ISLAMABAD: A World Bank (WB) analysis estimates that 45,000 people died prematurely in 2009 in Sindh from major environmental health hazards, and its economic impact in terms of GDP was 15 per cent of Sindh’s GDP, with an annual cost of about Rs372 billion.

The analysis is contained in a new publication ‘Sustainability and Poverty Alleviation: Confronting Environmental Threats in Sindh’. It has been posted by the World Bank on its website. The report has been prepared by a team led by World Bank environment specialist Ernesto Sanchez-Triana who has previously worked on projects in Pakistan. The World Bank acknowledges Sindh government’s fruitful collaboration in compilation of the report.

This means that almost one in every five deaths that occurred that year in the province was caused by environmental factors. More than half of these deaths occurred among young children, most of them younger than five. Among this vulnerable population group, three out of every 10 deaths were associated with an environmental risk.

In addition, thousands of people also suffered from illnesses that constrained them from studying, working, or going, about their daily lives, resulting in nearly 1.4 million disability-adjusted life years.

The assessment of environmental health effects and their economic costs presented in this publication was undertaken in early 2012. Assessment methodologies have undergone several major developments since then, as reflected in the local ‘Burden of Disease 2010’ project, released in December, 2012.

Under conservative assumptions, the cost of environmental disaster in Sindh is equivalent to between 11 and 19 per cent of the province’s GDP for 2009. The most important environmental problems are those affecting human health, which have an annual cost in the range of Rs261 to 486 billion in 2009, with a midpoint estimate of Rs372 billion. This cost is equivalent to 7 to 13 per cent of Sindh’s estimated GDP in 2009, with a midpoint estimate of 10 per cent.

Among the problems, inadequate water supply, sanitation, and hygiene has the highest cost; air pollution, both in urban areas and within households, is another pressing challenge. The problems associated with degradation of natural resources and losses from floods and other natural disasters have a cost equal to 5.3 per cent of the province’s GDP.

The report suggested that responding to Sindh’s most pressing environmental problems will require a major overhaul of the province’s environmental management and institutional framework.

It says: “The country’s environmental management framework relies on environmental impact analysis and the ill-enforced NEQS to improve environmental conditions. However, the severity of environmental degradation speaks to the ineffectiveness of these mechanisms and the need to develop other instruments.”

Moreover, environmental agencies’ capabilities are low, and they still need to adopt deep reforms to set up mechanisms for priority settings, efficient resource allocation, and adequate monitoring, evaluation and social learning, as well as mechanisms for enhancing accountability for environmental management. This has to be done while also adapting to the post-eighteenth amendment context, report says.

Given the significant premature deaths, illnesses, and economic costs caused by inadequate water supply, sanitation, and hygiene, as well as outdoor air pollution, the report recommended that lead exposure should also be tackled urgently, as it resulted in irreversible effects, including impaired intelligence in children, which have significant and lifelong consequences.

According to the report, nearly half of these premature deaths were caused by inadequate household water, sanitation, and hygiene; nearly one-quarter were from outdoor air pollution in urban areas mainly in Karachi; and the remainder by household air pollution, road traffic noise, and road traffic accidents.

Young children, mainly those younger than five years of age, are particularly vulnerable to environmental health risks. About 55 per cent of the total deaths were among children, and most of these were caused by diarrheal diseases, respiratory infections, and other infectious diseases.

Environmental health risks are also the cause of millions of cases of illness, injuries, and cognitive impairments in Sindh. There were an estimated 37.5 million cases of diarrheal disease in 2009 as a result of inadequate water supply, sanitation, and hygiene. Diarrheal infections in early childhood are a major contributor to poor nutritional status that leads to children being underweight or stunted.

Outdoor air pollution in urban areas, and household air pollution in rural areas, caused an estimated 4.9 million cases of upper and lower respiratory infections in children in 2009; an estimated 330,000 adults have chronic bronchitis as a result of air pollution. Some 1.6 million school-age children experience noise-induced cognitive impairment (NICI), and millions of adults suffer from sleep disturbance and annoyance from road traffic noise. Road traffic accidents caused approximately 6,000 permanent disabilities, 82,000 injuries requiring medical attention, and 445,000 minor injuries in 2009.

The majority of DALYs (0.8 million) were among children and were mainly caused by inadequate water supply, sanitation, and hygiene, and by household air pollution. The additional 0.6 million DALYs were among adults, two-thirds of which were caused by outdoor air pollution and road traffic noise.

Published in Dawn, July 22th, 2015

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