1. Ecohealth: Concept, Research Method, and Promotion Health and Sustainability ICSS-ASIA International Conference on Sustainability Science in Asia November 24, 2009, 08:30-10:30 Room B206, AIT, Thailand Moji K, Sengchanh K, Panom P, Tiengkham P. Research Institute for Humanity and Nature (RIHN, Chikyu-ken) National Institute of Public Health, Lao PDR Savannakhet Provincial Health Department, Lao PDR

2. Environmental Changes and Infectious Diseases in Tropical Asia The RIHN ecohealth project April 2008 to March 2013 Project leader Kazuhiko Moji Research Institute for Humanity and Nature (RIHN)

3. other diseases human behavior Socio-cultural factors economy history Natural Environment Inequality Poverty Malnutrition Unhealthy Environment Inadequate medical services No access Flood/ extreme events Infectious Diseases Climate change Infectious diseases are related with many factors

4. Human infectious diseases are the outcome of biological interaction among pathogens, vectors, and human beings. Infection occurs where they meet. 2-８PR: Environmental Changes and Infectious Diseases in Tropical Asia in Tropical Asia Global, Regional, and Local Environmental Changes: Deforestation Wet-rice cultivation Urbanization Changes in human behavior and ecology Changes in pathogen ecology Changes in vector behavior, ecology Environmental Changes, Interaction of Ecology of Pathogens, Vectors, and Human beings, and Infectious Disease Consequences Infectious Disease Socio-Economic Factors Cultural / Historical Background Climate change: Local/Regional/Global

5. The RIHN ecohealth project 2008-2012 1)Environmental Change in Tropical Asia 3) Mechanism/ change of ecological interaction among human, vector, pathogens 4)Changes in health profile （ infectious diseases, and health/ demographic transition 2) Socio-cultural/economic situation historical changes Study on Ecohealth/Demographic Transition in Tropical Asia Outcome 5) futurability: ecohealth education, ecohealth promotion, ecohealth development GMS-ecohealth study network

6. Ecosystem services and health and well-being of people

7. ecosystem and health Long-term human population health can be seen as an outcome of "human ecosystem" comprised of both biophysical and human elements. Human being is a part of the human ecosystem, and health cannot be sustained without sound human ecosystem. This is the essence of ecohealth concept. Western Model of EcoHealth Asian Model of ecohealth Ecosystem services Human wellbeing health survival Ecosystem human being

8. Human health should always be considered together with their environment. In other words, the real "human security," which is sustainable and assure the freedom of people, equals to "human and his environmental security." Environment should be secured in order to secure human health/life. Health can not be sustainablil y secured if environment is not secured Human and his environmental security Human Security Human Wellbeing Health profile of people Population Health

9. air, water, soil, climate Natural environment (flora etc.) Social environment Human being air, water, soil, climate Natural environment (flora etc.) Social environment Human being Changes in environment and human life style Changes in human ecosystem Changes in human population health Ecohistory/ecohealth transition: changes of human ecosystem and health Integrated long-term monitoring

10. 1.Importance of sound ecosystem for human health is easy to understand when a specific environmental degradation causes specific health hazard (as in Japan in 1970s). 2.This concept, however, is easy to be forgotten if there is no imminent health hazard. Up to the 20 century, there has been "the paradox between health and environment" in the modern era of industrialization; that is, life expectancy continues to prolong, while global environment continues to be degraded. 3.People rely too much on modern medicine in terms of their health, forgetting importance of environmental sustainability for their long-term health. 4.The world started to realize that this paradox would not work forever. Modern Paradox of Health and Environment

11. Effective research method of ecohealth in the era of global environmental issues, as a part of sustainable science, should be developed. And it should be utilized for the ecohealth promotion. Examples from the RIHN ecohealth project 1) The Lahanam HDSS: Health and Demographic Surveillance System (by Dr. Sengchanh K, MDGs, MCH, Liver fluke infection) 2) The Sepone Mobile Phone Network (by Dr. Tiengkham P, Malaria, Health System Strengthening) 3) International collaboration for infectious disease control (by Dr. Panom P,HIV/AIDS, etc. Thai-Lao-Vietnam, Lao-China) Ecohealth: Research Method

12. Loa PDR Good country! in terms of peaceful people (unspoiled) decent culture and tradition security (public peace and order) comfortable atmosphere (you can walk a street without fear and harassments.) All lead to social stability and potentiality of development Our task is to find a way how to make healthier and more prosperous societies, while keeping the Lao’s good tradition and environment! It is not the matter of mere economic development. “Westernization” (conventional modernization) is not the answer. Lao PDR would be a good model for ecohealth development

13. 2) Sepone Mobile Phone Project 1) Lahanam HDSS: Health and Demographic Surveillance System 3) border health

15. 1. Lahanam HDSS: covering 9000 local population

16. Registered Population Total Fertility Rate: 3.1 Number of deaths by age group

17. Overall prevalence ： 63.1% (N=710)

18. KaLouk Kao (20 house holds) 117 Population (female: 59) 2. Sepone District Mobile Phone Project: 158 villages of ethnic minority groups scattered in the forest/mountain (Malaria endemic area). Pop. 30,000 To improve communication: establish mobile phone network of VHVs (village health volunteers) health centers, district health office, province malaria center.

19. Anopheles dirus Anopheles minimus Number of Malaria Inpatients in Sepone District, Savannakhet, Lao PDR, in 2006 Monthly Rainfall of Sepone District, Savannakhet, Lao PDR. Between 1988 and 2005: Average, 1940mm/year

20. Location of bombing in Sepone during the Vietnam war

21. 3. International Population Mobility and Infectious Diseases

22. 22

23. Discussion points: ICSS-Asia: 1 1)problem identification 1) health situation/health transition and health risks, 2) environmental situation/change and risks 3) concept of human ecosystem, sustainability, and ecohealth 2) pathways for solution 1) integrated long-term monitoring system (standardized) in order to understand the mechanism of transition 3) stakeholders' participation 1) common understanding of the problem 2) participation to the monitoring/surveillance

24. Discussion points: ICSS-Asia: 2 4) role of academia 1) Leading the accumulation of knowledge/facts 2) Establishing new study of “sustainability/futurability /risks” 3) Dissemination of knowledge/meaningful information 5) practical projects for sustainable development 1) Asian research network on ecohealth 2) Integration of ecohealth research with sustainability science 3) Establishing long-term cooperation/collaboration mechanism for the next generation Thank you for your attention.

25. MDG 7: ENSURE ENVIRONMENTAL SUSTAINABILITY Target 1: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources Immediate action is needed to contain rising greenhouse gas emissions Success in limiting ozone-depleting substances is also helping to mitigate climate change Target 2: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss Marine areas and land conservation need greater attention Deforestation slows and more forests are designated for biodiversity conservation The number of species threatened with extinction is rising rapidly Fish stocks require improved fisheries management to reduce depletion Target 3: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation Almost half of the world’s population face a scarcity of water More people are using improved sanitation facilities, but meeting the target will require a redoubling of efforts In developing regions, nearly one in four uses no form of sanitation Though access to improved drinking water has expanded, nearly one billion people do without Women shoulder the largest burden in collecting water Target 4: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers Simple, low-cost interventions could significantly improve the lives of many slum dwellers

26. Ecohistory: changes of ecology/ecosystem? Ecohistory and environmental history: different? RIHN ecohistory project (Akimichi 2003-2008) changes of human environment changes of human environmental use changes of (natural) resource use changes of relation between human and his environment Health in ecohistory (ecohistory of health?) change/transition of ecohealth: change of health by change of environment/ecosystem