Disclaimer: The views expressed in this paper/presentation are the views of the author and

do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its
Board of Governors, or the governments they represent. ADB does not guarantee the
accuracy of the data included in this paper and accepts no responsibility for any
consequence of their use. Terminology used may not necessarily be consistent with ADB
official terms.

Why we need to step up addressing

integrated border development
and transboundary health issues
Joint Health & Environment Brownbag Seminar, 22 June 2018
Dr F Silva, Dr S Roth, Dr G Peralta, Dr J Shandro and the HIA Team
 Outline

1. Why this topic is important

2. Critical issues, case studies

3. Possible solutions

4. Discussion
Burden of Disease, Environmental causes and Health effects

7.8 million deaths per year

27%
of all deaths were
linked to the
environment
(2015)
5.6 million
deaths due to
non-communicable
1
ISCHEMIC
HEART DISEASE
st

diseases
1,492,500

TRANSPORT
INJURIES
INTESTINAL
INFECTIOUS
DISEASES
146,458
5 th
DIARRHEAL
537453
4th
LOWER
RESPIRATORY
2
CHRONIC
nd

57,474 DISEASES INFECTIONS RESPIRATORY

8th 7th DISEASES

3
639,943 708,278
UNINTENTIONAL 1,414,181
INJURIES
55,729
9th
10th
6 th rd
CANCERS STROKE
MALARIA 1,080,564
41,983 537,453 Source:
Institute of Health Metrics, 2015
Burden of Disease, Environmental causes and Health effects

7.8 million deaths per year

27%
of all deaths were
linked to the
environment
(2015)
5.6 million
deaths due to
non-communicable
1
ISCHEMIC
st

HEART DISEASE
diseases
1,492,500

TRANSPORT
INJURIES
INTESTINAL
INFECTIOUS
DISEASES
146,458
5 th
DIARRHEAL
537453
4th
LOWER
RESPIRATORY
2
CHRONIC
nd

57,474 DISEASES INFECTIONS RESPIRATORY

8th 7th DISEASES

3
639,943 708,278
UNINTENTIONAL 1,414,181
INJURIES
55,729
9th
10th
6 th
Life expectancy
rdis increasing
CANCERS STROKE
MALARIA
41,983 537,453 Healthy life1,080,564
expectance,
Source:
not so much
Institute of Health Metrics, 2015
Transboundary air pollution and health impacts
Transboundary air pollution and health impacts
 Emerging and re-emerging Infectious Diseases

Drug-resistant
malaria in the
GMS…

… a regional and
global public Confirmed sites of drug-
resistance malaria and
health crisis economic corridors

Source: ADB, WHO

 Emerging and re-emerging Infectious Diseases
Dengue present in more than 124
countries and territories
Every year:
70 to 100 million infected persons
Estimated over 2 million severe forms
(among which 90 % are children)
Approximately 21 000 deaths

http://www.who.int/csr/disease/dengue/impact/en/
Emerging and re-emerging Infectious Diseases
 Emerging and re-emerging Infectious Diseases
Something out of a movie?
Or is real life the source of inspiration?
 Trends and Pressures

Asian economy growing Investment needs of $1.7

at 6% annually. trillion per year until 2030.

4 billion people in Asia GMS pipeline: 100+ projects in

in 2015. transport, energy and BEZ
60 billion USD

50 (?) million annual 725% increase in demand for

cross-border movements poultry meat
Trends and Pressures

50 million people affected

500 SEZ and industrial zones across GMS
• Many along 11 GMS economic corridors
• SEZs are outside of cities often in areas, which
still need significant development

• SEZ new economic engines supported by new and

diverse communities
• Many health risks and opportunities

• SEZs provide opportunities to improve social

determinants of health of communities and improve
access to health services
• Set standards for occupational health

• SEZs have multiple stakeholders

 Outline

1. Why this topic is important

2. Critical issues, case studies

3. Possible solutions
4. Discussion
Mobile and migrant populations
the emergence and spread of infectious diseases
Lincang Border Economic
Cooperation Zone

PRC

MYA
 This is what we want to prevent

- Construction site, mosquito breeding

and dengue transmission

- 55 dengue cases in construction workers

- 35 dengue cases in community

- Construction work ordered to stop

- Delays, fines, reputational impact

 Transboundary impacts in energy sector
Transboundary pollution and health effects

BURNING FUEL Meteorological Background

conditions air pollution
Other industry
EMISSIONS
AIR QUALITY
Road traffic

Forest fires
Agricultural burning
HEALTH IMPACTS
Other determinants (RESPIRATORY,
of health / disease CARDIOVASCULAR)
(indoor air pollution)
 BURNING FUEL
Biomass Other
burning sources

EMISSIONS

Background Weather
Thailand air pollution conditions

AIR QUALITY
Other risk
factors
(indoor air
pollution)

HEALTH IMPACTS
 Other transboundary impacts…
…economic corridors, hydropower development

• HIV transmission
• Road safety, road traffic incidents and injuries
• River and sediment flows, food security, nutrition
 Outline

1. Why this topic is important

2. Critical issues, case studies

3. Possible solutions
4. Discussion
So, what can we do to address integrated border
development and transboundary health issues?
Scale-up health-focused
RPG initiatives
Tune RCI to Health Promotion

Trial innovative solutions

- Asia-Pacific HIA network
- HIA curricula in BSc and
MSc in the GMS
Strengthen HIA within - Partnerships with
safeguards Private sector

Streamline OHS and CHS

mitigation

20
Leveraging positive health outcomes from RCI initiatives and infrastructure development
Regional Cooperation and Integration
Cross-border infrastructure

-
-
Stronger Safeguards + Initiatives in
+
(Health Impact Assessment) + Regional Public Goods
+
+
Health determinants

Health outcomes
 Strengthen HIA within Safeguards
A Systematic Approach to Assessing Health Impacts

Lack of structured method; HIA in EIA

focus on pre-determined
set of health issues
 Strengthen HIA within Safeguards
A Systematic Approach to Assessing Health Impacts

INSTITUTIONALIZE
Develop tools and integrate HIA in
sector guidelines and policies

DEVELOP SKILLS
Capacity Dev through training in ADB and DMCs

MODEL BUILDING
Demonstrate HIA good practice in selected projects
 Strengthen HIA within Safeguards
A Systematic Approach to Assessing Health Impacts

- Thilawa SEZ (MYA)

- Clear evidence
- Mukdahan SEZ (THA)
- Clear demand from DMCs
- Sevan-SENO SEZ (LAO)
Accessible and
Appropriate
Safety and Health Services
Security for
All
Proper Zoning

Strategic
Organized Traffic Resettlement
Planning

Appropriate Waste
Management
 Strengthen HIA within Safeguards
A Systematic Approach to Assessing Health Impacts

- Thilawa SEZ (MYA)

- Clear evidence
- Mukdahan SEZ (THA)
- Clear demand from DMCs
- Sevan-SENO SEZ (LAO)
Accessible and
Appropriate
Safety and Health Services
Security for
All
Proper Zoning

Strategic
Organized Traffic Resettlement
Planning
MODEL BUILDING
Appropriate Waste
Management
 Outline

1. Why this topic is important

2. Critical issues, case studies

3. Possible solutions
4. Discussion
 Future of HIA in ADB
The time is coming

• ADB known for Healthy Design

• ADB staff trained on HIA
• ADB leading amongst MFIs
• Sector specific HIA guidelines
• Health benefits maximized, all risks mitigated
• Guidelines on economic benefits
• OHS / CHS management and monitoring
strengthened

• Intersectoral collaboration for

health promotion streamlined
• Health enhancement measures
topping up existing projects
components
Thank you for your attention!
For further enquiries:
Susann Roth (sroth@adb.org)