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2016-07-30T13:18:56Z

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2016-07-30T13:18:20Z

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2016-01-17T10:56:10Z

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Haiyan Is A Call To Action: Risk Must Be The Heart of Development

2013-11-22T17:01:10Z

Once more a disaster is centre-stage and slowly, as before, attention shifts from the challenge of response to the failure to prevent.

The destruction wrought by typhoon Haiyan has yet to be fully understood, and the total cost, in terms of shattered lives and financial loss, can still only be imagined. What we know is that Haiyan, one of the strongest storms on record, and the storm surge created by the funnelling of water in Leyte Gulf, has created a level of devastating impact usually reserved for tsunamis. Before and after photographs are similar to those we saw in Aceh after the 2004 Indian-Ocean tsunami, villages wiped from the landscape, cargo ships piled up along the coastline.

That this has happened in the Philippines is somewhat perverse. Disaster risk is built into the country’s development planning, and considered as a threat to national security. Politicians better have disaster prominence in their manifesto if they want to be elected. The government is investing heavily in risk reduction, close to $1 billion a year. And, perhaps more important, disaster risk has entered civil consciousness; prevention and preparing for the regular impact of typhoons, landslides, flooding and earthquakes is of central importance across society.

What does it mean for the international community when a country with arguably one of the most advanced risk management legislative frameworks, a committed government, significant national investment, and often deemed a success story, is unable to both prevent a disaster of this magnitude and to comprehensively prepare? And what does this mean for other contexts?

Of finance, equity and mind-set changes

While the Philippines provides a rare example of a country with proactive investment into preparedness and risk reduction, in other countries wherein risk is not a core part of their development approach, the state of preparedness is far less evident.

Part of the challenge lies in the financing architecture, with overseas development assistance for emergency preparedness largely deriving from humanitarian financing mechanisms that are released only in the aftermath of a crisis. While this reflects a long history of calls by humanitarians to seek ways to stop the cyclical nature of response – and be better prepared for that response - it does little for the communities or states at risk.

There has long been the call for a fundamental mind-set change, and with this transformation of the financing architecture; a move that would take developing countries closer towards the Philippines model and see stronger commitment to preparedness and risk reduction. We need to apply the same logic as the donor governments do in their own constituents: to invest in early warning systems, search and rescue, build capacity for response, devise contingency plans and train personnel to cope with the range of likely risks to be faced. In some regards this is a matter of equity – to support action that we would warrant as necessary of our own constituents. In other regards, this is a matter of economics; it is more cost effective and cost efficient to invest in preparedness as opposed to response only. And yet international funds devoted to disaster prevention and preparedness are a small fraction of what is spent in reconstruction and response. Latest research shows that if you combine the financing of 12 of the poorest countries, for every $1 on disaster 'risk reduction', $160,000 has been spent on disaster 'response'.

A matter of humanitarian aid or development?

What does this mean in practice? While the response to typhoon Haiyan calls heavily upon the international community in the immediate aftermath of the disaster, the impacts have undermined development progress and will continue to set back progress in the future. Understanding risk, being ready for crises and establishing systems of preparedness for emergency response are therefore the responsibility of all: nations, humanitarians and development actors.

As we have seen in the Philippines, emergency response requires near term preparedness activities (e.g. stockpiling of food and non-food items); it also requires a history of investment to enable longer term preparedness to be established, and to be effective and efficient in a crisis (e.g. legislation and budgetary measures to resource these activities). The activities required across the ‘preparedness continuum’ therefore span the humanitarian and development divide.

Challenges ahead

Without more effective and scaled up pre-disaster preparedness measures, vulnerabilities will persist and humanitarian needs will continue to overwhelm the limited resources and recovery capacities of local, national and international actors. However, choosing to deploy or prioritise resources to reduce risks and prepare for disasters presents significant challenges for policy makers. Limited resources and heightened donor expectations provide a difficult context in which to make the case for a new approach. Notwithstanding, a new approach is what is required.

First, a paradigm shift to foreground emergency preparedness in the current response-dominated approach is paramount and a more holistic appreciation of the role of preparedness in humanitarian initiatives is necessary. The way funding is currently structured impedes that holistic approach. However, to separate out preparedness activities to fit existing bifurcated aid structures would simply reinforce an unhelpful humanitarian response/development divide that accentuates short-term, disjointed planning. To bring together preparedness activities as a discrete set of issues risks creating (yet) another silo. Moreover, humanitarian aid budgets are finite and will be more likely under acute pressure in years to come.

It is therefore safe to say that the solutions lie in making more efficient use of existing mechanisms, humanitarian and development, and creating incentives to prioritise preparedness action. Of course, as the Philippines exemplify, the head start given by preparedness does not remove the obligation or imperative for donors or agencies to respond to emergency needs in these countries. It does mean, however, that any such response will be able to meet needs in a more timely, appropriate, and effective manner; in contrast to no preparedness having taken place.

Secondly, a more integrated operational response needs to be found that works to support cost effective pre-emptive action. As noted by the World Bank President, the humanitarian landscape calls for a new approach to ‘shift from being crises fighters to proactive and systematic risk managers.’ Investment in preparedness should be based on a global, regional, national and subnational assessment of risk, related to vulnerability and capacity in country. Such an assessment would allow for better prioritisation of resources where the need is greatest. In high-risk countries, humanitarian and development actors need to work together to develop and support coordinated multi-year and multi-stakeholder systems that integrate preparedness, based on a collaborative and coordinated understanding of risk.

As our thoughts and action return to the immense task at-hand to restore some degree of normality to those affected in the Philippines, experts warn that the ‘one off events’ could well become the norm. While attribution to climate change is extremely complex, we can know that the complicating impact of climate change on disaster extremes in the Philippines poses difficult questions for the humanitarian and development communities going forward.

What is clear is that system change is needed: we need wait no longer to realise that fact.

By Katie Peters (Research Fellow, ODI), Jan Kellett (Senior Research Advisor, ODI), and Sandra Aviles (Officer-in-Charge, FAO Office in Geneva, and IASC TT Chair for Funding Preparedness).

A new report launched on 9th December 2013 by the Overseas Development Institute will set out a new way forward for the current state of financing of emergency preparedness.

Uttarakhand Flood and Mass Fatality Management

2013-07-05T11:09:15Z

The care with which our dead are treated is a mark of how civilized a society we are. – Charles Haddon-Cave.

The recent flash flood, cloudbursts, and landslides on 16th and 17th June in five districts of Rudraprayag, Uttarkashi, Chamoli, Pithoragarh and Tehri of Uttarakhand State of India poses a serious question about our preparedness to deal with mass fatality in India. We do not know the exact figure of death toll but it is estimated that minimum 1,000 - 5,000 people may have lost their lives in this natural disaster. There has been no official assessment yet but unofficial estimates indicated that the death toll might rise manifold. It will be only known after improvement in weather conditions and debris clearance.

Natural disasters and calamities are not new in India. In the earthquake resulting in the Tsunami in 26th December 2004, almost 11,000 people died and over 5,000 are missing and feared dead (Ministry of Home Affairs, Government of India). This raises a serious issue related to management and cremation of dead bodies. Management of the dead bodies in a proper and dignified manner is one of the most difficult aspects of disaster response which is also related to management of recovered bodies, their identification, storage and disposal of dead bodies. Despite several disasters and large number of deaths, the government of India is not having a policy or plan for mass cremation or fatality infrastructure preparedness plans for the management and cremation of dead bodies.

In a recent Uttarakhand disaster, the government is facing the challenge of the disposal of hundreds of corpses. If it is not handled properly, there may be an epidemic outbreak leading to more death in the already ravaged hills. Interestingly, in the absence of policy and plan to manage the death bodies, as an emergency measure, the government is consulting the holy men regarding mass cremation and proper ritual. The corpses have been lying for days, some since June 16, out in the sun and rain, and in an advanced stage of decay and decomposition. It is unfortunate that it is more than a week and still bodies are waiting for cremation due to lack of preparedness, unavailability of woods and bad weather. Now the government is sending the forensic teams for taking pictures of bodies and DNA samples.

It is sad that, after the disaster, the Central and the State government are finalising the standard operating procedures for identification and cremation of the bodies, which should be done much before after the 2004 tsunami in which 11,000 people died. It is a high time and the government should learn from this disaster and prepare a mass fatality infrastructure preparedness policy. The policy should focus on operational procedures for body recovery; storage of bodies; body identification and medico-legal investigation protocol; funeral services and final disposition of mass fatalities; and providing family assistance. Considering that India is multi-ethnic, multi-religious country, in disposing of bodies, ethnic and religious sensitivities should be maintained and addressed appropriately. The government should realise and understand that inadequate capacity to deal with dead bodies may affect the psychological well-being of survivors which may result in distress to families, community; and it may lead to another epidemic.

Superbugs, Humans And The G8: A Global Reckoning

2013-06-19T17:17:54Z

Let's ask the G8 to consider the case of Ms. D.

She was a mother of six, her youngest child two years old. She caught a cold on a Sunday. The cold weakened her and led to a bacterial pneumonia. It was 1943, and the world was busy making war. Ms. D stood at the threshold of the antibiotic era. But she never crossed it: her pneumonia killed her, efficiently, by Thursday.

Now consider the case of Mr. S, a twenty-eight year-old software engineer. Seventy years after the death of Ms. D, he planned an adventure vacation in North Africa. While there, he was involved in a bus accident. His lower legs were crushed, resulting in several open fractures. He was airlifted to his home country, Switzerland, but not before spending three days in a Cairo intensive care unit. By the time he arrived in Switzerland, several "superbugs" had nested and were growing happily in his leg bones; two of them were fully resistant to all known antibiotics save colistin. Colistin is an old drug that had all but vanished during the antibiotic era's golden years: it is rapidly toxic to the kidneys and nerves. Mr. S would need continuously high levels of this toxic drug in his blood for at least half a year to reach the bacteria in his broken bones; this would almost certainly lead to the death of both kidneys. So he was offered a choice by his physicians: try to save the legs--with a high chance of going on kidney dialysis for the rest of a shortened life at the age of 28, and an unknown chance of actually curing the infection--or amputate the legs before the infection spread to the rest of his body and killed him.

Mr. S chose a double leg amputation. He lived.

Both of these patients serve as "book ends" to the golden era of antibiotics. Both are real. There are differences, of course. Ms. D's generation lived with stories like hers. In the battle of Medicine vs. Fate, the balance of power lay firmly on the side of Fate. In our generation, however, we have believed that Medicine can shape and change Fate, because for us it always did. The younger among us have seen only the vaccine, not the deadly and deforming disease: few doctors under the age of sixty have ever encountered a case of measles. We have taken the antimicrobial, and within a few days, our only worry became remembering to swallow the pills-not having to take leave of our children before they were old enough to remember us. It is never easy to accept the abrupt end of a young life, and the loss of Ms. D still reverberates in the covered-but open-wounds of her children, seventy years on. But it may be harder for our generation to accept these sudden disappearances of life and limb--to witness this alteration in the balance of power--because we never questioned Medicine's superiority.

We need to, though. There have been no successful discoveries of new classes of antibiotics since 1987. Meanwhile, the Centers for Disease Control and Prevention recently warned the public of a four-fold increase in one group of "nightmare bacteria" known by doctors as carbapenem-resistant Enterobacteriaceae (CRE) in just one decade; up to half of patients who get CRE bloodstream infections die.

The G8 Summit taking place now in Northern Ireland has rightly prioritized global antimicrobial resistance as a "major health security challenge of the twenty-first century." Science ministers of the eight countries are calling for intensive international collaboration to achieve the concrete goals of (1) avoiding the misuse of remaining antibiotics and (2) streamlining and facilitating the development of new antibiotics as well as (3) rapid diagnostics to accelerate the identification and treatment of these resistant organisms before they spread to others.

The key element to the success of such initiatives is of course international collaboration. Microbes have been globalized along with the rest of the world. In the history of the planet, there has never been such rapid and distant microbial spread. Thanks to mass travel, Dengue (also known as "break-bone fever") has returned to the U.S. and may soon become endemic in some states. The West Nile virus, never before seen in the western hemisphere, also arrived by plane and rapidly spread across the nation. CRE, the nightmare bacteria, were first identified in the US in 2001; they have now been reported in all but seven of the fifty states. Data sharing among international infection control experts, institutions, and the biotechnology and pharmaceutical industries is essential. Facilitating the exchange of ideas for novel measures to combat the global threat of antimicrobial resistance is also essential.

Here in Geneva, will start in a few days the second biennial conference of the International Consortium for Prevention and Infection Control, made up of physicians, nurses, scientists and other personnel who have dedicated their lives to infection control in humans. From June 25th through the 28th, over 1,200 experts from eighty-four countries will gather to exchange ideas, strategies and local outcomes of recent and ongoing studies. What worked--and what didn't--will be discussed and scrutinized. Concrete strategies will be argued and debated; those that pass these tests will be laid down for further development and implementation. In these three days, the seedlings of international collaborative efforts--from laboratory experiments to multicenter clinical studies, both observational and interventional--will be planted.

Though we never knew her, we would like to think that Ms. D would be happy. Mr. S recently told us that he was.

From 25-28 June, over 1,000 world experts in the prevention and control of healthcare-associated infections will gather in Geneva for the 2nd International Conference on Prevention & Infection Control (ICPIC). Over the next two weeks, The Global Journal will showcase the inspiring stories behind the vital work being done to reduce the global burden of this preventable public health challenge.

Request the Special ICPIC Edition of The Global Journal.

At the Crossroads of Public Health, Intellectual Property and Trade

2013-02-06T11:21:30Z

For the first time, the three global institutions dealing with health, intellectual property and trade have pooled their expertise on a study of policies needed to advance medical technologies and ensure they reach the people who need them most.

The book, Promoting Access to Medical Technologies and Innovation: Intersections Between Public Health, Intellectual Property and Trade was launched at the World Trade Organization (WTO) in Geneva on 5 February, by the heads of the three bodies. Former Swiss President, Ruth Dreifuss, who is also a former Chairperson of the World Health Organization's (WHO) Commission on Intellectual Property, Innovation and Public Health, chaired the event.

The goal of the study is ambitious, aiming to support governments – particularly in developing countries – that want to increase access to effective treatments while containing costs. A guide for policy-makers, academics and researchers, the book brings together a vast amount of analytical and factual material on medicines, technologies and innovation, in one concise volume.

“Promoting both medical innovation and access to the fruits of that innovation is indispensable for progress towards improved and more equitable health outcomes,” said Dreifuss. World Health Organization Director-General Dr Margaret Chan said the report “sets out a comprehensive and coherent inventory of legal instruments and policy options that can be drawn on to craft measures that meet national public health objectives.”

The purpose of a joint publication is to enhance the global understanding of health, including its trade and intellectual property dimensions, while providing policy-makers with sustainable solutions for effective health policies. The book looks at ways to tailor systems that encourage innovation, yielding new treatments for the diseases of the poor and ensuring sustainable and equitable access to these innovations. It also sets out the international policy framework, as well as the factors shaping that policy.

Much attention is paid to health challenges such as HIV/AIDS, malaria, tuberculosis and non-communicable diseases. The evolution of research and development as well as alternative ways of promoting innovation for neglected diseases are also explored. The study demonstrates how the way in which intellectual property rights such as patents and trademarks are obtained and managed determines access to medical technologies and innovation. Equally, trade rules (pricing policies, taxes and import duties on medicines, procurement, regulation, technology transfer, compulsory and voluntary licences) can either promote or hinder innovation and access to medicines.

While the study does not prescribe any way to deal with a country's particular health problems, it is a cutting-edge tool for decision-makers to face the evolving worldwide burden of disease. By explaining trade and intellectual property rules and their link to health in a global context to a non-specialist audience, the book unlocks complex global health problems. Ultimately, it delivers solutions to meet objectives such as the right to health and the United Nations’ Millennium Development Goals.

Photo on Frontpage © Health Poverty Action

Photo © Allied Healthcare Group

A Global Alliance for a Toxics-Free World

2013-01-24T18:58:28Z

As negotiations on a new Mercury Convention wrap up in Geneva, Richard Fuller presents the Global Alliance on Health and Pollution (GAHP), a new collaborative body tasked with coordinating resources and activities to solve toxic pollution problems in low- and middle-income countries.

The Global Alliance on Health and Pollution participated in the INC5 negotiations as an observer. Could you tell us more about GAHP and its role in addressing toxic pollution?

The Global Alliance on Health and Pollution is a newly formed organization that was created in July last year. Its membership comprises most of the large development agencies – the World Bank, Inter-American Development Bank (BID), Asian Development Bank – UN agencies such as UNEP, UNIDO and WHO (as an observer), and donor agencies such as the European Commission. The purpose of our organization is to help the developing world deal with toxic hotspots and help them to solve environmental health problems. This is a larger problem than most people are aware of. Some of the research coming out now finds that the amount of health damage caused by chemicals in toxic hotspots is as significant as that of malaria or tuberculosis.

GAHP is a collaborative organization that has Blacksmith Institute as secretariat, and the World Bank and European Commission currently taking the lead in funding resources. One of the activities of the Alliance is to expand the inventory of contaminated sites that Blacksmith had started. In about fifty countries, we have been doing site assessments in places that are potentially toxic and dangerous. In all these countries there are trained investigators - usually staff from the environmental health department of national universities – who go and visit sites and follow through on a protocol that was developed in conjunction with John Hopkins university and Mt Sinai University. It is a rapid-assessment version of the Superfund USA evaluation protocol, and aims to take enough samples of contaminants to determine if there are toxins at levels that exceed either local standards or US EPA standards, and then determine if they are in a pathway of exposure into a local population. This is the '3 P method': pollutant, pathway, population. If there are toxins at a level that is significant – usually it reaches a minimum of five times the EPA standard – and there is an affected population, then a set of data is collected that can provide the starting point for that country to be able to prioritize clean-up operations. Obviously, places where the most number of children are killed or injured should be dealt with first. The Alliance has taken on this role of helping countries in a collaborative way, reviewing and identifying these toxic problems, and assisting in clean-up.

Which standards does GAHP use to assess levels of pollution and decide which toxic sites have priority?

We can use local standards as a reference to determine if the toxin is elevated or not, but if there are no local standards for a particular country, we usually use either EU or US EPA standards. In reality, it does not matter that much which standard you use. For example when looking at lead in soil, standards differ slightly from one country to another. But this can be somewhat irrelevant for our work because most of the sites we measure have contamination levels that are well in excess of these standards anyway.

At the beginning of the final round of negotiations on the new Mercury Convention here in Geneva, David Piper from UNEP's chemical branch said that so far UNEP has mostly been trying to regulate manufactured toxic chemical substances. This time, it is focusing its efforts on mercury, a complex natural element. Do you think this affects the negotiation process in any way?

For us, the fact that mercury is an element rather than a manufactured chemical is not so important. What we are concerned about is whether humans are being damaged by exposure to toxic pollutants. There are certainly natural mercury sources in different countries which affect people who live around them. But the majority of mercury exposures are from human activities, and the largest immediate source of exposure is probably artisanal gold-mining, because mercury there is so localized and concentrated. We see our responsibility to deal with toxic hotspots that were created by humans.

What kind of outcome do you expect from the current Mercury Convention negotiations?

It seems like there is going to be quite a good document coming out of the negotiations. Some of the drafts really have some strength and are calling for substantive action, so I am hopeful. There is not much that deals specifically with cleaning toxic hotspots and the language used is mostly voluntary. But that is fine, we cannot expect governments to commit to such processes and I do not think it is appropriate to include them in a treaty anyway. It is a country's prerogative to decide how to deal with toxic hotspots, according to its own means, so a treaty does not necessarily mean there will be direct requirements to deal with the issues GAHP deals with. This treaty brings attention to the problem and that is what matters for us.

What are the main goals of GAHP for the future?

There is a long way to go. Very few countries are actually doing something about their environmental health problems. In fact, there are only three or four in the developing world. In the West, these problems have been dealt with for decades. But there are neighborhoods and towns with very serious and acute toxic hotspots, some where life expectancy is less than forty. The Alliance will work in a collaborative way to bring resources to all these places through different avenues. We will help them to learn what they need to do and implement programmes that will save lives.

Mercury is one of the problems we face, but the largest and most significant toxicant today is lead. Primary smelters take lead (Pb) ore from the ground and make lead as a raw product or as a by-product from making copper for instance, and the lead then exposes populations living around these smelters. But several times worse than this is informal battery recycling smelting or melting, which is taking place in urban centres in every city throughout the tropics. People collect used car batteries, bust them open with an axe, pull out the lead plates and melt the material that is inside so they can recover the lead. But they throw out all the lead oxide onto the ground which then spreads through the community and poisons children. The lead collected in that way provides an income for many people, but millions of people are badly intoxicated as a result. In our database of acute toxic hotspots, lead is the worst toxin, then chromium, mercury, pesticides, radionuclides and so on. But heavy metals cause the most problems.

Global Mercury Agreement to Lift Health Threats from Lives of Millions World Wide

Final Negotiations on Mercury Convention Kick Off in Geneva

Who Killed the Hippocratic Oath?

2013-01-23T08:09:39Z

Thieves of Virtue: When Bioethics Stole Medecin, Tom Koch, The MIT Press, £20.95.

Born in the 1960s, bioethics was to bring “a specific kind of analytic, moral philosophy to questions of medical care and healthcare delivery.” In this well researched book, Tom Koch explains why contemporary bioethics fails to fulfill its role – to the detriment of patients, research subjects and citizens. Under the old Hippocratic Code, medical practitioners were care givers of the individual as well as society at large. The code was idealistic and simplistic: some acts were encouraged and others – such as abortion or euthanasia – prohibited. But the clinical, environmental and social elements of the Hippocratic vision also provided a guide as to how health could be promoted. It was left for societies to find the balance between economic constraint and human necessity.

In the late 19th century, however, the focus shifted from patient care and communal responsibility to individual autonomy and economic efficiency. Practitioners were elevated to authoritative positions as medical judges, including the power to decide whether to give, withhold, withdrawor continue care. The new goal of medicine through fundamental research became “the definition of the acceptable person within a population whose composition could be controlled to the advantage of the state and its economies.”

Borrowing from Confucius, Koch warns us against “thieves of virtue” –bioethicists who promote as universal a perception of medical ethics whose end is moral action. They teach, write, advise hospitals and review boards, and generally serve as “surrogates of the general public” when ethical issues arise in practice and research. While bioethicists present the scarcity of medical services as natural, Koch argues that scarcity is the predictable result of “economic choices and political decisions made with full knowledge of the dire consequences.” Scarcity disappears when the US Congress votes to fund dialysis as a national entitlement, or when local healthboards argue for urban sanitation and preventive measures against epidemics.

As political actors and social participants, bioethicists shape health policy. Their assumptions define life, health and normalcy; the care or non-care of persons depends on their perspective on the human condition. Through various case studies, Koch explains that bioethicists can – and do – regularly deny care for those with limiting cognitive, physical or sensory attributes, advocating the right to die as an individual choice rather than the right to live with dignity despite difference.

Koch’s critique is an appeal for a transformed medical ethics that is humanist, responsible, and defensible. A fundamental question to be revisited is whether we understand society as an economic enterprise in which patients are consumers, or a “social covenant in which all are able to participate…irrespective of their physical abilities.”

- AS

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Global Mercury Agreement to Lift Health Threats from Lives of Millions World-Wide

2013-01-20T17:22:50Z

Photo: During the afternoon plenary with Naoko Ishii, GEF CEO and Chairperson; Achim Steiner, UNEP Executive Director; Tim Kasten, UNEP; INC Chair Fernando Lugris, Uruguay; Jacob Duer, INC Team Coordinator, UNEP; Masa Nagai, UNEP; and Nina Cromnier, Rapporteur, Sweden.

In the early hours of Saturday morning, delegates from nearly 140 nations clinched a deal on a global Mercury Convention aiming to regulate emissions and releases of a notorious heavy metal with significant health and environmental effects. Over 900 people including government delegates, civil society groups, profit and non-profit organisations took part in extensive negotiations on complex issues such as mercury-related health impacts.

Uruguayan Chair of negotiations Fernando Lugris emphasized the significance of this achievement in the post-Rio+20 world. The Minamata Convention on Mercury – named after a city in Japan where serious health damage occurred as a result of mercury pollution in the mid-20th Century – provides controls and reductions across a range of products, processes and industries where mercury is used, released or emitted. These range from batteries, lamps and cosmetics to the mining, cement and coal-fired power sectors. The new agreement also addresses the direct mining of mercury, export and import of the metal and safe storage of waste mercury.

The Convention is the outcome of a lengthy process that started in 2009 and will be open for signature at a diplomatic conference in Japan in October. UNEP representatives are confident that the 50 ratifications required for the Convention to come into force will be achieved within the next three to four years. Initial funding to fast track action until the new treaty comes into force has been pledged by Japan, Norway and Switzerland. Support for developing countries is also expected from the Global Environment Facility[1] once the convention is operational.

Achim Steiner, Executive Director of the UN Environment Programme (UNEP) which convened the negotiations in Geneva, said: “After complex and often all night sessions here in Geneva, nations have today laid the foundations for a global response to a pollutant whose notoriety has been recognized for well over a century.”

“Everyone in the world stands to benefit from the decisions taken this week in Geneva - in particular the workers and families of small-scale gold miners, the peoples of the Arctic and this generation of mothers and babies and the generations to come. I look forward to swift ratification of the Minamata Convention so that it comes into force as soon as possible,” he said.

Chair of negotiations Fernando Lugris emphasized that the Minamata Convention is not a soft law instrument but a legally binding agreement that will become part of international environmental law. Compliance will however depend on guidance and monitoring from the Conference of the Parties (COP) to be established once the Convention comes into force.

“This treaty will not bring immediate reductions of mercury emissions. It will need to be improved and strengthened, to make all fish safe to eat,” said David Lennett from the Natural Resources Defense Council representing the Zero Mercury Working Group a global coalition of environmental NGOs “Still, the treaty will phase out mercury in many products and we welcome it as a starting point.”

Ambassador Franz Perrez of the Federal Ministry for the Environment, Switzerland said: “Switzerland, which initiated with Norway the negotiations for a mercury convention, is very pleased about this impressive success. It will help us to protect human health and the environment all over the world and is a proof that multilateralism can work when political will exists.”

The scope of the new treaty which puts in controls and also reduction measures in respect to mercury is as follows.

Products

Governments have agreed on a range of mercury containing products whose production, export and import will be banned by 2020.

These include:

Batteries, except for ‘button cell’ batteries used in implantable medical devices
Switches and relays
Certain types of compact fluorescent lamps (CFLs)
Mercury in cold cathode fluorescent lamps and external electrode fluorescent lamps
Soaps and cosmetics

Certain kinds of non-electronic medical devices such as thermometers and blood pressure devices are also included for phase-out by 2020.

Governments approved exceptions for some large measuring devices where currently there are no mercury-free alternatives:

Vaccines where mercury is used as a preservative have been excluded from the treaty as have products used in religious or traditional activities

Delegates agreed to a phase-down of the use of dental fillings using mercury amalgam.

Artisanal and Small-Scale Gold Mining (ASGM)

The booming price of gold in recent years has triggered a significant growth in small-scale mining where mercury is used to separate gold from the ore-bearing rock.

Emissions and releases from such operations and from coal-fired power stations represent the biggest source of mercury pollution world-wide.

Workers and their families involved in small-scale gold mining are exposed to mercury pollution in several ways including through inhalation during the smelting.

Mercury is also being released into river systems from these small-scale operations where it can contaminate fish, the food chain and people downstream.

Governments agreed that the treaty will require countries to draw up strategies to reduce the amount of mercury used by small-scale miners.
Nations with artisanal and small-scale gold mining operations will draw up national plans within three years of the treaty entering into force to reduce and if possible eliminate the use of mercury in such operations
Public awareness campaigns and support for mercury-free alternatives will also be part of the plans

From Power Stations to Cement Factories

The new treaty will control mercury emissions and releases from various large industrial facilities ranging from coal-fired power stations and industrial boilers to certain kinds of smelters handling for example zinc and gold.

Waste incineration and cement clinker facilities are also on the list.

Nations agreed to install the Best Available Technologies on new power plants and facilities with plans to be drawn up to bring emissions down from existing ones.

The negotiations were initially looking to set thresholds on the size of plants or level of emissions to be controlled. But it was decided this week to defer this until the first Conference of the Parties (COP) after the conventions comes into force.

Notes

Background to the fifth session of the Intergovernmental Negotiating Committee to prepare a global legally binding instrument on mercury (INC5)

Global Mercury Assessment 2013

Time to Act

[1] http://www.thegef.org/gef/