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FRESH AIR is a beautiful illustration of a "health in all policies" approach and has the potential to have a direct impact on three of the United Nations' SDGs and increase the possibility of success in at least two more.

 

SDG3 Ensure healthy lives and promote well-being for all at all ages

Goal 3 seeks to ensure health and well-being for all, at every stage of life. The Goal addresses all major health priorities, including reproductive maternal and child health; communicable, non-communicable and environmental diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines. It also calls for more research and development, increased health financing, and strengthened capacity of all countries in health risk reduction and management.    

FRESH AIR is tackling one of the main NCDs: chronic respiratory diseases by implementation of smoking cessation programmes, improving diagnosis of childhood respiratory problems, reducing exposure to smoke from indoor biomass, and exploring how to improve access to effective treatments including smoking cessation and pulmonary rehabilitation. We are working locally, collaborating globally to build capacity in local workforces to tackle non-communicable respiratory diseases, working with Community Health Workers in Uganda,  primary care teams in Vietnam, Crete and respiratory teams in the Kyrgyz Republic. FRESH AIR is therefore is contributing to these SDG3 targets:

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate

3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States

 

SDG 4 Quality Education

Goal 4 strongly supports the reduction of persistent disparities in education.   Children from the poorest 20 per cent of households are nearly four times more likely to be out of school than their richest peers. Out-of-school rates are also higher in rural areas and among children from households headed by someone with less than a primary education.

In high income countries chronic respiratory diseases have a huge impact on children's ability to attend school, and this is likely to be the case in low income countries too, compounded by other socio-economic challenges.  If FRESH AIR can help communities put in place measures to tackle chronic respiratory diseases, and to engage local communities, such as Community Health Workers in learning about and sharing knowledge about lung health and clean fuel and cookstoves, it may also have an impact on SD4 targets. In particular:

4.4 By 2030, substantially increase the number of youth and adults who have relevant skills, including technical and vocational skills, for employment, decent jobs and entrepreneurship

4.5 By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities, indigenous peoples and children in vulnerable situations

4.7 By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable development and sustainable lifestyles

It will also mean that communities may have a greater preparedness to benefit from SDG 7

 

SDG 7 Ensure access to affordable, reliable, sustainable and modern energy for all

The proportion of the world’s population with access to clean fuels and technologies for cooking increased from 51 per cent in 2000 to 58 per cent in 2014, although there has been limited progress since 2010. The absolute number of people relying on polluting fuels and technologies for cooking, such as solid fuels and kerosene, however, has actually increased, reaching an estimated three billion people. Limited progress since 2010 falls substantially short of global population growth and is almost exclusively confined to urban areas.

FRESH AIR is working with colleagues in Masindi, Uganda, and EnDev to test the implementation of cleaner cookstoves, and to reduce reliance on wood and kerosene.  In the Kyrgyz Republic we are exploring what is possible and affordable to reduce reliance on the use of animal dung as the fuel for cooking and heating in the Highlands. In Crete, the challenge is the return to use of wood-burning stoves in financially austere times.  The challenges in rural Vietnam are being mapped out in site visits now.  By helping communities understand the health problems associated with the fuels they use, and connecting with schemes aiming to address SDG 7, FRESH AIR will help prepare communities to benefit from other SD7 interventions. In particular:

7.1 By 2030, ensure universal access to affordable, reliable and modern energy services

And by using reliable, modern energy services, there may be an impact on SDG 15 where wood is the preferred fuel:

SDG 15 Life on Land
Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss.

15.2 By 2020, promote the implementation of sustainable management of all types of forests, halt deforestation, restore degraded forests and substantially increase afforestation and reforestation globally

 

For more on the SDGs go to the UN website.

 

Siân Williams,

Executive Officer, IPCRG

1 Comment

  1. Thanks Sian,

    FRESH AIR has opened my eyes to treating both the roots of illness and its social context. The roots may be biomass smoke exposure, especially in children and pregnant women; or smoking and how poverty interacts with health. If you are ill with CRD you cannot perform the activities needed to sustain a family an the implications are dire, if you are poor you have to use wood fires in small spaces, burn kerosene lamps with thick black smoke..... The time taken to get that wood is time wasted when food can be grown, paid work done, children educated etc. 

    Doctors tend to focus on the lungs in CRD, but the wider issues are what cases the harm-

    • social stigma for people with persistent cough leading to depression and deterioration
    • the vicious circle: breathlessness- inactivity - deconditioning means progressive loss of functional ability, increased dependence and less money and food. less food means weaker muscles etc
    • wasted money on ineffective treatments are particular sad- cough medicines, antibiotics and other unproven or toxic treatments

    Its a big job changing attitudes, but when you see the impact pulmonary rehab has on people who deteriorating fast, who get their lives back, we know there is hope. Hope from the wider perspective of medicine, not the narrow prism of medication.