Occupational Health in the Eastern Mediterranean Region Challenges Opportunities

1. Occupational Health in the Eastern Mediterranean RegionChallenges & Opportunities Dr. Said Arnaout RA/HSG,WHO-EMRO arnaouts@emro.who.int

3. Eastern Mediterranean Region

4. Per capita GDP in international dollars, 2004 Source: WHO Core Health Indicators 2006

5. Population of EMRin thousands, WHO 2005

6. Percentage of 15-64 Age Group

7. Percentage of non-nationals in the 15-64 age group

8. Labour Force in EMR 10 – 50% of the active population Non-local/ immigrant workers represent the majority of the workforce in some Gulf countries

10. Unemployed in EMR 13%Source: RD’s AR 2004

11. Informal labour force No precise estimates However, it represents about 24.7% of the currently employed labour force in Bahrain and about 46.8% in Pakistan

12. Working children Working children (Child labour) are present in several countries Figures are available only in few of them The working children are usually present in: agricultural activities, construction, industrial activities and small workshops

13. Working Women Are in increase

14. What are the main challenges, facing occupational health in EMR?

15. The Definition of Occupational Health (ILO & WHO) “The promotion and maintenance of the highest degree of physical, mental, social well-being of workers in all occupations – total health for all at work”

16. OH&S Dilemma in EMR Rapid growth of general population and young people reaching adulthood (huge increase in labour force, unemployment) Inequity, poverty, conflicts, disasters Conventional as well as new challenges Insufficient and inadequate OH&S services (human resources, infrastructure, education, training, research) Diverse spectrum of occupational and general health risks (Triple Burden)

17. Triple Burden of Disease Communicable Diseases Non-communicable Diseases Occupational and Work-related Diseases

18. Regional Situation OH Services are significantly varied from one EM country to another Variations include both qualitative and quantitative parameters There are very good amount of experience in some EM countries, and could be used, exchanged or even replicated by other countries There is a pressing need to enhance and progress OH services in every EM country

19. The greatest challenge How to transform the difficulties into opportunities?

20. Role of WHO/EMRO Extensive efforts are being made in countries of the region, in collaboration with the Regional Office to further develop and strengthen national programmes on occupational health and work safety Main Goal: By 2020 healthy workplaces and work practices will be widely adopted in Eastern Mediterranean Countries

21. Important Country Activities Bahrain: OSH Authority Tunisia: - Regular publication of OHS Journal - Annual OHS Conference on regular basis Jordan: National Strategy OHS Iran: Training Course on ILO Classification of Pneumoconiosis Kuwait: Healthy Work Places Workshop KSA: national Workshop on OHS in Medical practices UAE: National Training Workshop on OHS for PHC Physicians Egypt: Several training courses for PHC workers National workshop on protecting HCWs & preventing needlestick injuries, 4-5 Dec. 2006

22. Important Regional Activities Regional Consultative meeting on the development trends of occupational health and safety in the EMR “Current status and perspective”, Damascus, Syria, 16-18 Dec. 2003 Intercountry workshop on primary health care and basic occupational health services: Challenges and opportunities in Eastern Mediterranean Region, Sharm ElSheikh, Egypt, 12-14 July 2005 Regional activities at GCC Level

24. Inter-regional activities the WHO/ILO Joint Efforts on Occupational Health and Safety in Africa Unified Country Profile on Occupational Health in Egypt, prepared jointly with all partners concerned on occupational health and safety at national level A workshop on the national occupational health and safety profile in Egypt was successfully organized in EMRO, Egypt, 29–30 October 2003, as an activity of these joint efforts

25. Collaborative Programmes With WHO in OSH for the 06-07 Biennium

26. The WHO Global Plan of Action on Workers Health2008-2017 A Fresh Look & New Opportunities

27. In 1996, the 49th WHA with Resolution 49.12 endorsed the Global Strategy on Occupational Health for All strengthening of international and national policies for health at work promotion of a healthy work environment, healthy work practices and health at work (iii) strengthening of occupational health services (iv) establishment of appropriate support services for occupational health (v) development of occupational health standards based on scientific risk assessment; (vi) development of human resources; (vii) establishment of registration and data systems; and (viii) strengthening of research

28. New political realities, initiatives and requests by the Member States call for renewed attention and global action by WHO on occupational health

29. WHO Response There is a need to move from strategy to practical action in the area of workers health WHO developed the Global Plan of Action on Workers Health 2008-2017 to provide new impetus for action

30. The plan is based on the proposals for action made by: the Member States, the consultations with: WHO Regional Offices, relevant WHO technical programmes, the WHO Collaborating Centres for Occupational Health, the International Labour Office/ILO and international organizations of employers and workers

31. The health of the workers depends on a combination of factors and a complex interaction between them Working environment: mechanical, physical, chemical, biological, ergonomic, psycho-social factors; Social determinants related to work: employment status, occupational position, social inequalities and poverty; Work-related health behaviour: individual preventative health practices and personal health-related behaviour; Access to health services: adequate and affordable occupational health services for promotion, prevention, cure and rehabilitation;

32. This plan of action deals with workers health in a broader context Workers health is a public health approach to addressing the health problems of working populations It focuses on: primary prevention of occupational and work-related diseases and injuries protection and promotion of the health of workers Occupational health constitutes the core of this approach

33. GPA on Workers’ Health2008 - 2017 Outlines newly emerging challenges Sets goals for protection and promotion of workers health Recommends a series of strategic actions to be taken by the Member States and the WHO Secretariat over a ten year period

34. Objectives of GPA on Workers’ Health Develop and implement policy instruments on workers’ health Protect and promote health at the workplace Improve the performance of and the access to occupational health services Provide and communicate evidence for action and practice Incorporate workers’ health into other polices

35. The Challenges Too many workers are still: exposed to unacceptable levels of occupational hazards, fall victim to occupational diseases and work accidents, and lose their working capacity and income potential In many countries the existence of occupational health services is very limited and less than 15% of workers have access to them

36. The Challenge & Opportunity  Globalization Major impact through: growing internationalization, competition, changes in the regulatory strategies, major changes in enterprise structures and associated technology changes. Numerous positive effects: Increasing world trade Growing interaction among countries, The development of new information technologies

37. Positive Role of Some Multinational Enterprises Play an increasing role in shaping working conditions in the different countries They can bring jobs, expertise, new work practices, better working conditions, and preventive health culture to the host countries

38. Negative Role of Some Multinational Enterprises Different standards for health protection at work in the different countries Commercial advantage

39. The Challenge Unemployment, Job Insecurity & increasing human interaction Certain working methods and emerging forms of work organization such as: outsourcing, downsizing, and flexible work practices have an impact on workers Psychosocial hazards, and work-related stress, resulting in burn-out, depression, coronary heart disease, musculoskeletal and other physical and mental disorders

40. The Challenge Informal Economy The traditional worker-employer relationship does not exist No healthy and safe working conditions The costs are borne by the community and not by the employers

41. The Challenge & OpportunityCollaboration between all actors in the health sector Occupational health is an integral part of public health and its activities can be enhanced with the involvement of: health promotion, environmental health, disease prevention, the provision of general health services at work and other public health programmes

42. The Challenge & OpportunityMDGs What actions are needed to break the vicious cycle?

43. The Challenge & OpportunityMDGs Elimination of hazardous child labour, Promotion of women's health and protection of reproductive health at work, Combating HIV/AIDS, tuberculosis, malaria, and other major diseases at the workplace Introduction of clean technologies and systems for management of health at work

44. Further improvement of the health of workers requires a holistic public health approach Combining occupational health with health protection and promotion, Reaching out to workers families and communities, Tackling social determinants of health Providing health services adequate to the specific needs of working populations