GeFIL-Global Health

Chiho WATANABE

Dept Human Ecology
SchoolCopyright (c) 2015 Chiho Watanabe,
except of International Health1
where noted, all rights reserved
Graduate School of Medicine

Let me introduce myself …
Born in mid-20century. Lived in Tokyo, Sapporo, Sendai and Rochester
Hobby; bike, ski, band・Research field
Toxicology (experimental ⇒ human population) ⇒ human ecology/sustainability science.
Both toxicology and human ecology examine human-environmental relationship.
研究分野： 毒性学（実験⇒人間集団の調査）⇒人類生態学，サステナビリティ（学）毒性学 も 人類生態学 も 人間と環境との関係．

・ Effects of hazardous chemicals and essential trace elements on development of organisms.
[both experimental and field studies]
周産期における 有害物質（水銀・ヒ素・カドミウムなど）への曝露 または 必須元素（セレン）の欠乏が神経・行動発達におよぼす影響（実験研究とフィールド研究）．
・ Susceptibility to arsenic toxicity in South Asian populations [field studies]
南アジアの地下水汚染（ヒ素）：誰が敏感か？（フィールド研究）
・Impact of life style transition on health and environment in rural Asia [field studies]
アジア・オセアニア農村部のライフスタイルの変化で，健康や環境はどう変わっているのか？（フィールド研究）
・Utilization of earth observation data to solve environment-health problems in urban areas.
衛星データ・気候予測モデルが，アジア都市部の環境−健康課題を予測・解決するのにどう役立つ
Copyright (c) 2015 Chiho Watanabe, except
2か？（フィールド＋α）
where noted, all rights reservedCurrent situation of global health
Overall situation ….. Fairly good achievement
during 20th century

Gap …. Between developed vs. developing
countries, between rich and poor
Emerging problems …..
Climate impacts on health, etc.
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

3Gaps

MDGs (2000-2015) mainly focused on developing countries.
Three goals targeted health; “typical global health issues”.
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved4

Emerging problems-Climate change, ageing, increasing financial burden ….

The most recent IPCC report (AR5) spends substantial pages
on health impact of climate change.
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

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Major causes of death in human history + “Emergent"Globalization”

infectiousdiseases”,+ NTD

Emergence of + Measles,
larger cities
smallpox, rubella
Emergence of + Diseases spread through
Small cities
Human-human infection+ bacterial infection in GI
Beginning ofor in respiratory system
Food
Production
trauma, warfare, arbovirus，TB, labies

New health issues have kept on “emerging”
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

6

Recent “epidemiological transition”
Communicable diseases ⇨ “con-communicable diseases”.
Non-communicablediseasesCommunicablediseasestime
Concept of health:“a given fact/fate” ⇨“what we can manipulate”.
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

7Solution for health issues
involves non-medical actions.

Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

8Green alleviates heat; Dhaka, Bangladesh
Surface Temperature; April
2002

NDVI (Greenness)
2013

2008

Temperature（data: Dr. Ohyoshi JAXA-EORC）

2008（analysis: Dr. Yasumoto）

Day

April 2013

5°C

Night
0.5oC difference
can beRelevant to health.

Each dot:
1km grid area

Greenness (NDVI)Appropriate urban
planning can reduce health risk.
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved9Weekly mortality

Change in Temperature-mortality relationship
Temperature – mortality relationships (cultural ; temporal change)
in 20th Century in London

Weekly temperature

Possible causes: Engineering (A/C), health service(improved ambulance serves and emergency care),education (hygieneCopyrighteducation)(Carson et al., 2006).
(c) 2015 Chiho Watanabe, except
10
where noted, all rights reservedLiver Fluke (Opisthorchis viverrini) ; a parasitosis in Thailand,
which might increase the risk of cancer.
Water
Body

Medicaltreatment

Defecation
site

Human

Eatingraw fishFishing

Water
EmbryonatedFlow velocity
Seasonal change
Egg

Fish

MiracidiumSnailMetacercaria
HabitatFood habit
Breeding Season

Habitat anddensity

Cercaria

Treatment of patients (red) would not terminate thiscycle. Land/water use, snail/fish ecology, and humanbehavior can be the target of intervention (green).
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

Moji et al. (2013)11

Thinking about
Priority and Conflict

Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

12Who should be saved?
Survival %→Cost of saving healthy life [USD/DALY]

CVD63DM102
Malaria 6TB11Future?
Future?
Modern-day

developed
Traditionaldeveloping• Disability-Adjusted Life Years(Cohen, 2006)

Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

Age→13

Production and use of chemicalfertilizer changes Nitrogen flow
Rockstrom et al. (2008)“Can irrigation hazardous to your health?”from future earth topic (2013)

What should be saved;
food production vs. humanhealth?

Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

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The super killer

Dichloro-diphenyl
Trichloroethane (DDT)
ジクロロジフェニル
トリクロロエタン

The super killer
1940s introduced
1970s expelled2006 re-introduced (WHO)Health of children / health of ecosystem ?
Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

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The way out …. Potential output fields
Engineering
Agriculture
Ecology

Architecture
Urban design
Hygieneinfrastructure

Conservation

Healthissue

Policy on

Health・environment・
economics

Medicine
Clinical,Preventive,
Public Health

Demography

Educationon
Health・Copyright (c) 2015 Chiho Watanabe, except
environment
where noted, all rights reserved

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SDGs (2015-)

for both developed and developing countries

Copyright (c) 2015 Chiho Watanabe, except
where noted, all rights reserved

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Global HealthDon’t leave it to doctors!

END

Thanks, andhopeCopyrightto (c)seeyouat the2015 ChihoWatanabe,except class!
where noted, all rights reserved

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