oil, health, and development | 1 |1 | international policy conference “competitiveness &...
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Oil, health, and development |1 |
INTERNATIONAL POLICY CONFERENCE
“COMPETITIVENESS & DIVERSIFICATION: STRATEGIC CHALLENGES IN A PETROLEUM-
RICH ECONOMY”
Health Challenges in a Petroleum Rich Economy
Daniel Kertesz
14 – 15 march 2011, Accra, Ghana
Health Challenges in a Petroleum Rich Economy
Health Challenges in a Petroleum Rich Economy
Daniel KerteszWHO Representative in Ghana
World Health Organization
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Key messagesKey messages
Health is vital for successful growth of oil and gas sector and for development of region
Health impacts associated not only with environmental risk factors
Opportunity through health, to make sure that this oil is good for development
Health system a key partner
Many tools and good practice examples of how to do this
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OverviewOverview
1. Why is it important for people to be healthy?
2. What are the specific health concerns when considering the oil and gas industry?
3. Who is affected
4. Why can’t we deal with these?
5. How can stronger health systems mitigate effects
6. Introduce the idea of Health Impact Assessment (HIA)
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Why is it important for people to be healthy?
Why is it important for people to be healthy?
Human health is very easy to relate to – intuitively we all know and appreciate good health and understand the impact of bad health
Loss of health can have catastrophic consequences for individuals and for families
Development progress is measured with health indicators (e.g. MDGs)
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… healthy population is vital for local economic development…
… healthy population is vital for local economic development…
Labour pool– Higher costs - non-wage labour
costs – Reduced performance and
productivity of workers– Longer term, due to reduced
educational attainment, less qualified local labour pool
Heavy burden of disease – Tuberculosis– Alcoholism– HIV/AIDs– Malaria
High health insurance costs
Catastrophic costs of disease for families
Less competitive
Less attractive investment climate
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…..also for industry……..also for industry…
Liability for pollution and environment and health damages
Impact of projects on disease and impacts of diseases on projects
– Disease transmission
Disease and well-being affects linkages with communities
– Perceptions, expectations and reactions to business
cost of doing business
social licence to operate
reputational risks
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Oil and gas extraction: Direct impacts on health
Oil and gas extraction: Direct impacts on health
Pollution:– Air emissions - NOx, SOx, PM, dust– Soil and ground water contamination– Vibration and noise pollution
Degradation:– Change in soil quality– land use changes, damage to ecosystems, loss of biodiversity
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Direct impacts on healthDirect impacts on health
Operation of equipment and machinery– Road traffic accidents– Construction– Fires, explosions
Exposure to hazardous substances – Chemicals, – heavy metals
Heat stress, exposure to UV radiation
Ergonomic injuries
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Indirect impacts on healthIndirect impacts on health
Changing patterns of communicable diseases– Tuberculosis, HIV/AIDS, Malaria– Respiratory infectious diseases– Sexually transmitted infections
Food and waterborne illness – Local service / infrastructure are overwhelmed
Increase in non communicable diseases– “Boom town” effect: more money, more food of poorer quality, less
exercise, more obesity, more heart disease– Violence, alcohol abuse, mental health problems– Stress, anxiety and social tensions
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rapid developmentexample pathways to health outcomes
rapid developmentexample pathways to health outcomes
Change in spending patterns
Diet (quality) and lifestyle
Cardiovascular disease
Diabetes
Obesity
Alcoholism
Respiratory disorders
Injury or death
Access to motorized transport
Nutritional status
Levels of physical activity
Stress, mental well-being
Road traffic accidents
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Why can’t we deal with these?Why can’t we deal with these?
Underestimation of health impacts by governments– Inadequate consideration of all implications, lack of awareness
Institutional barriers dividing sector functions
Weak national/local health systems not equipped to identify or manage impacts
– Strain on access to limited services– Procurement and supply of commodities– Inadequate quantity/quality of human resources for health– Poor surveillance, information management
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Who is affected?Who is affected?
Outbreak of mass poisoning from sodium bromide - 458 cases in Luanda, Angola
sodium bromide used widely in oil and gas industry
Entered the local market and was mistaken for table salt
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What is a health system?What is a health system?
All organizations, people and actions whose primary interest is to promote, restore or maintain health
Has 6 building blocks:– Service delivery– Health workforce– Information– Medical products, vaccines, technologies– Financing– Leadership and governance
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How good health systems can mitigate impact
How good health systems can mitigate impact
Identification of health risks (and benefits)– And interventions to address them using simple, low cost
public health interventions
Monitoring, reporting and evaluation– Epidemiological and health indicators for baseline– Early warning and monitoring of unintended impacts– Measuring net "social" benefits or losses generated as a result
of growth of the petroleum industry
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How good health systems can mitigate impact
How good health systems can mitigate impact
Responding to community concerns and perceptions of risk
– Health sector experienced with risk communication and can engage in dialogue on community concerns about health risks
Emergency preparedness and response – Public health response to chemical incidents– Recognition and accurate diagnosis of chemical exposure
Responding to health issues– Delivery of medical services to workers and to communities
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Key messagesKey messages
Health is vital for successful growth of oil and gas sector and for development of region
Health impacts not only associated with environmental risk factors
Opportunity through health, to anticipate to make sure that this oil is good for development
Health system a key partner
Many tools and good practice examples of how to do this
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Thank youThank you
Daniel Kertesz
World Health Organization RepresentativeGhana
Extra slidesExtra slides
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Example: Alberta, CANADA (2010)Example: Alberta, CANADA (2010)
"boom town"– virtual doubling of population in less than a decade
Community health status lower in oil sands areas than in other regions - inequity
Individual and family pressures– Inflation (rent, food prices)– Housing and labour shortages
Infrastructure pressures– Investment in health infrastructure
not as fast as population growth
Increased crime, alcohol and drug use, family stress
Fort McMurry and the Oil Sands, Photo: Gord Mckenna
Source: RSC Expert Panel, Environmental and Health Impacts of Canada's Oil Sands Industry, Dec 2010
Health impacts of oil and gas extraction activities
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Health impact assessment (HIA)Health impact assessment (HIA)
Health impact assessment– is a key tool/process/platform to facilitate the integration of
health considerations into development policies, plans, and projects
The use of HIA can enable the upstream assessment/identification of
– potential health impacts associated with a particular policy, plan
– opportunities to address those impacts. HIA can enable foresight to help ensure that the legacy is positive.
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How does HIA work?How does HIA work?
Analysis of activities to determine potential health impacts
Determination of baseline of health status and assessment/estimation of potential health impacts
Generates recommendations on intervention options
Framework for monitoring and evaluation
Process and platform for systematically engaging all stakeholders in decision-making process
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Onshore facilitiesOnshore facilities
The footprint of oil and gas activities is much bigger than just the well.
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Ancillary facilities and infrastructureAncillary facilities and infrastructure
Requires construction of pipelines, transport corridors, sometimes ports, and power and water infrastructure.
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HIA procedureHIA procedure
Screening
Scoping
Appraisal
Reporting
Monitoring
Quickly establishes "health relevance" of the policy or project. Is HIA required?
Identifies key health issues & public concerns, establishes ToR, sets boundaries.
Rapid or in-depth assessment of health impacts using available evidence – who will be affected, baseline, prediction, significance, mitigation.
Conclusions and recommendations to remove/mitigate negative impacts on health or to enhance positive.
Action, where appropriate, to monitor actual impacts on health to enhance existing evidence base.
Policy, programme , or project development phase for prospective assessments.
Policy or project implementation phase
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Strategic Environmental Assessment
1. Establishing the context for the SEA Screening Setting objectives Identifying stakeholders
2. Implementing the SEA Scoping (in dialogue with stakeholders) Collecting baseline data Identifying alternatives Identifying how to enhance opportunities and
mitigate impacts Quality Assurance Reporting
3. Informing and influencing decision making Making recommendations
4. Monitoring and evaluating Monitor decisions taken on the proposal Monitor implementation of the proposal Evaluation of both the SEA and the proposal
Screening – to establish health relevance of the proposal
HIA can be easily integrated into other IAsHIA can be easily integrated into other IAs
Appraisal – assessment of health impacts using available evidence
Scoping – where health relevance exists, identifies questions to ask and defines boundaries for the assessment
Reporting – development and communication of conclusions and recommendations to remove/mitigate negative impacts on health or enhance positive impacts
Monitoring – action, where appropriate to monitor actual impacts on health to enhance existing evidence base
Health impact assessment (HIA)
DAC Guidance on SEA in Development Cooperation, OECD 2006 WHO, 2003