The health landscape in Latin America and the Caribbean is challenging and is closely linked to environmental care. According to data from the Pan American Health Organization, 13% of deaths in the region are currently attributed to environmental risks, accounting for 847,000 deaths per year.
Recently, the UN General Assembly adopted a historic resolution declaring that access to a clean, healthy and sustainable environment is a universal human right. With this resolution, countries, international organizations and the private sector are urged to intensify efforts to ensure a healthy environment for all and to curb the triple crisis that our planet is facing: the climate emergency, pollution and the loss of biodiversity.
Both the climate crisis and the emergence of zoonotic diseases have roots in habitat destruction, the introduction of invasive species, changes in land use, pollution, population growth and overexploitation of natural resources. These crises reaffirm the need to substantially broaden the scope of health-related issues and adopt systemic and transdisciplinary approaches, taking into consideration the sustainable management of natural resources.
Our Environmental and Social Policy Framework (ESPF), which was approved in the context of COVID-19 and of our commitment to climate action, reflects this understanding and promotes health protection under the notion of integrated risk and impact assessment in different sectors for humans, animals and ecosystems. In so doing, we seek to go beyond a focus on disease control to embrace a more comprehensive understanding of the links between health and other sectors.
Health impacts are integrated in a cross-cutting manner in the different standards of the ESPF from a systemic perspective, under the mitigation hierarchy approach. The ESPF includes instruments to address them, such as the health impact assessment, the exclusion list of substances that are hazardous to health and the development of the respective mitigation plans. Let’s take a quick look at how the different Environmental and Social Performance Standards (ESPS) address the health topic.
ESPS 1: Assessment and Management of Environmental and Social Risks and Impacts
ESPS 1 focuses on the impacts and risks of a project on its surroundings and states that, in the process of identifying these, consideration will be given to risks associated with pandemics, epidemics and any spread of communicable diseases caused or exacerbated by project activities. It also considers the potential impacts of the project on natural resources, including food security. Finally, it considers disease outbreaks within emergency situations for which preparedness and response measures must be in place.
ESPS 2: Labor and Working Conditions
ESPS 2 focuses on impacts to the project workforce and considers that, in the event of pandemics or epidemics, the borrower should develop and implement occupational health and safety measures and protocols to protect workers from the risk of exposure to disease. This should be done in accordance with national guidelines and international best practices, such as those recommended by the World Health Organization.
ESPS 3: Resource Efficiency and Pollution Prevention
ESPS 3 addresses the potential adverse impacts of the project on existing environmental conditions, including the assimilative capacity of ecosystems, present and future land use, proximity to areas of biodiversity importance, and potential cumulative impacts with uncertain or irreversible consequences. It also regulates the use and management of pesticides and promotes integrated pest and/or vector management to prevent significant economic damage from pests and the transmission of diseases to humans and animals.
ESPS 4: Community Health, Safety and Security
ESPS 4 considers how the project’s direct, indirect and cumulative effects on priority ecosystem services may result in adverse health risks and impacts to people affected by its operations. For example, natural resource depletion or degradation, such as adverse impacts on the quality, quantity and availability of freshwater, can result in health-related risks and impacts.
ESPS 4 also requires avoiding or minimizing community exposure to waterborne, vector-borne and communicable diseases that may be caused or exacerbated by project activities, taking into account the differential exposure of vulnerable groups and their heightened sensitivity. In the case of certain diseases that are endemic in the communities located within the project’s area of influence, the borrower is encouraged to explore opportunities during the life cycle of the operation to improve environmental conditions that may contribute to minimizing the incidence of such diseases. In the case of non-endemic disease outbreaks, the borrower should take measures to prevent community exposure.
ESPS 5: Land Acquisition and Involuntary Resettlement
On health issues, ESPS 5 states that due attention should be paid to risks related to disease outbreaks, natural disasters, and climate change at resettlement sites. Under no circumstances shall displaced persons be relocated to places with active disease outbreaks or to disaster-prone areas.
ESPS 6: Biodiversity Conservation and Sustainable Management of Living Natural Resources
This standard states that no project activities with potential adverse impacts will be implemented in critical habitats and that a well-designed long-term biodiversity monitoring and assessment program aimed at evaluating the status of these habitats must be included. It also limits the intentional or accidental introduction of exotic species of flora and fauna, since they can become invasive and cause changes in the ecosystem that can give rise to vectors that affect the health of the neighboring population. Finally, ESPS 6 provides measures to avoid creating conditions that facilitate the transmission of zoonotic diseases to workers, communities and populated areas.
ESPS 7: Indigenous Peoples
ESPS 7 recognizes that Indigenous Peoples, as distinct social and cultural peoples, are often among the most marginalized and vulnerable segments of the population. Indigenous Peoples are particularly vulnerable if their lands and resources are transformed, invaded or significantly degraded. This vulnerability may include exposure to impoverishment and disease, so conducting socio-cultural diagnoses that analyze, among other factors, health parameters is recommended.
ESPS 9: Gender Equality
ESPS 9 examines the risk of disproportionate project impacts on women, girls, and sexual and gender minorities. Risk areas include exposure to disease and an analysis to identify potential health impacts and include mitigation measures to avoid and prevent them is expected.
A multidimensional approach to health and the environment
Latin America and the Caribbean face a convergence of risks that threaten the fragile relationship between human health and ecosystem health. Therefore, an integrated approach to health from the beginning of a project’s life cycle can foster broader benefits. The implementation of health and environmental impact assessments provided for in our ESPF becomes an indispensable tool, taking into consideration that the relationship between health and the environment determines a fundamental part of our well-being.