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NOT FOR ATTRIBUTION; FOR DISCUSSION PURPOSES ONLY. Environmental Health : Costs of Environmental Health Damage And Net Benefits of Priority Interventions. A Contribution to the Country Environmental Analysis for the Philippines (Part 1) by Agustin L. Arcenas. - PowerPoint PPT PresentationTRANSCRIPT
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FOR DISCUSSION PURPOSES ONLY
Environmental Health :Costs of Environmental Health
DamageAnd Net Benefits of Priority
Interventions
A Contribution to theCountry Environmental Analysis for
the Philippines(Part 1)
byAgustin L. Arcenas
World Bank CEA Workshop, June 16-17, 2008
Environmental Health - Areas of Concern
Outdoor Air Pollution (OAP)
Indoor Air Pollution (IAP)
Water Pollution, Sanitation and Hygiene (WSH)
Basic Outline of the Study (for each area of concern)I. The basic issues and state of the environmentII. Level of exposure to pollutants and, sanitation
and hygiene problems in the PhilippinesIII. Morbidity IncidenceIV. Economic cost of MorbidityV. Mortality Incidence due to environmentVI. Economic cost of mortalityVII. Suggested policy interventionsVIII. Economic evaluation of policy interventions
How the study was done… Calculate the proportion of total cases of illnesses
that are attributable to pollution, sanitation and hygiene
Using WHO and Philippine data, determine the cost of treatment and foregone income from illnesses and premature deaths
Aggregate the economic costs and values from these calculations
Total Economic Costs of Environmental Health Problems
Total: PhP 9 billion
Water, Sanitation
and Hygiene4.869 B
54%
Indoor Air Pollution2.303 B
25%
Outdoor Air Pollution1.868 B
21%
Morbidity-Mortality shares
MORTALITYPhP 3 B
33%
MORBIDITYPhP 6 B
67%
0
3
5
8
10
1
The Economic Costs of Illnesses caused by Outdoor
Air Pollution
Sources of PM emissions
Sector Average Emissions (tons/year)
% of Total
Stationary Sources 1,083 5.46
Mobile Sources 16,725 84.34
Households 18 0.09
Solid Waste Burning 2,005 10.11
TOTAL 19,831 100
Source: Monitoring Report, 2004
What we know so far… There has been a drop in PM emissions in Metro
Manila since 2003
The number of vehicles in the country is growing
Diesel contributes more to PM than gasoline
Main source of PM emissions in the country – 2 stroke-tricycles
The bulk of vehicles in the country are the tricycles followed by utility vehicles
PM Emissions from Mobile Sources, 2006
0
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
2006 PM Emissions from MobileSources
Cars
Jeeps/UV
SUV
Trucks
Buses
Motorcyles/Tricyles
Trailers
Morbidity Cases - OAP
Urban22,732
19%
Metro Manila30,23625%
Rural66,112
56%
Total: 119,080
Costs to Society of OAP-related Illnesses
Direct Cost to Households
896 M49%
Lost Income Due to
Premature Deaths697 M37%
Lost Income Due to Illness
118 M6%
Philhealth Subsidy156 M
8%
Total: PhP 1.9 billion
Costs to Households of Treatment - OAP, 2003
Total: PhP 896 million
Metro Manila205 M23%
Urban 152 M17%
Rural539 M60%
Foregone Income due to OAP-related Illnesses
Total: PhP 118 million
Rural55 M47%
Urban 22 M19%
Metro Manila41 M34%
Cost of Premature Deaths due to OAP, 2003
45
124
236
292
0 75 150 225 300
Lost Income (in PhP millions)
Under 1-19
20-34
35-49
50-64
Age Group
Total: PhP 697 million
Potential Interventions to curb OAP Inspection and maintenance (I/M) programs
Installation of pollution control devices
Rehabilitation of Current Traffic Management System
Investments in Additional Mass Transport System
The Economic Costs of Illnesses caused by Indoor
Air Pollution
Primary Cooking Fuel for Households, 2004
Primary Cooking Fuel for Households, 2004 (percentage of households)
LPG, 42.68
Kerosene, 4.81
Fuelwood, 41.98
Charcoal, 7.17
Others, 2.06Electricity, 1.29
Source: HECS, 2004
Households Exposed to Indoor Air Pollution (in %)
14.0%
1.1%
11.5%
20.4%
0% 5% 10% 15% 20% 25%
National
Metro Manila
Urban
Rural
Morbidity Cases - IAP
Urban13,938
12%
Metro Manila1,4121%
Rural99,315
87%
Total: 114,665
Costs to Society of IAP-related Illnesses
Direct Cost to Households
774 M34%
Philhealth Subsidy
81 M4%
Lost Income Due to Illness
82 M4%
Lost Income Due to
Premature Deaths1.366 B
58%
Total: PhP 2.3 billion
Costs to Households of Treatment - IAP, 2003
Metro Manila8 M1%
Rural683 M88%
Urban 83 M11%
Total: PhP 774 million
Foregone Income due to IAP-Illnesses, 2003
Total: PhP 82 million
Urban 12 M14%
Metro Manila3 M4%
Rural67 M82%
Cost of Premature Deaths due to IAP, 2003
129
176
510
551
0 150 300 450 600
Lost Income (in PhP millions)
Under 1-19
20-34
35-49
50-64
Age Group
Total: PhP 1.4 billion
Potential Interventions to curb impacts of IAP
Promote improved household living environment (improved ventilation)
Promote use of “improved” stoves
Effect changes in cooking practices
Environmental Health :Costs of Environmental Health
DamageAnd Net Benefits of Priority
Interventions
A Contribution to theCountry Environmental Analysis for
the Philippines(Part 2)
byAgustin L. Arcenas
World Bank CEA Workshop, June 16-17, 2008
The Economic Costs of Water Pollution, Sanitation
and Hygiene Issues
Household Access to Improved Water Supply and Sanitation, 2003 (National)
VaImproved sanitation, unimproved water
supply10.81%
VbImproved water
supply, unimproved
sanitation9.80%
VIUnimproved water
supply and sanitation5.18%
IV Improved water
supply and sanitation74.21%
Morbidity Cases - WSH
Rural341,164
70%
Urban84,868
17%
Metro Manila62,39313%
Total: 488,425
Costs to Society of WSH-related Illnesses
Total: PhP 4.9 billion
Philhealth Subsidy426 M
9%
Lost Income Due to Illness
465 M10%
Lost Income Due to
Premature Deaths933 M19%
Direct Cost to Households
3 B62%
Costs to Households of Treatment - WSH, 2003
Rural2.255 B
74%
Metro Manila330 M11%
Urban 458 M15%
Total: PhP 3.0 Billion
Foregone Income due to Illnesses from WSH, 2003
Rural293 M63%
Urban 87 M19%
Metro Manila85 M18%
Total: PhP 465 million
Costs of Premature Deaths due to WSH, 2003
Total: PhP 933 million
392
171
233
137
0 100 200 300 400
Lost Income (in PhP millions)
Under 1-19
20-34
35-49
50-64
Age Group
Potential Interventions to eliminate illnesses from WSH Water Sanitation and Hygiene
Improved water supply and quality
Hygiene Promotion
Construction of Sanitation Facilities (i.e. Latrines)
Health Benefits of Different Water and Sanitation Interventions
25
32
45
39
0
5
10
15
20
25
30
35
40
45
50
Improved drinkingw ater
Improved sanitation Improved hygiene Household w atertreatment
% R
ed
ucti
on
Source: Fewtrell, et al, 2005
Median Construction Cost of Water Supply Facilities for Select Regions
102
31 23 21
49
92
64
17 2234
144
4155 48
36
0
40
80
120
160
HouseConnection
Standpost Borehole Dug Well Rainwater
Africa Asia Latin America/ Caribbean
Source: Disease Control Priorities in Developing Countries, second edition, 2006, Figure 41.1
WHS Preferred Interventions (Ranked According to Cost-Effectiveness) Cost-Effectiveness Ranking
Intervention
1st Hygiene Promotion
2nd Sanitation promotion
3rd Water Sector regulation and advocacy
4th Water supply - Hand pump or standpost
5th Water supply - House connection
6th Sanitation - Construction and Promotion
Based on: Disease Control Priorities in Developing Countries, 2006.
Final Word
Hygiene is two-thirds of health
Lebanese Proverb