Publication Year: 2017

Tackling the health burden of air pollution in South Asia

Summary

Air pollution exposure is the second most important risk factor for ill health in South Asia, contributing to between 13% and 21.7% of all deaths and approximately 58 million disability adjusted life years (DALYs) through chronic and acute respiratory and cardiovascular illnesses.1 Of the top 30 cities in the world with the poorest air quality in 2016, 17 are in South Asia.2 The impact of air pollution transcends boundaries. The “brown cloud”—caused by pollution from carbon aerosols—is a phenomenon captured in satellite images of atmospheric haze over South Asia, as well as China. South Asia has one of the highest concentrations of black carbon emissions from cars and trucks, cooking stoves, and industrial facilities. In addition to their effect on health, black carbon particles are a short lived climate pollutant with a possible impact on precipitation patterns and on the Himalayan glacier system, which threatens water resources in the region.3

Collective regional action to monitor air quality and implement evidence based policies and interventions is needed. While countries have introduced promising initiatives in recent years, comprehensive health centred strategies are lacking. We present the status of air pollution and health effects in South Asia, and propose urgent, concerted action across sectors to achieve recommended air quality standards for the people of the region.

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Trump’s Toxic Announcement on Climate Change

Introduction

President Donald Trump’s announcement that the United States will exit from the Paris Agreement betrays a fundamental misunderstanding of the way the agreement works. It also goes against long-agreed climate principles, and is blind to emergent clean energy trends. In practical terms, the US had activated a rollback of mitigation policies and contributions to climate finance prior to this announcement. Until there are changes in domestic US climate politics—of which there are positive signs—the US cannot be regarded a reliable partner for global climate cooperation.

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Redefining public health leadership in the sustainable development goal era

Abstract

Adoption of the Sustainable Development Goals (SDGs) by member states of the United Nations (UN) has set a new agenda for public health action at national and global levels. The changed context calls for a reframing of what constitutes effective leadership in public health, through a construct that reflects the interdependence of leadership at multiple levels across the health system and its partners in other sectors. This is especially important in the context of Low and Middle Income Countries (LMICs) that are facing complex demographic and epidemiological transitions. The health system needs to exercise leadership that effectively mobilises all its resources for maximising health impact, and channels trans-disciplinary learning into well-coordinated multi-sectoral action on the wider determinants of health. Leadership is essential not only at the level of inspirational individuals who can create collective vision and commitment but also at the level of supportive institutions situated in or aligned to the health system. In turn, the health system as a whole has to exercise leadership that advances public health in the framework of sustainable development. This commentary examines the desirable attributes of effective leadership at each of these levels and explores the nature of their inter-dependence.

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