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NOT FOR ATTRIBUTION; FOR DISCUSSION PURPOSES ONLY. Environmental Health : Costs of Environmental Health Damage And Net Benefits of Priority Interventions. A Contribution to the Country Environmental Analysis for the Philippines (Part 1) by Agustin L. Arcenas.

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    1. NOT FOR ATTRIBUTION; FOR DISCUSSION PURPOSES ONLY

    2. Environmental Health :Costs of Environmental Health DamageAnd Net Benefits of Priority Interventions A Contribution to the Country Environmental Analysis for the Philippines (Part 1) by Agustin L. Arcenas World Bank CEA Workshop, June 16-17, 2008

    3. Environmental Health - Areas of Concern • Outdoor Air Pollution (OAP) • Indoor Air Pollution (IAP) • Water Pollution, Sanitation and Hygiene (WSH)

    4. Basic Outline of the Study (for each area of concern) • The basic issues and state of the environment • Level of exposure to pollutants and, sanitation and hygiene problems in the Philippines • Morbidity Incidence • Economic cost of Morbidity • Mortality Incidence due to environment • Economic cost of mortality • Suggested policy interventions • Economic evaluation of policy interventions

    5. How the study was done… • Calculate the proportion of total cases of illnesses that are attributable to pollution, sanitation and hygiene • Using WHO and Philippine data, determine the cost of treatment and foregone income from illnesses and premature deaths • Aggregate the economic costs and values from these calculations

    6. Total Economic Costs of Environmental Health Problems Total: PhP 9 billion

    7. Morbidity-Mortality shares

    8. The Economic Costs of Illnesses caused by Outdoor Air Pollution

    9. Sources of PM emissions Source: Monitoring Report, 2004

    10. What we know so far… • There has been a drop in PM emissions in Metro Manila since 2003 • The number of vehicles in the country is growing • Diesel contributes more to PM than gasoline • Main source of PM emissions in the country – 2 stroke-tricycles • The bulk of vehicles in the country are the tricycles followed by utility vehicles

    11. PM Emissions from Mobile Sources, 2006

    12. Morbidity Cases - OAP Total: 119,080

    13. Costs to Society of OAP-related Illnesses Total: PhP 1.9 billion

    14. Costs to Households of Treatment - OAP, 2003 Total: PhP 896 million

    15. Foregone Income due to OAP-related Illnesses Total: PhP 118 million

    16. Cost of Premature Deaths due to OAP, 2003 Total: PhP 697 million

    17. Potential Interventions to curb OAP • Inspection and maintenance (I/M) programs • Installation of pollution control devices • Rehabilitation of Current Traffic Management System • Investments in Additional Mass Transport System

    18. The Economic Costs of Illnesses caused by Indoor Air Pollution

    19. Primary Cooking Fuel for Households, 2004 Source: HECS, 2004

    20. Households Exposed to Indoor Air Pollution (in %)

    21. Morbidity Cases - IAP Total: 114,665

    22. Costs to Society of IAP-related Illnesses Total: PhP 2.3 billion

    23. Costs to Households of Treatment - IAP, 2003 Total: PhP 774 million

    24. Foregone Income due to IAP-Illnesses, 2003 Total: PhP 82 million

    25. Cost of Premature Deaths due to IAP, 2003 Total: PhP 1.4 billion

    26. Potential Interventions to curb impacts of IAP • Promote improved household living environment (improved ventilation) • Promote use of “improved” stoves • Effect changes in cooking practices

    27. Environmental Health :Costs of Environmental Health DamageAnd Net Benefits of Priority Interventions A Contribution to the Country Environmental Analysis for the Philippines (Part 2) by Agustin L. Arcenas World Bank CEA Workshop, June 16-17, 2008

    28. The Economic Costs of Water Pollution, Sanitation and Hygiene Issues

    29. Household Access to Improved Water Supply and Sanitation, 2003 (National)

    30. Morbidity Cases - WSH Total: 488,425

    31. Costs to Society of WSH-related Illnesses Total: PhP 4.9 billion

    32. Costs to Households of Treatment - WSH, 2003 Total: PhP 3.0 Billion

    33. Foregone Income due to Illnesses from WSH, 2003 Total: PhP 465 million

    34. Costs of Premature Deaths due to WSH, 2003 Total: PhP 933 million

    35. Potential Interventions to eliminate illnesses from WSH • Water Sanitation and Hygiene • Improved water supply and quality • Hygiene Promotion • Construction of Sanitation Facilities (i.e. Latrines)

    36. Health Benefits of Different Water and Sanitation Interventions Source: Fewtrell, et al, 2005

    37. Median Construction Cost of Water Supply Facilities for Select Regions Source: Disease Control Priorities in Developing Countries, second edition, 2006, Figure 41.1

    38. WHS Preferred Interventions (Ranked According to Cost-Effectiveness) Based on: Disease Control Priorities in Developing Countries, 2006.

    39. Final Word Hygiene is two-thirds of health Lebanese Proverb