oil, health, and development | 1 |1 | international policy conference “competitiveness &...

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



Daniel KerteszWHO Representative in Ghana

World Health Organization


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


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)


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)


… 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


…..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


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


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


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


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


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


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


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


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




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


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


Thank youThank you

Daniel Kertesz

World Health Organization RepresentativeGhana

[email protected]

Extra slidesExtra slides


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


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.


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


Onshore facilitiesOnshore facilities

The footprint of oil and gas activities is much bigger than just the well.


Ancillary facilities and infrastructureAncillary facilities and infrastructure

Requires construction of pipelines, transport corridors, sometimes ports, and power and water infrastructure.


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


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

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