MOTION 3 - 2019 - FEEDBACK

2019 -  MOTION 3 -

Recognizing and acting upon the medical and humanitarian emergency linked to environmental degradation, especially climate change

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MOTION 

In a context of amplified and accelerated crises and disaster patterns linked to environmental degradation – especially climate change – which has important health effects on the vulnerable populations, the General Assembly calls on OCB to take this issue to the next level by recognizing and acting upon the medical and humanitarian emergency it constitutes.

This should translate into OCB:

  • drastically stepping up its analysis and response in a coordinated manner;
  • adapting its medical, operational and logistics approaches;
  • allocating the relevant resources and expertise, and strengthening interdisciplinary synergies;
  • engaging more strongly its internal and external positioning and advocacy, and building partnerships, given the power of our voice and the impact it yields.

At a movement-wide level, we ask for the organization to review its global strategy in the face of the climate crisis and subsequent humanitarian crises, and that an institutional policy linked to environmental degradation and health be adopted without delay in order to best guide and inform MSF’s operational response strategies, its footprint mitigation plans, and its internal and external positioning. 

Sylviane Bachy, Joke Massa, Mit Philips, Angela Uyen, Yves Wailly, Maria Ten Palomares, Peter Maes, Ali Ouattara, Andrew Mews, René Ghislain Colgo, Renata Reis, Catherine Bachy, Eric Goemare, Antoine Tercieux, Peter Casaer, Laura Trivino Duran, Stephanie Marheux, Quentin Pullinckx, Ken Xue, Natasha Reyes, Celine Miroir, Belkacem Ait Yahia, Tom Corbet, Joel Ghazi, Daniela Munyoz, Elvina Motard, Helen Ander, Francois Giddey, Asadullah Khan, Toufic Kronfol, Jean-François Vraux, Genevieve Georges, Damien Scarlett, Michel Vasic, Eric Morel, Eva Kongs, Jonathan Delchambre, Robin Vincent Smith, Rudi Jano, Carlos Cortez, Celine Van Lamsweerde, Melik Khiari, Todwell Gobvu, Esther Casas, Christophe Castaigne, Armand Sprecher, Dimitri Eynikel, Rodd Gerstenhaber and Catherine Doutrewe

 

BACKGROUND AND EXPLANATION

The impact of environmental degradation –including climate change- on health, displacement and conflict are no longer disputable. They are disproportionately affecting the most vulnerable, the ones that MSF seeks to help, and this trend is far from going downward.

Here are some examples[1]:

  • The vectorial capacity for the dengue transmission was the highest on record in 2016, while malaria transmission capacity increased by 28% in the sub-Sahara highlands since the 1950’s.
  • CC is driving increases in coastal areas suitable for cholera epidemics (24% in the coastal areas of the Baltic region alone), and it expands suitable habitat for the rodent vector of Lassa fever (M. natalensis).
  • People in more than 90% of cities breathe polluted air, affecting their cardiovascular and respiratory health. According to WHO, air pollution is the largest environmental cause of disease and premature deaths worldwide. Outdoor and indoor air pollution are responsible for more than 7 million premature deaths per year.
  • 157 million more people were exposed to heatwave events in 2017 compared with 2000.  The Pakistan Meteorological Department already reports an increase in the length of heat waves across the country on annual basis. Karachi, where we have a project, is part of Sindh province. Drought needs assessment reports show that as a result of climate change, heat waves will continue to increase in Sindh.
  • Severe drought in 2018 affected hundreds of thousands of people, from Central Asia to Central America, from the Sahel to North Korea.
  • Typhoons and cyclones are more frequent and with higher intensity (2 cyclones hit Mozambique within less than 6 weeks, as you know).
  • In fact, in 2017, the numbers of internally displaced by environmental hazards (disasters) were higher (18.8 million) than those displaced by conflicts (11.8 million).
  • Besides impacting access to healthcare, access to water, food and shelter, extreme weather events also trigger post-traumatic stress disorders, major depressive disorders and anxiety.
  • But there are also the less obvious impacts:
    •  The global risk of venomous snake bites, which already affects 2,5 million people annually, is also on the rise.
    • Diseases are resurging. Anthrax spores were released last summer in the Siberian tundra following unusual temperatures rising to 35°C.
  • Not to mention the sea levels rising, forcing people to move, often to urban areas…   

This is just a snapshot of what we’re facing, and as we know, it’s unlikely to get better unless there’s a massive and swift global shift.

The UN Intergovernmental Panel on Climate Change (the IPCC) warned that the world has until 2030 – barely over a decade, to make the drastic but necessary changes if warming is to be restricted to 1.5°C (as per the 2015 Paris Agreement), or we will set off an irreversible chain of reactions beyond human control[2]. This means that emissions have to be reduced by 45% before 2030, which is currently not matching reality. With current government policies, we’re actually headed to more than 3°C.

The global south is already the most affected. Hotspots vulnerable to CC include South East Asia and the Pacific, the Middle East, Sahel, Central Africa and Central America. MSF is already present in most of these places. But the questions are: are we ready, how to prepare, how do we adapt and add policies and practices, make choices, add environmental degradation including climate change thinking to context analysis. Do we have the funding and added skills, how to collaborate, position local and international advocacy and do our work in a resource-limited world while also ensuring we 'do no harm' by limiting our own footprint? 

Some aid organizations started adapting their interventions and shifted their mindset, recognizing the nexus between climate, environment and health. The international federation of Red Cross and Red Crescent Societies (IFRC) for example, the largest humanitarian network, has a CC center, action plan, minimum standards, technical advice, post-disaster environmental impact assessments, and they work with environmental field advisors.  Many others are following suit.

Within MSF, a motion was adopted by the IGA in the summer of 2017. It called for the movement to “debate and promote actions to develop concrete capacities and expertise around medical and humanitarian consequences of environmental degradation on health and MSF's impact on the environment."

Some initiatives have been taking place in recent years. A mapping of ‘Environmental Actions’ across sections was produced by MSF-Canada, which also wrote an internal paper on some possible ways forward for MSF. An informal “MSF, Climate and Health” working group (about 140 members today –both internal/external) was created, the OCB WatSan unit shifted to a more comprehensive environmental health approach, the logistics department developed an energy vision, several TIC projects were developed across MSF, offices are turning greener, and an intersectional workshop on humanitarian action in a warming world took place in Geneva last October. In 2018, MSFB/the MSF-B Green Team also submitted a motion calling for MSF’s commitment to ‘being environmentally responsible in practices and choices. It was adopted, but was mostly related to the Brussels office.

While these initiatives are welcome, the matter of the fact is that they don’t match the urgency we’re facing. Also, most of them are developed in silo.

There is no overall organizational link, no clear leadership, no formal platforms for exchange or synergy creation, no commitment of resources to take on the issue seriously, and no environmental policy at the institutional level to prioritize this issue and guide our operational, medical and logistics approaches as well as clarify MSF’s stand and positioning internally and externally. This must change. Urgently. Not acting would be a failure to honor our ethical and medical responsibility –primarily towards beneficiaries, but also towards our donors.

MSF must plan, assess and respond to meet the changing context we’re facing. And that goes beyond some pilot projects or a switch from plastic to ceramics cups!

It means taking it to the next level, adapting our e-prep, adjusting our energy-choices but also procurement policies and services, rethink the way we fly, the way we manage our hazardous waste among many others things. Guided by the “do-no-harm” principles, the health sector needs to lead by example when it comes to responding to this emergency, and must make choices that limit any negative direct impact on human health, the environment and climate.

It is also important for MSF to go beyond its humanitarian response and use its public positioning to contribute to awareness and change, especially as anticipated needs will far exceed the current response capabilities of relief organizations.

As a field-based organization, we witness first-hand what populations are facing. Through our action, there’s a wealth of data we sit on or could produce that can contribute to research and advocacy. As a key global health actor (maybe not in our mind but in the mind of many), there is an expectation that the power of our voice will be used to help raise awareness on the unfolding medical, humanitarian and environmental crisis, so as to mitigate its impact it but also possibly help prevent it to escalate further. Should we leave it to the school children taking to the streets in the face of this crisis and not contribute our powerful voice?

MSF is often not at ease with addressing such systemic problems. We were uncomfortable with the HIV/AIDS crisis at first. Yet, given the extent of the health emergency it constituted and the harm it was causing, we built capacity to respond, engage, innovate. We joined forces with others, advocated, and we contributed significantly to tackling the crisis head on and in ground breaking ways. Similarly, we addressed flaws and gaps in the system for those dying because of a lack of access to essential medicines, and we continue to do so.

Well today, the reality is: CC and environmental degradation are already exacerbating impacts on health and risks for vulnerable people to become more vulnerable.

That’s why motions and recommendations, from the East Africa Association to Paris, the UK, Geneva or Toronto are coming on the forefront of the General Assemblies this year, asking MSF to ramp up and adapt its response. And that’s why OCB members of various backgrounds and places in the world, spanning from supply, logistics, medical, finance, communications, advocacy, emergency response, field and offices have come together today with this motion.

We ask OCB to review strategically its operations, advocacy and footprint in order to integrate the health & humanitarian effects of the current and future climate crisis, and we also ask for the adoption of a policy by the movement.

A similar motion was just adopted by MSF-OCG (Vote outcomes: For: 215 – Against: 21 – Abstention: 25). We hope you will do the same, and will back up this motion massively.

 

[1] List of sources:

-Watts N. et al. (2018) The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. The Lancet, Vol. 392, Issue 10063,P2479-2514. https://doi.org/10.1016/S0140-6736(18)32594-7

-David W. Redding et al. (2016) Environmental‐mechanistic modelling of the impact of global change on human zoonotic disease emergence: a case study of Lassa fever. https://besjournals.onlinelibrary.wiley.com/doi/full/10.1111/2041-210X.12549

-Sindh drought needs assessment report, 2019 https://reliefweb.int/report/pakistan/sindh-drought-needs-assessment-sdna-report-january-2019;

-Climate Risks and Food Security Analysis: A Special Report for Pakistan, 2019

-IDMC, Global report on Internal Displacement, 2018 : http://www.internal-displacement.org/global-report/grid2018/

-WHO. 2016. “Ambient (Outdoor) Air Quality and Health.” Fact Sheet. http://www.who.int/mediacentre/factsheets/fs313/en/

-Landrigan, Philip J, BE Richard Fuller, Nereus J R Acosta, Olusoji Adeyi, Robert Arnold, Prof Niladri (Nil) Basu, Abdoulaye Bibi Baldé, et al. 2017. “The Lancet Commission on Pollution an Health.” The Lancet 391 (10119): 462–512. https://doi.org/10.1016/S0140-6736(17)32345-0

 

 

FEEDBACK (Final draft)

The clear call for MSF and OCB to recognize and act upon environmental degradation and the medical and humanitarian emergency it constitutes that came out of the 2019 OCB Gathering has brought forward a range of actions from the executive, with the most significant being the following:

A recognition in the 2020-23 MSF OCB Strategic Orientations that MSF has to adapt to environmental degradation and climate change, including the need to develop “models of intervention, better understanding of emerging medical needs and appropriate public positioning and advocacy on the topic”. The Strategic Orientations also includes a commitment by OCB to be environmentally responsible by considering more sustainable solutions where possible, including a critical consideration of procurement services, waste management and energy related choices. Different departments or units in OCB (such as Environmental Health, Log, Supply or HR) are shifting to more comprehensive approaches towards environmental degradation and climate change as it is reflected in their strategic plans and orientations.

The establishment of a 'Climate-Environment-Health Circle', gathering people from OPS, Medical, Logistics, Supply, Human Resources, Communications and Advocacy departments, both at Headquarter and Field level.

The development of an MSF OCB Climate-Environment-Health (CEH) Action Plan 2020-2023, which was endorsed by the Codir in October 2020. In the process of developing the action plan, input was gathered from almost 50 people, mainly field staff, working in different areas of expertise and in different contexts. The final document proposes practical and effective actions at short, medium and long term perspective, and is divided into three domains: mitigation, adaptation and advocacy. It is focused around the following areas: Adapted operational support, technical solutions and practices, and advocacy and awareness. For each action, the expected direct environmental or operational impacts are listed, as well as the co-benefits linked to cost reduction, appropriate technologies, etc.

Next steps

The next steps will include mapping and monitoring CEH’s initiatives within MSF, and OCB in particular, capitalize on them, and disseminate best practices and lessons learnt, as well as broaden the reflection and analysis on the topic at executive and associative level in a series of webinars/discussions.