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Report
of
An InterdisciplinaryWorkshop on
Biodiversity and Human Health Linkages
dialogue and action
Entebbe, Uganda,
23
28
June
2002
Organized by
Vector Control Division, Ministry
of
Health, Uganda
Institute
of
Environmental and Natural Resources,
University, Uganda
Danish Bilharziasis Laboratory, Denmark
In collaboration with
Department
of
Protectionof the Human Environment, PEEM Secretariat, WHO,
Switzerland
Division
of
Policy Development and Law, UNEP, Kenya
Biosystematics Unit,ICIPE, Kenya
Sponsored by the
Danish Bilharziasis Laboratory
Danida
and Human Health
Entebbe Workshop 23-28 June
2002
Table
of
contents
Workshop recommendations
..........................................................................
3
Introduction
.......................................................................................................
4
Objectives of the workshop
.............................................................................
5
Proceedings of the workshop
.........................................................................
8
Informal opening and welcoming words
....................................................
8
Theme presentations
...................................................................................
8
Panta Kasoma: Ecosystems goods and services in the promotion of human health
And well-being
.....................................................................................................................
8
Robert
Bos:
Ecosystem disturbance. biodiversity loss and their implication for
Human health
......................................................................................................................
9
Interdisciplinary group work and field trip
.................................................
9
Group session 1
.
Generation of a biodiversity health issues matrix
.................................
Group session
2:
WHO DPSEEA model
...........................................................................
13
Group session 3:Knowledge base validation
...................................................................
17
Field trip: Visit
to
a planned hydro-power plant (Bujagali Hydroelectric Power
Project) on the Victoria Nile
...............................................................................................
19
Group session
4:
Creating an enabling environment for cross-disciplinary research:
Support through awareness creation. policy adjustment and establishing
Inter-institutional links
........................................................................................................
20
Discussion Club
.........................................................................................
23
Abstracts of presentations
.................................................................................................
23
Annexes
1
.
Composition of the Organizing Committee and the Scientific Committee
...............................
30
2
.
Workshop Programme
.............................................................................................................
31
3
.
List of participants
....................................................................................................................
34
4
.
Thematic presentations
...........................................................................................................
37
5
.
Summary of the workshop evaluation
.....................................................................................
48
6.
Press release
...........................................................................................................................
52
Biodiversityand Human Health Linkages
Entebbe Workshop
23-28
June
2002
2
and Human Health Linkages Entebbe Workshop23-28June 2002
Workshop recommendations
3
BiodiversityandHuman HealthLinkages
Entebbe Workshop 23-28June 2002
Introduction
Welive in
a
worldof change
-
for
or for
worse
The background for the initiativeto hold a workshop on the topic of “Biodiversity and Human
Health Linkages” was the increased recognition by leading scientists and health professionals
that public health is influenced by the adverse effects of broad environmental change. Such
change is exemplified in the accelerating degradation of the bio-physical environment, in the
unstable global and socio-economic environment and in fragile political environments,among
others.Thus a need has been identifiedto look at the issue of environmental degradation with a
focus on the health implications of biodiversity
loss,
by reviewing and updating the knowledge
base,developing new research initiatives and establishingplansfor future intersectoral action.
The classical perception of biodiversity is that of species variation, and this has linked the
concept of biodiversity to ideas related to the preservation and conservation
of
nature and
threatened species, sometimes at a relatively
level.As the concept evolved,the diversity
at different levels,in the continuumfrom the molecular genetics level to the ecosystem level
added a new dimension.In recent years attempts have been made to view the notion of
biodiversityin a more holistic manner by also including the relationship between biodiversity,the
environment and human health from different perspectives of importance. The following are
examples of some of these relationships:
Many medical products are derived from plants and trees;thus the rain forest might have
tremendous potential as a source of newdrugs,and valuable species have undoubtedly yet
to be discovered;
Many animals and their organs give us the opportunity of doing research or imitating
systems which can be usedto improve human lifeor cure certain diseases;
Many organisms are good indicators and predictors of negative environmental changes;
The
loss
inthe variety of traditional food sources can have a significant impact on nutritional
status andthereby on the health of local populations;
Environmental disturbances such as deforestation or water resources development can
affect transmission conditions for a variety of health hazards;
Campaigns against genetically modified crops are growing daily,since such agricultural
practices might alter the existence basis for those organisms necessary for pollination and
natural pest control.
As a consequence of general overall development,most nations have a history of
interference with the natural balanceof ecosystems, often resulting in dramatic, adverse effects
on human populationsand individual organisms. Ecosystems are disturbed and if no initiatives
are taken to reinstate the previous balance between man and nature,vast resources will be
necessaryto fight relatedsocial andresultant human health problems.The present initiative can
thus be seen
as
an attempt to create awareness
of
these relationships, while at the same time
promoting intersectoral collaboration for remedial and preventive action.
The Danish Bilharziasis Laboratory
(DBL),
the Vector Control Division (VCD),Ministry of
Health of Uganda,and the Institute of Environmental and Natural Resources,
University (MUIENR),organized this first workshop of its kind in Africa through a collaboration
with the World Health Organization (WHO, Geneva, Department of Protection of the Human
Environment,PEEMSecretariat),the United Nations Environment Programme (UNEP,Nairobi,
Divisionof PolicyDevelopment and Law),andthe InternationalCentre for Insect Physiology and
Ecology(ICIPE,Nairobi, Biosystematics Unit).
4
Biodiversityand Human
Linkages
Entebbe
Workshop23-28
June 2002
Objectives
of the
workshop
The vision for the future beyond the workshop is to enhance human health and biodiversity
conservationthrough an ecosystem approach to natural resources management.
Overall objective
The overall and long-term objective of the workshop is to promotethe health of ecosystems
and humans in their common dependency on biodiversity,through intersectoral dialogue and
action between health and nature conservation researchers,practitionersand policy makers.
Specific objectives
The specific objectives of the workshop were:
To enhance awareness of the linkages between biodiversity and human health among
health and biodiversityprofessionals at all levels;
To review the state of knowledge on the interrelationship between biodiversity and human
health;
To identify gaps in knowledge and mechanisms for inter-disciplinary research;
To identtfytraining needs and relevant best practices
.
Anticipated outcome
At a pre-workshop meeting attended by the Scientific Committee members it was agreed
that the workshop should strive towards achieving the following:
An
inventory of relevant ongoing projects which might benefit from a biodiversity or health
component;
A researchagenda;
Recommendationsfor research,training and best practices;
The establishment of a network of health and biodiversity professionals;
An awareness brochure and a summation of proceedings.
Planning and implementation
The planning and implementation of the workshop was made possible through the good
collaboration between members of the Organizing
and the Scientific Committee.
Their composition is presented inAnnex
1
A
pre-workshop meeting of the Scientific Committee
nine months in advance established a framework for the workshop, discussed context and
content and identified a number of key speakers to present each of the five identified themes
judged relevant to the workshop,which were thefollowing:
Ecosystem disturbance and biodiversity
loss
andtheir implications for human health;
Ecosystem goods andservices inthe promotion of human health andwell-being;
Biodiversity,food security,nutrition and human health;
The roleof
intraditional medicine and drug discovery;
Options and opportunities for community based actions on biodiversity and health.
Speakers for the four other themes were identified,
and invited to the workshop
not only as thematic speakers but also as participants in the workshop as a whole.
Unfortunately,the presenters for themes four and five did not arrive, creating a situation which
left the organizers ina difficult position.
The challenge was then to ensure that the two themes would be covered during group work
and plenary discussions.
To
ensure a high level of participation and opportunities for
a
viable
exchange
of
knowledge and experience among the participants,much emphasis was put on
cross-disciplinary group work with subsequent sharing of informationanddiscussions at plenary
5
Biodiversity and Human HealthLinkages
Entebbe Workshop
23-28
June
2002
sessions.It was found relevant to include a field trip to a planned development project allowing
for a discussion regarding some of the health determinants inherent in such a project.See
Annex 2 for an overview of the final workshop programme.
Participants
The workshop was attended by 30 participantsfromfive countries (Kenya, Uganda, Malawi,
Zambia and Zimbabwe). See Annex 3 for a complete list of participants. Participants were
recruitedthrough a nomination and selection procedure carried out by the Scientific
Forty-two individuals were nominated from eight countries and 36 were selected to participate.
Key selection criteria included gender,professional background and country representation.
Due to some
cancellations,late replacements had to be made for some of the
participants,resulting
in
a skewed representation in relation to what originally had been
intended.
Pre-workshop expectations
On the first day of the workshop,prior to the start of the official programme, participants were
asked to express briefly their expectations for the outcome of the workshop.The following
summary is a representation of these expectations in relation to “advocacy and awareness
creation,mechanismsfor collaboration, knowledge base and research agenda and action to be
taken”:
Advocacyand awareness creation
Awareness and improved
among the workshop participants about
biodiversityand healthand the links betweenthem;
Shared experiences and knowledge on biodiversity and healthissues;
A report or brochure which presents the
issues that emerged from the
workshop, aimed at putting these issues on the agenda for policy- and decision-makers in
the countriesof East and Southern Africa;
Options to include health in the work of the Convention on Biological Diversity and the
MillenniumEcosystem Assessment;
A strengthened focus on traditional medicine at the community level and the key role of
medicinal plants in bio-diverseecosystems.
Mechanisms for collaboration
Consensus on how to bridge gaps and achieve closer cooperation between health and
environment professionals(scientists,programmemanagers,policy- and decision-makers);
Framework, network and/or any other suitable mechanisms for effective collaborative
working relations between people and institutionswith different disciplinary backgroundsand
for disseminationof
A list of potential partners for future collaborative activities of a biodiversity/ health nature at
different levels.
Knowledge base and researchagenda
An assessment of the state of our knowledge of biodiversity and health links, with knowledge
gaps clearly identified;
A
research agenda addressing the knowledge gaps and mechanisms for cross-disciplinary
researchcooperation;
A list of practical interventions and good practices that address both biodiversity
conservation and health protection and promotion:
A base for focused,explicit and
environmental management interventions for
biodiversity and health,especiallyat the community level.
6
Biodiversitvand Human Health Linkaaes
Entebbe
Workshop
23-28
June
2002
A
plan
of
as follow-up to the workshop that will include activities at the
policy level (new policies, adjustment and harmonization of policies in the health and
environment sectors); cross-disciplinary research activities, capacity building at the country
level and advocacyfor
issues at the community level;
A
plan for the development of short training courses and other capacity building activities on
biodiversityand health;
A
plan to carry out case studies with concrete illustrative examples of how biodiversity health
issues can be successfullyaddressed at the community level.
7
Biodiversityand Human Health Linkages
Entebbe Workshop
23-28 June
2002
Proceedings
of
the workshop
Informal opening and welcoming words
An informal session was held on the evening before the start of the workshop during which
T.K. Kristensen, DBL, warmly welcomed guests, participants and staff, and which was followed
by dinner.
R.Bos, WHO, welcomed participants to what he described as a pioneering workshop, in that
it was the first time on the African continent that an interdisciplinary group of scientists and
government officials from the disciplines of
and public health were
gathered with a view to exploring opportunities for joint research as well as initiating an
awareness of the important links between biodiversity degradation and human health. He also
praised the opportunity for a dialogue among participants and for the new institutional linkages
which would now be established, as reflected in the overall and specific objectives of the
workshop.
It
was emphasized that high priority would be given
to
interdisciplinary, exploratory group
work rather than to a multitude of detailed, thematic presentations, in recognition of the need
to
establish a proper evidence base for
linkages among participants and for
a
dissemination of workshop results to proper institutions and authorities.
Theme presentations
As an initial stage setting for discussions in subsequent group work, four thematic
presentations had been planned and confirmed by presenters, but
as
mentioned earlier, two
presenters were unable
to
attend, thus leaving the audience with the following two, interesting
presentations by P.Kasoma, Professor at the Institute of Environment and Natural Resources,
University and R.Bos, Scientist at the Department of Protection of the Human
Environment,World Health Organization, Geneva.
P.
Kasoma: Ecosystem goods and services in the promotion of human health and well-
being
(See Annex
4
for a copy of the overhead presentation)
The presenter emphasized that life, as we know it today, is the result of billions of years of
biological evolution. The multitude of resulting organisms and their genes have therefore
evolved into an elaborate life support system that is maintained through numerous interactions
between the organisms themselves and their physical environment. The ecosystems in which
these organisms occur are in a dynamic equilibrium that is self-regulating. Human beings are an
integral part of this life support system.
Ecosystems provide certain goods and services which ensure the well-being and health of
the human species. The goods include food, medicines, fuel, craft materials, timber, etc. Food
and medicines have a direct bearing on human health by ensuring
and
free human beings. Other goods such as timber and non-timber forest products also contribute
to incomes of communities.
But as human health is defined
as a
of
complefe physical, mental and social well-being
NOT
merely the absence
of
disease or infirmity
(WHO Constitution,
natural
ecosystems also form the basis for leisure activities such as wildlife viewing, mountaineering,
angling, scuba-diving, trekking, etc.
Natural vegetation, especially the forest, plays a big part in protection of watersheds and in
doing
so,
ensures clean and reliable water supplies
to
human communities. Wetlands are
known to play a purifying role for domestic and industrial effluents hence protecting larger water
bodies from pollution.
Ecosystems also perform the function of nutrient storage and recycling thereby ensuring the
maintenance of life on earth. Climate at micro and macro levels is also strongly influenced by
natural ecosystems. Deforestation and wetland drainage for example, have been known to
influence local climate as well as having global impacts.
8
Biodiversity and Human Healfh Linkages
Entebbe Workshop 23-28 June
2002
Global food security depends to a very large extent on the existence and survival of
pollinator organisms such as bees,moths,flies, beetles, birds and bats. Without these
organisms,many of our crops would not be able
to
reproduce and provide food.
The ecology of many organisms is currently known well enough for some of them
to
be used
as indicators of ecosystem
such as aquatic pollution. They thus provide an
warning system for human beings using those ecosystems, for remedial action
to
be taken.
Since ecosystem relationships resemble a web of connections from one living organism
to
many others and
to
the non-living world, no ecosystem stands alone. Healthy and intact
ecosystems permit the survival and maintenance of a balance between living things and the
resources they need
to
survive; such as the
dioxide balance in the atmosphere,
regulation of populations of pest organisms and
so
on.
P.Kasoma concluded that ecosystems therefore play a fundamental role in the health and
well-being of humans. The fact that they continue
to
be degraded may lie in ignorance or the
fact that appropriate economic value has
not
been attached
to
the goods and services they
provide. This needs
to
be changed.
R.
Bos:
Ecosystem disturbance, biodiversity loss and their implications for human health
(see Annex
4
for a copy of the
presentation)
The presenter continued along the lines of his workshop opening remarks and emphasized
that by having a multidisciplinary audience there was a need
to
start off by agreeing on some
definitions and setting some boundaries related
to
the overall theme of his presentation.
Defining issues such as health and health determinants, the presenter continued discussing on
which health problems
to
focus as regards the relation
to
biodiversity and ecosystem
disturbance.The burden of disease of selected relevant health problems was highlighted in the
global and African context. A number of driving forces were mentioned as relevant for environ-
mental changes seen in Africa, for example global climate change, change in land use patterns,
hydrology, human circulation and settlements and agricultural development. As examples of the
effects of biodiversity on human health the variation in pathogens, vectors and reservoirs were
mentioned as determinants that influence epidemiology and control options. The phenomenon
of buffering,
the proportion of competent versus non-competent reservoir hosts, was
emphasized and it was concluded that greater biodiversity in the tropical belt results in a greater
pathogen and vector biodiversity, but it also results in greater
biodiversity which
may or may not have a buffering effect.
Other health determinants such as variations in the human host with respect
to
immune and
nutritional status were mentioned. As regards the effects of ecosystem disturbance, examples
were given relating climate change to changes in disease patterns. The question was asked
whether disease changes are linked
to
biodiversity changes, or whether they simply reflect
density effects linked
to
temperature and rainfall. Although there are many confounding factors,
the
“El
Nitio”
in 1997 in East Africa was mentioned
as
being clearly a density
dependent effect. Deforestation and other land use pattern changes such as agricultural
development and urbanization were mentioned and examples given on the close relationship
to
changes in disease patterns.
R.
Bos
concluded by highlighting that assessment of
links can only be done at the local level and that mapping is an important
tool
to
identify possible study sites for such links.The community aspect was emphasized by stating
that community involvement in nature conservation can be strongly promoted by introducing a
health component. Finally, the
research goes beyond its academic value only
where there are clear opportunities for a win-win situation from the start.
Interdisciplinary group work and field trip
An effort was made
to
compose four groups with a mixed representation of participants from
different disciplines, countries and sectors. The groups worked independently under the
guidance of two facilitators circulating among the groups. Every morning a plenary session
sought
to
clarify unsolved questions and
to
update the groups on general progress.
9
Biodiversitvand Human Health
Entebbe
23-28
June
2002
Group session I
:
Generation
of
a
issues matrix
Taking a starting point in the immediate knowledge and experience by participants on
biodiversity and human health issues,
R.
Bos
introduced participants
to
the first group work
which aimed at brainstorming any
or health issue relating
to
each
other. It was consideredconvenient
to
use
a
matrix where the linkages between biodiversity and
health could be briefly described.
Group 1-4 (consolidatedfindings):
Table
1
on the following pages represents the consolidated matrix initiated by participants and
finalized by the organisers:
Biodiversityand Human
Linkages
Workshop23-28
June
2002
I
0
L
m
a
m
m
>
0
m
0
0
a
m
0
C
m
0
11
Table
1.
Rapid
assessment
of
the
nature
of
possible
links
between
biodiversity
aspects
and
health
issues
Measlesvascular
diseases
Respirat.
diseases diseases
Malaria
AIDS
Malnutrition
Schisto-
somiasissomiasis
(Cont'd)
ECOSYSTEM
DISTURBANCE
Deforestation
(loss
of
medicinal
plants
throughout)
use
Irrigation
Helminth
infections
+
riverine
deforestation
mayreduce
vector
habitats
++
less
predators on
snails
+
loss
of
forestfood
+
loss
of
livelihood,
migration
++
in
SE
Asia:
malaria
decrease;in
otherparts
malariamay
increase
++habitat
+
less
access
to
fuel
wood
hasan
impact on
indoor air
pollution
+
agricultural
waste may
provide
alternative
fuel
+
of
urban green
+
cropping may
undermine
nutritional
statuslocal
communities
(cash
subsistence)
+
can be positive or
negativebased on
local condition
++
shellfish
Use
of
night soil
Aquaculture
Cropping
patterns
Chemical inputs
Wastewater
use
Unplanned
urbanization
+
less
natural
enemies
+
untreated
wastewater
richin
contaminants
+
parasite load
in environment
morevaried
++
reduction
of
predator
populations
+
habitat
simplification:
urban vector
species
+
increased
variation in
HIV
strains
increased
variation in
HIV
strains
accelerated
spreadof
varieties
+
+
+
biodiversity
loss
stream
destroy
livelihoods,
cause
unplanned
migration
I
-
Industrialization
+accelerated
-
+
accelerated
spread of
pathogens
Opening
up
areas
through
transport
(emerging infections)
+
Pathogens
spread faster,
diversity of
pathogens
increases
+
accelerated
spreadofdrug
resistant strains
+
accelerate
dspreadof
virus
strains
spread
of
parasite
++
changesin
vector
populationslikely
to
in
increased risk
+
electricity
provisionmay
reduce
reliance on
organicfuels
andindoorair
pollution
+
vector
species
diversity
downstream
maydecrease
Dams
criticallylinked;
+
indirectlylinked;
-
no
link
Biodiversitv and Human Health Linkaaes
Entebbe
23-28
June
2002
session
2:
Driving forces, environmental pressures and human health (WHO DPSEEAmodel)
In the process of matrix development it was found useful
to
clarify the pathway or chain of
events linking biodiversity change to change in community health status. The
so
called
WHO
DPSEEA model’ was introduced and its relevance explained. Driving force;Environmental
Pressure;State of the environment; Exposure to benefits and/or risks; Effects on the health
status of the Community:Action to cope and improve health
Generally, the driving forces create or influence the conditions in which health hazards can
be promoted or be averted. Population growth and economic development are examples of
forces that may exert different kinds of environmental pressures such as transport, agriculture
and forestry. The pressures can lead to changes in the state of the environment including the
biodiversity.Whether the environmental change will ultimately lead to increased ill health
depends on many factors (determinants), for example the degree to which humans are actually
exposed to hazards. Levels of exposuremay rangefrom harmless and acceptable to dangerous
and unacceptable. Exposure may lead
to
a variety of health effects to which action may be
taken
to
improvehealth.
The groups were asked
to
take three specific
issues from the matrix they
developed and to analyze them in accordance with the DPSEEA model, segregating the ones
where biodiversity change plays a role in the pathway
to
health from those where biodiversity
change is of no consequence in the chain of events
to
health.Each group tackled a different
category of biodiversityissues:
Ecosystem products and services
2)
Medicinal plants
3)
Ecosystemdisturbance
4) Foodsecurity and agro-ecosystem management
The following four copies of the transparencies or flip charts prepared by the individual groups
were presentedwith more detailed explanationsof the topics in question:
World Health Organization.
1997.
Healthand Environment in Sustainable Development. Fiveyears after
the
Earth
Summit.WHO, Geneva
13
Biodiversityand Human Health Linkages
Entebbe Workshop 23-28
June
2002
Group 1
-
ecosvstemproductsand services (results):
Driving forces
environmental effects
human health
Population
growth habitat destruction wetland reclamation
deforestat io n
pesticides
grazing
agricultural pressure mono-cultures
Economicdevelopment
agricultural development
industrial development
mono-culturesof tobacco,coffee,tea,cotton,
pollution (air, water, land,noise)
detrimental effects on biodiversity
ecosystem service (pollination)
less pollinators
human health
-
less food production
banana, mango, sugarcane, maize
natural (herbal) medicines
Action
-policy:plantation owners pay back locally
-habitat management programmes
-creating awareness
of
ecosystem services
-research:monitoring, basic research into pollination
14
Biodiversity and Human Health Linkages
Entebbe
23-28
June 2002
Group
2
-
medicinal plants
15
and HumanHealthLinkages
Entebbe
23-28
June 2002
Group
3
-
ecosvstemdisturbance(results):
16
and Human HealthLinkages
Entebbe
Workshop
23-28June
2002
Group
4
-foodsecurity and
management (results):
Having completed the group work on the DPSEEA model, the groups then finalized the
matrix exercise
(cf.
above).
Groupsession
3:
Knowledge base validation
The groups went on discussing the evidence base of
health correlations.
For specific and priority correlations,the following questions were raised
-
do we have scientific
evidence with respect to:
Relevant indicators (both for biodiversity determinants andfor healthoutcomes)?
The natureand magnitude of mechanisms that link biodiversity and health?
Effectiveand appropriatetechniques/ methodologies related to assessment, monitoring and
managementlinterventions?
Inthe process of validatingthe knowledge base,the groups also identified critical gaps inour
knowledgeand tried to formulate research questionsthat address these gaps.
17
Biodiversity and Human Health Linkages
Entebbe Workshop23-28June
2002
Group
1
(consolidated
findings):
Biodiversity health issue addressed:Agro-ecosystem biodiversity-health links (malaria)
-
how
does the level of ecosystemvariabilitycome to expression on healthindicators?
Pressures:habitat simplification
managementpressures,such as chemical input
There is a good knowledge basethat irrigation, chemical inputs, fisheries and livestock all have
an impact onmalaria
Research questions:
Howdo population densitiesand dynamics affect health?
Speciescompetition
Speciessuccession
Redressedbalancesinfoodwebs
Considering agriculture as a form of ecosystem management, what are the parameters of best
practice in terms of biodiversity conservation,health protection and buildingsynergies between
thetwo?
Variables indesign and operationof hydraulic infrastructure
Variables in agricultural practice,suchas intermittent irrigation, integrated pest management,
selection
Options for segregating ecosystem risk factors from humans (settlement siting,house
screening,using mosquito nets)
What are critical health service activities supporting the environmental management
approaches?
Health Impact Assessment
Effectsof public health chemicals (drugs and insecticides)
Howto manageeffectiveintersectoral action?
Group
2
(consolidated
findings):
issues addressed:Water resources development,biodiversity and health
(schistosomiasis)
-
pathogen-vector-host interaction at the molecular level.
There is a well-developed knowledge base on the ecological settings and environmental
determinants that keep the schistosomiasis cycle in motion.Behavioural determinants are an
essential part of the full picture. Biodiversity indicators include the presence and densities
of
pathogens and vector species,competitors and predators and proportion of infected
intermediatehosts.
Research questions:
What are the impacts of biodiversity levels on the population dynamics of the snail intermediate
hostsand
parasites?
Balance between snails and predators
Balance between snails and competitors
Ecosystemdeterminantsof population dynamics of snails,their predatorsand competitors.
Roleof biodiversity in the distribution of snail populations.
What arethe variables that play a role inthe intermediate
interactions?
Optimal conditions for cercarial shedding
Howdoes variation in the ecosystemaffect
relationship?
Howcanthis variation be manipulated to affect the
relationship?
18
Biodiversityand Human Health Linkages
Workshop
23-28
June
2002
Group
3
(consolidated findings):
issue addressed:
Wetlands, water purification and
diseases
-
changes in ecosystem service and changes in health.
Clear indicators: Taxonomy and inventory, population structure, natural resource utilization
levels
Incidence, morbidity and mortality, pathogen diversity
Management options: wetland restoration and recovery; removal of ecosystem disturbance;
regulation of resource utilization; strengthening
of
health services
to
meet specific needs
Research questions:
What is the nature of the process and which elements are relevant
to
human health?
What is the profile of species
loss
in wetland destruction and what are the critical events for
health?
How does the health status of communities impact the biodiversity status of a wetland?
How can wetland restoration best contribute
to
human health?
Group
4
(consolidated findings):
issue addressed
Deforestation and medicinal plants
-
the health price of
missed opportunities
There are a number of knowledge gaps for which research questions can be raised or need
to
be developed:
A description of species and their role as a source of medicinal compounds
Analysis and characterisation of active ingredients
How can commercial interests be harnessed to ensure
(1)
community livelihood and
(2)
conservation needs?
How can the relative value of traditional and modern medicine best be assessed in specific
settings?
Field trip:
Visit to a planned hydro-power plant (Bujagali Hydroelectric Power Project) on the
Victoria Nile
In order
to
put the theoretical discussions of the first days into the context of a real-life water
resources development project, a field trip was made
to
a site near the planned "Bujagali
Hydroelectric Power Project"on the Victoria Nile,
2.5
km downstream of Bujagali Falls. The
project will comprise a 250 MW power station housing
5
x
50 MW Kaplan Turbine generation
units with an associated
30
m high embankment and spillway works. The visit gave participants
an opportunity to relate on-site environmental observations
to
the contents of the Environmental
Impact Assessment Report (Environmental
Impact Statement
(EIS))
of the project and in
particular the possible health determinants in the surrounding environment. After the visit,
R.
Bos gave a brief summary of the health issues mentioned in the
EIS
and their relation
to
the
planned project. Although no specific Health Impact Assessment had been done on the
proposed project, the health component of the
EIS
was considered quite thorough and covered
the major health concerns related
to
construction and operation of the power station. Little
or
no attention was paid, however,
to
opportunities
to
change the project design and/or operation
in order
to
reduce possible health risks.
19
Biodiversityand Human Health Linkages
Entebbe Workshop
23-28
June
2002
Group session
4:
Creating an enabling environment for
research
Framework
for
group discussions
Key issuesfor discussion
in
the groups:
Favourable policy framework
Health research policies
research policies
Policiesfor intersectoral collaboration
General researchand technology policies
Inter-institutional linkages
Identificationof institutions that would contribute
to
a multidisciplinary research effort (try
to
provide specific examples fromyour various countries)
What should be the nature of such linkages (strictly scientific, or should there be sharing of
resources,andjoint strategiesfor resource mobilization)?
Networking
Different levels of networking
Mechanismsat the national level (electronicor through existing committees, etc)
International networking
Scope of functions of the network
-
purely exchange
of
information or also dissemination
to
programme managers
Promotional activities
A
brochure
Other ways of bringing this issue
to
the attention of the
20
Biodiversity and Human Health Linkages Entebbe Workshop 23-28June
2002
Group 1 (results):
There are a number of policy-makingbodies in each country that are relevant in the context
of addressing biodiversity health links. While they may have different names in different
countries,their remits are similar and
so
is the hierarchical structure in which they operate.
All countries have the equivalent of a National Research Council. Among more specialized
entities can be included a Medical Research Council, an Agricultural Research Council and an
Environmental Council (or Natural Resources Board), which usually has a research component.
These entities are accountable to the National Research Council. While there is an entity for
each relevant sectoral area,there is little communication between them.National Research
Councils usually do not play a pro-active role
in
promoting such dialogues.
A number of policies are important and have, in principle,an intersectoral nature:in the
environment sector,policies for Environmental Impact Assessment,policies to prevent
deforestation and conservation policies aimed at wetlands protection are in place in most
African countries. On the social side, there are health policies in some countries also
addressing Health Impact Assessment and Social Impact Assessment in the context of EIA.
The implementation of policies takes place at the local level through district or provincial
development committees.They provide a natural environment for intersectoral action that is
often barred at the national level because of conflict over scarce resources.
So
while
harmonization
of
sectoral policies (between health, agriculture and environment sectors) often
remains an elusive goal,and the planning process reflects this lack of dialogue, when it comes
to operations at the regional, provincial or district level the reality is different. Supra-nationally,
some regional entities play a role, such as the Zambezi River BasinAuthority,the Lake Victoria
Environmental Protection Agency and the East African Parliament.
So
where do things go wrong? The following points were listed by the group:
Failureto consult all relevant lead agencies,becauseof lack of awareness or carelessness.
Unmatched representation (differences in delegation of decision-making powers in different
sectors).
General apathy
Overlapping responsibilities
Lack of policy enforcement
Generally,research and development policies are mainly institution driven and aim at
promoting sustainable development. They are either academic or applied and their linkswith the
research questions from potential clients are usually weak.Inter-institutional linkages on
environment issues run through
(insects,international), the Southern African Network for
Training on Environment (Under SADEC),
(forestry, international) and
(water
management,international).For health there are the Biomedical Research and Training
Institute ((BRTI)
-
health research network, international), the Blair Research Institute in
Zimbabwe and the appropriate bodies under the Organization of African Unity.
Initially networking should be informal, through e-mail, web-sites,databases,newslettersand
journals. National conferences and workshops will support networking efforts and help raise
awareness. Promotional activities should consider the following vehicles: media, school
curricula,bannerson the internet and drama and music.
Group2 (results):
This group identified National Research Councils as critical, with their network of specific
research institutions. Wherever these institutions are linked to ministries intersectoral
collaboration will be difficult,because ministries tend to focus on their own core issues.
Institutions with the potential for intersectoral collaboration exist,however,in all countries.
Their activities may include networking (at the national and international level), promotion
(targeting relevant existing groups),capacity building aimed at strengthening inter-institutional
links and workshops that serve as a fertile ground for promoting networking. Resource sharing
will be critical for effective and durable intersectoral action.
Important contributions to further awareness creation could be made through the write-up of
a position paper,through
a
brochureand through general advocacy activities. Special attention
21
and Human Health Linkages
Entebbe Workshop
23-28
June
2002
should be given to community involvement in the further shaping of conducive policy
frameworks.
Group
3
(results):
Health research policies are of limited scope,they address ethical issues in health research,
the development and testing of pharmaceuticals and sometimes they set the context for the use
of medicinal plants and traditional medicine. Environmental policies tend to be conservation
policies, with attentionto special ecosystemssuch as wetlands,andfor the protectionof wildlife.
There are no policies that aim to promote intersectoral collaboration as such;all existing
intersectoral
is based on personal contacts.
A
policy framework of this nature could be
developed using an ecosystems approach,
through a national seminar where all
stakeholders are focused on linkingtheir
issuesto wetland destruction, for example.
Group
4
(results):
Health
Biodiversity/Policyfor
General Country
Research
Environment lntersectoral
Research
Policy Research Policy
Collaboration Technology
Medica
I
not clear for research nil National Council
Research
for Science Zimbabwe
Council (MRC)
and Technology
Health ot clear for research same
Systems
Research
Committee
(no clear national
mandate)
Policy
Malawi
KenyaMedical available,but national
Research mandate unclear nil
Institute
(KEMRI)
Available,but Environmentalpolicy nil
mandate drafted,research
unclear component not clear
same Kenya
same Zambia
Unclear Environmental policy nil same Uganda
with research component
In summarizing the conclusions of the four groups,it can thus be said that an inventory of
relevant institutions will need to be prepared in each country,and mechanisms for networking
include national and/or institutional committees,electronic media between institutes and
countries and a newsletter for regional exchange of information set up.The functions of a
22
Biodiversity and Human Health Linkages
Entebbe Workshop
23-28
June
2002
network may include proposal preparation, exchange of new information and dissemination of
synthesized information to stakeholders.Promotional activities may include the compilation of
the workshop report, its distribution and a consolidation of feedback received, the production of
a brochure,regional and national press releases,a review of the workshop in leading journals, a
releaseof the workshop report on the web and advocacy.
In the concluding discussion it was noted that all groups had referred
to
the need for a
workshop report but also a separate brochure on the key issues,aimed at national policy
makers.This material could also be used for the organization of national workshops and
seminars.
With respect to the knowledge base matrix,it was agreed that the Secretariat would make an
attempt
to
finish
it
and that ideasfor case studies on
links beelaborated.
National Research and Technology Councils should be asked to take the lead in the
promotionof multidisciplinaryresearch,bringingthe various relevant partners together.
Several suggestionswere made for a home base
to
coordinatethe follow-up and networking.
ICIPE,as an African-based research institution with a stake in both biodiversity and health
issues,would seem the best option and the
representative would look into the
possibilitieson return.
Discussionclub
In an attempt
to
share knowledge and information and stimulate further discussions related
to the overall workshop theme,participants were invited to submit informal presentations to be
delivered under relaxed conditions at three evening sessions and the following were given:
Biodiversity
of
African freshwater snails
-
with a comment on a possible
relation
Aslak Joergensen
Danish
Laboratory,Jaegersborg
ID,
2920
Denmark
Biodiversity has gained increased interest since the 1992 Rio Conference where it was
internationallyagreed that the protectionand monitoringof the global biological diversity needed
to
be put on the political agenda.In recent years relationships between biodiversity and health
have accumulated in the scientific literature. The following abstract (presentation) will focus on
two
topics:
1)
biodiversity of African freshwater snails and 2) a possible snail biodiversity-health
relationship.
A general increase in species number towards the equator,as is seen in many animal
groups,is found in the distribution of African freshwater gastropods.This pattern was found by
Brown
994)
when he plotted gastropod distributions on the African continent. The analysis by
Brown excluded the rich endemic lake fauna of gastropods.Otherwise,the pattern would have
shown that freshwater gastropods are more prone to speciate and survive in large old lakes.
The size and age of lakes have been shown,on a world-wide basis,to be the most important
factors that determine the number of freshwater gastropod species.A large lake has many
specialized habitats and longevity is necessary for the speciation to occur. Lake Victoria is
perhaps the case that differs fromthe rule. The current lake is estimated to be 12,500years old,
but a rich endemic fauna of
Prosobranchia) and
(Planorbidae, Pulmonata) has nevertheless evolved. This can perhaps be explained by survival
of species in isolated refugia during the drying up events of the lake.
A rich natural biodiversity of freshwater snails can perhaps act as a buffer system that
prevents that single snail species dominate the fauna.A general hypothesis could state:
“Change in the environment can lead to change in the faunal composition which can lead to an
increase in the number of intermediate host snails due to the elimination of natural competitors.”
A more specific hypothesis could be:“Organic pollution leads to water deprivedof oxygen which
is inhabitable by prosobranchs,but not to pulmonates (intermediate host of several parasites)
which can
air as an oxygen source”.This hypothesis still needs to be verified.
23
Biodiversity and Human Health Linkages
Entebbe Workshop
23-28
June
2002
Diversity
of
freshwater gastropods in lake habitats with or without
anthropogenic influences in Lake Victoria,Kenya
Charles N.Lange
National Museums of Kenya,Dept of Invertebrate Zoology,
P.
Box
40658
Nairobi,Kenya
Explorationof freshwater snails in Africa has been running for many years with systematics,
medical and veterinary malacology as the priority subjects over the years.Over the years of
malacological exploration,
have investigated the impact of various factors on
snails. However, the role of human environmental disturbance on snail diversity patterns has
only been done superficially. But given the proceeding degradation of these freshwater
ecosystems
in
the developing countries particularly in tropical Africa, one would hypothesise
that human influences can impact snail diversity patterns. As such,comprehensive investigation
of the role of anthropogenic factors on snails’ diversity patterns, could probably contribute to
better understanding and management of problems associated with potential
diseases as well as molluscan conservation.The present study seeks to investigate the
influence of human environmental degradation on freshwater snail biodiversity and implications
on potential snail-borne diseases in LakeVictoria, Kenya. The project is currently six months old
and is being implemented using different snail sampling methods at selected highly disturbed
fishing beaches and least disturbed areas around Ndereand Mbitapoint region of Lake Victoria.
The first round of snail sampling hasjust been completed and snail identification is in progress.
An overall observation from this round of sampling was comparatively higher abundance of
pulmonate snails from the fishing beaches compared to the least disturbed areas. The project
will provide explanation on the viability of environmental conservation in control of schistosome
intermediate host snails. The project will also be a valuable foundation for formulation of
conservation management policies for the regional molluscan biodiversity, wetlands and wildlife.
Adaptation
of
Anopheles
mosquitoes to urban environments
Charles Mbogo
Kenya Medical Research Institute, Centre for Geographic MedicineResearch
P.
Box
428,
Kenya
Investigatingand understandingthe relationship among humans,the environment and insect
population dynamics is essential to the development of predictive models of insect adaptation to
changing urban ecosystems inAfrica.In order to understandhowincreased human activity and
urbanization affect insect populations,geographicand ecological investigations were carried out
to examine possible spatial and temporal correlations between climatic changes, demographic
changes,socioeconomic status,variable water conditions, insect population dynamics, and
human behaviour.This study that was aimed at investigating the adaptability of
Anopheles
mosquitoes
in
urban environment was conducted in Kisumu and Malindi towns,Kenya.We
stratified both cities based on the level of planning and drainage observed across the urban
areas.This resulted in five strata for each site:
1)
planned,well drained;2) planned,poorly
drained;
3)
unplanned,well drained;4) unplanned,poorly drained, and
5)
rural.The stratification
enabled us to control for the strong environmental and topographical variation that we believed
would influence mosquito larval ecology.
The larval habitats and houses were mapped using GPS.Adult mosquitoes were collected
from the sampled houses using light traps and pyrethrumspreadsheet spray collections, while
mosquito larvae were sampled using the standard dipping technique.Sampling was done at
two-week intervals between April and September 2001.The mosquito adults and larvae were
identified using morphological features. Samples of
An. gambiae
were further identified by
PCR.
Our preliminary results showed that
93%
and
66%
of the breeding habitats were
in Malindi and Kisumu,respectively.
Anopheles
mosquitoes were found breeding in diverse
larval aquatic habitats such as swimming pools,car tracks, ponds, flower gardens,septic and
water tanks. Among these larval habitats, car tracks and swimming pools produced the highest
number of
Anopheles
larvae.We have collected
An.gambiae
and
An. arabiensis
of the
An.
gambiae
complex,plus
An.
merus,a brackish-water adapted species in Malindi.On the species
24