development decisions should involve a thorough consideration of issues related to environment and health, ahead of major investments and infrastructure commitments. But that is not always the case. Why?
A HELI review of environment and health decision-making in a developing country context analyzed the driving forces that shape environment and health policy, synthesizing the results of in-depth interviews with experts and decision-makers, and findings from an extensive literature review. The review concluded that the primary barriers to more effective policy are neither a lack of evidence nor a lack of knowledge. They are economic, institutional, political and social.
Macroeconomic factors such as trade globalization, market liberalization, debt burdens and structural adjustment policies are among the most powerful drivers of national political agendas and, indirectly, environment and health policies.
Environmental hazards, which may be unseen and/or emerge slowly over time, also compete as policy priorities with social, political, economic and humanitarian crises - some of which may be related to long-neglected environmental problems (e.g. floods and epidemics or drought and famine).