Health impacts of planetary change, swelling cities: New assignment for UN think tank in Malaysia

United Nations University will help pioneer a fresh trail in global health research, exploring links between the planet's health and human health at an institute in Kuala Lumpur generously supported by Malaysia.

As the world's post-2015 development agenda takes shape, including new sustainable development goals (SDGs), the UNU International Institute for Global Health (UNU-IIGH) has been assigned a new mandate focused on several key issues of universal concern, including:

• Health impacts of biodiversity loss and climate change. The work will include identifying potential adaptation strategies and options to mitigate harm
• Physical and mental health hazards posed by the world's rapid ongoing urbanization and how to optimize city development for better health
• Health problems due to trans-boundary pollution, including fossil fuel-related air pollution causing millions of premature deaths, especially in Asia.

  The recent report of the U.N. Intergovernmental Panel on Climate Change underscored the threat climate change poses to Earth's life-support systems, including:

• Changes in infectious disease patterns, and the mental health consequences of trauma, loss, and displacement from resource conflict or floods and drought due to extreme weather events and the loss of habitable (especially coastal) land
• Declines in regional food yields
• Freshwater shortages

Endowed by Malaysia with $40 million, UNU-IIGH funding is supplemented by support from sources worldwide.

"Our goals include advancing a detailed understanding of the specific risks ahead and underlining for the public and policy-makers alike the wealth of positive health-related co-benefits available from action on climate change," says UNU-IIGH Director Anthony Capon.

For example, a study co-authored by UNU-IIGH and published in March (at http://bit.ly/1hHmxOp) identified Uganda's under-18 population as the most vulnerable of all age groups to water-related health risks rising with climate variability—including cholera, typhoid, acute diarrhea, and dysentery.

The study warns that changes in climate worldwide and the variability of intensive rainfall patterns and flash flooding threaten more pandemics of such waterborne diseases and exacerbation of the incidence of infections, such as those borne by ticks.

Risks, opportunities in urbanization

Similarly, Dr. Capon adds, the rapid, ongoing urbanization of the world presents both risks and opportunities for human and environmental health.

"Cities concentrate people and economic activity and, therefore, they also concentrate resource consumption and waste production. This means that the way cities work can affect the health of people and planetary systems."

He adds: "During the next 20 to 30 years, the UN estimates 2 to 3 billion will be added to the population of the world's urban areas, more than 1 million people every week. Most of this population growth will be in medium-sized cities in low- and middle-income countries. This global urban transition offers an unparalleled opportunity to improve urban development and thereby protect the future health of people and ecosystems."

"It's imperative that we integrate our thinking about the health of people and our planetary systems and trends in order to clearly anticipate and mitigate problems ahead," says Prof. Tan Sri Zakri Abdul Hamid, Science Advisor to Malaysia's Prime Minister, co-chair of MIGHT, and Chair of a major new UN body on biodiversity and ecosystem services (IPBES.net).

"Though advancing slowly, threats to human health posed by such phenomena as climate change, biodiversity loss and haphazard urbanization are profound, and achieving and acting with broader perspective is fundamental. Helping the world create new insights into and address these concerns is a critical new assignment for UNU-IIGH and Malaysia is proud to host and support this work."

Says Malaysian Minister of Education II Dato' Seri Idris Jusoh: "UNU-IIGH is an important example of Malaysia's increasing contributions to global development in low- and middle-income countries. As well as UNU-IIGH, we are pleased to host UN University's finance and human resources centre here in Kuala Lumpur."

Adds the Minister: "With the increasing number of dengue cases occurring around Malaysia and outbreaks such as Middle East Respiratory Syndrome—Corona Virus (MERS-CoV) and avian influenza, as well as the emerging crisis of non-communicable diseases (obesity, diabetes, heart disease, cancers, tobacco epidemic) and health issues related to rapid urbanization and global environmental change, it is critical that Malaysians avail ourselves of the expertise of UNU-IIGH, which has been working to further so many important global health initiatives around the world."

Solid research foundation

A national of Australia and New Zealand, Dr. Capon notes that the foundation for meeting UNU-IIGH's new planetary and human health-focused assignment rests on solid research capabilities and results established in the institute's first seven years.

Among several other IIGH contributions to peer-reviewed health science to date:

• Factors underpinning water availability in a developing country: A 2012 study documents the relationship of several variables on water availability and management in Uganda—a matter of growing concern throughout the developing world.
• Child intelligence and nutrition: A 2013 study in Iran involving almost 500 children identifies child nutritional and iodine deficiency as "the most important factors related to child's intelligence," and urges food fortification, especially iodization of salt, a program for which was halted by war
• Arsenic-contaminated groundwater in Cambodia: Studies in 2013 (http://bit.ly/1hHmHVR, and http://bit.ly/1kQVwXO) show that, of 616 individuals from three provinces in Cambodia's Mekong River basin, on average one in six people—and in one province one in three—had high levels of arsenic in their bodies, attributed to both contaminated wells and food, specifically contaminated fish and cattle. Authors add that "the association between arsenicosis and the use of Chinese traditional medicine also needs further investigation."
• Mercury and DDT in Cambodian diets: Other studies in Cambodia (http://bit.ly/1oKi8sv and http://1.usa.gov/1oyGW8K) document dangerously high levels of mercury ingested via fish and elevated cancer risks from DDT in fish and vegetables.
• Improving health care in developing world through e-learning: A 2013 study underscores the importance of e-learning strategies to keep health care personnel abreast of technological developments, and how UNU-IIGH is contributing to that end.
• Lung problems in paint factories: A 2013 study documents lung problems among paint factory workers while a 2009 study looks at the effect of naphtha exposure on the lungs of workers in Malaysian tire factories.
• Health and auto pollution in Amman, Jordan: A 2012 study, recommends limiting local traffic density after assessing the air quality impact of a 7% annual increase in the number of registered cars in the city over the previous decade, 32% of them old models.
• Medical ethics and cancer: A 2013 commentary, meanwhile, addresses the troubling question of how to balance the desire to prolong life for certain cancer patients in Malaysia when treatment leads to extremely painful side effects.
• Health risks and school children: A 2011 study captures the relationship between asthma in early teenaged students and exposure to allergens, moulds and mycotoxin in Malaysia schools, while a 2012 study looks at the relationship between low levels of lead in the bloodstream of young Malaysia pupils and their cognitive and physical development.

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• Improving life's quality for blood disorder patients: A 2009 study investigates the blood disorder thalassaemia, which requires continuous transfusions and creates the side effect of iron-overload in the patient's blood. There is an expensive remedy for the side effect, however, and the study measures the quality of life improvement of thalassaemia patients on desferrioxamine treatment.

Assisting developing countries

UN Under Secretary-General David Malone, Rector of UN University, notes that "a major focus of UNU-IIGH is on helping developing countries to enhance their capability to deal with threats to human health, and to facilitate innovation and the dissemination of information."

Later this year, he adds, Dr. Zakri will become Chair of the UNU-IIGH Board of Advisors, succeeding the founding chair Dr. Abdallah Daar of Oman. Both men are members of the UN Secretary-General's new 26-member Scientific Advisory Board.

Says Dr. Malone: "The Government of Malaysia is an exceptionally generous supporter of UN University. We are thankful also to all those who have steered this institute through its earliest stages of growth, especially my friend and colleague Dr. Daar and founding Director Tan Sri Dato' Mohamed Salleh Mohamed Yasin of Malaysia. They have guided UNU-IIGH to a firm, valuable presence in the important arena of global health."

As outgoing Advisory Board Chair, Professor Daar, based at the University of Toronto, adds his praise of the UNU-IIGH, noting the institute has recruited excellent research fellows and gradate students from many countries.

"The affiliation of UNU-IIGH with universities in Malaysia is one of its key strengths, as is the great support it receives from the national government," says Dr. Daar. "It has delivered major, urgently needed public health training programs in developing countries like Yemen, and pioneered the development of free software and regional training programs for case-mix and health care information systems. It has also put environmental health on the regional agenda with its major studies in neighboring countries like Cambodia, examining the impact of environmental toxins such as arsenic in the water supply."

Provided by United Nations University International Institute for Global Health