Happy World Environment Day 2023

From: Prof Tjandra Yoga Aditama, Senior Disease Control Advisor, Australia Indonesia Health Security Partnership (AIHSP)

The world faces various health problems that require a comprehensive management approach. One of the most important public health programs that must be carried out is the One Health Approach‒a collaborative approach in human, animal, plant, and environmental health services that is carried out in an integrated manner across sectors and, of course, with the community.

In the last two years, Indonesia has held some important leadership positions in the international arena and has always raised the importance of the One Health Approach. When Indonesia assumed the G20 presidency in 2022, the Lombok G20 One Health Policy Brief was produced. This covered seven areas: (i) Awareness and Advocacy; (ii) Pandemic Prevention, Preparedness, and Response; (iii) Governance (multi-sector); (iv) Finance; (v) Implementation; (vi) Sharing Experiences and Capacity Building; and (vii) Monitoring and Evaluation. As the ASEAN Chair in 2023, Indonesia, on 10 May 2023 at the 42nd ASEAN Summit in Labuan Bajo, facilitated the adoption of the "ASEAN Leaders’ Declaration on the One Health Initiative". This declaration expressly states the need to establish a clear One Health network ("ASEAN One Health Network"), outlines the need for a comprehensive analysis of the implementation of One Health so far in the ASEAN region, and the need to establish a clear framework in the form of the “ASEAN One Health Joint Plan of Action”, which is currently being prepared.

The Australia Indonesia Health Security Partnership (AIHSP) played a central role in supporting the preparation of the G20 One Health Policy Brief in 2022 and the ASEAN Leaders’ Declaration on the One Health Initiative in 2023, as well as their implementation efforts, and it is hoped that this support will continue in the future.

Under the One Health collaborative approach described above, the importance of environmental health is always emphasised. Of course, we also know that the importance of preserving a healthy environment is not only related to the concept of "One Health" above. Since 1972 when the United Nations declared World Environment Day, it has been celebrated every year on 5 June. The decision was taken at the Stockholm Conference on the Human Environment (5–16 June 1972) and the first World Environment Day commemoration took place in 1973‒the theme of which was "Only One Earth". From 1973 to 2023, many themes have been adopted to make people aware of environmental conservation and issues. The theme for World Environment Day on 5 June 2023 itself will focus on plastic pollution solutions under the #BeatPlasticPollution campaign.

The world is being flooded with plastic. More than 400 million tons of plastic are produced each year‒one-half of which is designed for one-time only use. Of this amount, less than 10 per cent is recycled. An estimated 19-23 million tonnes end up in lakes, rivers, and seas. Today, that wasted plastic clogs up our landfills, dissolves into the ocean, and is burned, thereby creating toxic fumes‒making it one of the greatest threats to the planet. Not only that, what is rarely known is that microplastics can get into the food we eat, the water we drink, and even the air we breathe. Many plastic products also contain harmful additives that can threaten our health.

We know that various global environmental changes will affect human health‒such as climate change, depletion of the ozone layer, land degradation, reduced water resources, changes in ecosystem function, and loss of biodiversity. Climate change will lead to regional extreme weather events, rising temperatures, changes in rainfall patterns, and sea level rise. In climate change terminology, this component is known as the climate change hazard.

The health impacts arising from climate change can affect human health in two ways‒directly and indirectly. The direct impact that affects human health is in the form of direct exposure to changes in weather patterns, both in the form of fluctuations in temperature, rainfall, sea level rise, and an increase in the frequency of extreme weather. Indirect impacts can be through, for example, environmental factors such as changes in environmental quality including the quality of water, air, and food as well as changes in the lifestyle of disease-transmitting vectors. In general, an increase in temperature of 2-3⁰ C will increase the number of sufferers of vector-borne diseases by 3-5 per cent. Increasing temperature will also expand the distribution of vectors and increase the development and growth of parasites to become more infectious. Meanwhile, changes in rainfall along with changes in temperature and humidity can increase or decrease the population density of disease vectors and human contact with disease vectors. Changing swamp and mangrove ecosystems can also cause changes in the distribution pattern of disease vectors. In this case, we again see the direct relationship between environmental conditions, animals, and human health, as discussed above in the concept of One Health.

Depletion of the ozone layer in the stratosphere can increase the risk of developing skin cancer, while increasing temperatures due to climate change can increase surface ozone concentrations, which is one of the main air pollutants that can cause respiratory diseases. Loss of biodiversity can lead to scarcity of medicinal raw materials from plants. The decline in water resources causes limited access to clean water and healthy sanitation with various consequences. On the other hand, climate change can cause illness/death due to extreme weather events, landslides, floods, storms, and other natural disasters. Furthermore, malnutrition can occur due to disruption of food sources and harvests, which again shows the relationship between the environment, food crops, and human health, according to the One Health concept.

In regard to air pollution in particular, the World Health Organization (WHO) said that 9 out of 10 people in the world live in an environment where air pollution levels exceed WHO thresholds. According to WHO there are 4.2 million global deaths every year due to outdoor air pollution and millions more people die due to indoor air pollution.

In closing, let's give World Environment Day 2023 the momentum to protect and care for our environment, for the sake of our health now and that of our children and grandchildren in the future.