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AFED’s 13th Annual Conference Opens in Beirut: COVID-19 Exposed the Region’s Weak Healthcare Systems

Beirut, 10/11/2020

The Arab Forum for Environment and Development (AFED) launched its 13th annual report, Health and the Environment in Arab Countries, at an international virtual conference hosted by the American University of Beirut (AUB). Over 600 registered delegates from 45 countries participated, representing government and private agencies, universities, international organizations and civil society. Conference sessions are also being streamed live via AFEDonline and AFEDmag Facebook pages to over 1.5 million followers.
More than 150 experts from Arab and foreign universities and research centers contributed to the report. Core contributors include the Faculty of Health Sciences at AUB, researchers from the Arabian Gulf University in Bahrain, Cairo University and Alexandria University in Egypt, and Saint Joseph University of Beirut, with input from the WHO regional Centre for Environmental Health Action (CEHA).
The report’s seven chapters cover the relationship between health and water, air, waste, ocean pollution and climate change, as well as progress and obstacles in achieving the environmental health content of the Sustainable Development Goals (SDGs). The report highlights the effect of the environmental hazards on human health, citing lack of safely managed water, increased waste generation and poor disposal methods, climate change and pollution of the marine environment. The report calls for sharing expertise in health and environment related disciplines across the Arab countries, while intensifying regional cooperation – including through emergency preparedness – to face health and environmental disasters.
The report also notes that in the past year the COVID-19 pandemic has exposed the region’s weak healthcare systems and countries’ limited capacity to cope with emergent health crises. It has also made clear that the health of a nation cannot be sustained by only targeting groups that can afford to pay for healthcare services, pointing out that “health for all”, as stressed on in SDG 3, is a necessity.
Saab: Environmental degradation responsible for a quarter of deaths
Najib Saab, AFED’s Secretary General, said in his welcoming address that producing the report was in itself a challenging endeavor, not only due to the stressful working conditions created by the pandemic, which put limits on normal interaction, but also due to the consequences of the financial meltdown in Lebanon. The Beirut port explosion in August, which badly damaged the offices and facilities of AFED’s secretariat, compounded this. Saab disclosed that this situation resulted in a disturbing drop in funding from traditional partners and sponsors, threatening the continued existence of AFED itself.
Saab presented the main findings of the report, warning that the rate of deaths attributable to environmental factors is on the rise, currently estimated at 23 percent of all deaths in the Arab region. The report highlights the main environmental health risks in the region, whilst emphasizing concrete recommendations and lessons to be learned from past and current environmental and health crises, including the COVID-19 pandemic. Saab said that the report also stresses that a healthy environment is a prerequisite for a healthy population.
Badran: Regional cooperation in health and environment
Joining from Amman, Chairman of AFED Board of Trustees Dr. Adnan Badran noted that COVID-19 has imposed difficult economic and social realities on us, as a result of our negligence, which has left a severe impact on nature. This has led to a radical change in the transmission and spread of diseases, turning them into epidemics and a global pandemic, at a frightening speed. Badran noted that this calls on us to “cooperate in an integrated approach to preserve the health of humanity in an interconnected ecosystem encompassing plants, animals, humans and affecting livelihood as a whole, to build capacities to deal with these epidemics and their repercussions and to reduce their economic and social risks.” Badran called on the ministries of health and environment in the Arab region to emphasize the importance of the relation between human public health and the natural environment, within the framework of regional cooperation.
Khuri: Remaking the world to be more inclusive, sustainable and equitable
In his address, AUB President Dr. Fadlo Khuri noted: “The environment, food security, public health, employment, and labor issues are all connected and spiraling downward in Lebanon and in the Arab world. Now, more than ever, is the time for action and solidarity across borders and societies.” He continued: “We need to remake the world to be more inclusive, more sustainable, and more equitable. That is the ultimate goal of this report and so much of what we all endeavor to do. It will not happen overnight, and it will not be easy, but if we persist and give it our all, I am confident that we will prevail.”
Lambertini: Stop exploiting nature or else expect the next pandemic
Marco Lambertini, Director General of the World Wildlife Fund (WWF) who joined the conference from Geneva, delivered the opening keynote speech. Addressing the relation between nature and health, especially in regards to the spread of viruses such as corona, he called for “urgently recognizing the links between the destruction of nature and human health, or we will soon see the next pandemic.” He continued: “We must curb the high risk trade and consumption of wildlife, halt deforestation and land conversion as well as manage food production sustainably. These actions will help prevent the spillover of pathogens to humans, and also address other global risks to our society like biodiversity loss and climate change. The science is clear: unsustainable exploitation of nature has become an enormous risk to us all.”
Sessions on air, climate, seas and waste
Dr. Iman Nuwayhid, former Dean of the Faculty of Health Sciences at AUB, moderated the first session, which focused on the health challenges of the SDGs and the impact of the COVID-19 pandemic. Panelists were Dr. Rima Habib, Professor and Chairperson of the Department of Environmental Health at the Faculty of Health Sciences at AUB and Dr. Basel Al-Yousfi, Director of the WHO Regional Centre for Environmental Health Action (CEHA). Habib called for establishing a primary health care system, including health education, as part of regional strategies that set common goals to achieve the SDGs. Al-Yousfi indicated that over 676,000 Arab citizens are expected to lose their lives prematurely in 2020 due to exposure to conventional environmental risks. This number will increase as more environmental risk factors and their impacts emerge, including hunger and malnutrition, which calls for a major shift in the way environmental health priorities are managed.
The second session covered climate change and air quality, moderated by Dr. Farid Chaaban, Professor of Electrical Engineering at AUB. Participating in the session were Dr. Randah Hamadeh, Professor and Vice Dean of Graduate Studies and Research at the College of Medicine and Medical Sciences at Arabian Gulf University Bahrain, and Dr. Djihan Hassan, Adjunct Professor at the American University in Cairo. They discussed the direct and indirect effects of climate change on health, from a global and Arab world perspectives, in addition to the current adaptation strategies used to address climate change and the resulting benefits for human health. Dr. Hassan Dhaini, professor at the Faculty of Health Sciences at AUB, presented the results of the chapter he coauthored on air pollution, stressing the close connection between air pollution, climate change and COVID-19: “Air pollution contributes to the deaths of about 7 million people around the world annually, which far exceeds the number of deaths expected from COVID-19.”
The conference resumes on Wednesday with two sessions, the first on water, marine environment and health, moderated by Dr. Waleed Al-Zubari, Coordinator of the Water Resources Management Program at the College of Graduate Studies at the Arabian Gulf University in Bahrain. Panelists are Dr. Mey Jurdi, Professor of Environmental Health at the Faculty of Health Sciences at AUB, Dr. Amr El-Sammak, Professor of Marine Sciences and Dr. Amira Hamdan, Professor of Marine Sciences at Alexandria University. The session will cover the effects of the corona pandemic in relation to the emergence of a number of risks and challenges that GCC countries have not previously witnessed, in addition to the challenges facing the achievement of the SDGs related to water and sanitation, and the impacts of the marine environment on human health in the Arab region.
The closing session will be on waste management and health, moderated by Dr. Ahmed Gaber, Professor at Cairo University and CEO of Chemonics Egypt. The panelists are Dr. May Massoud, Director of the Interfaculty Graduate Environmental Sciences Program at AUB, and Dr. Laila Iskander, former Minister of Environment in Egypt, who will share her experience in involving local residents into the waste treatment process. The session will discuss the important impacts of waste management on health, quality of life, environmental preservation, sustainability and the economy. It will also include a review and assessment of waste management practices in Arab countries, the potential health and environmental impacts of different types of solid waste and an examination into alternatives for sustainable and integrated solid waste management.
The full AFED report on Health and the Environment in Arab Countries can be accessed via

Notes to the Editor
Main Findings and Recommendations of AFED Report on Health and the Environment in Arab Countries
- Over 676,000 Arab citizens will lose their lives prematurely in 2020 due to exposure to conventional environmental risks.
- Diseases most driven and impacted by environmental causes in the Arab countries include cardiovascular diseases, diarrheal diseases, respiratory infections and cancers.
- The main environmental risk drivers of these disease groups are ambient and household air pollution, lack of access to clean water, marine pollution, uncontrolled urbanization, land degradation and exposure to waste and harmful chemicals.
- The COVID-19 pandemic has highlighted the lack of access to safely managed water, sanitation and hygiene (WASH) services.
- 50 million Arabs have no access to basic drinking water services and 74 million people in the region with no access to basic sanitation services.
- These poor WASH services cause 40,000 premature, avoidable deaths annually.
- Only 9 of the 22 Arab countries are on track to achieve SDG 6 on clean water and sanitation.
- Wars and refugees increased the stress on the already scarce water resources.
- Countries should develop and implement water and sanitation programs, commit to financing, and advance the enabling conditions that make strong policies, laws and plans possible.
- Levels of air pollution exceed the WHO limits by 5 to 10 times.
- Several Arab cities are among the 20 most polluted cities in the world.
- Significant rise in the number of deaths attributed to indoor and outdoor air pollution.
- The overall disease burden due to air pollution is increasing, with a higher prevalence of cardiopulmonary disease, cancer incidence, and more cases of asthma.
- Coronavirus gave an added sense of urgency to enhancing air quality, as studies have shown evidence of the relationship between air pollution and the increase in and acuteness of cases.
- Need to improve health risk assessments based on air monitoring and modeling studies, which would provide Arab policy-makers with the right control tools to reduce the public health impact of air pollution.
- Solid waste generation has been increasing at an alarming rate in the Arab region due to population growth and changing production and consumption patterns.
- Health problems attributed to solid waste mismanagement: respiratory disorders, eye infections and gastrointestinal.
- 53 percent of all generated waste indiscriminately disposed of in an unsanitary manner.
- The COVID-19 pandemic has increased the use of single-use items such as masks and gloves, generating more hazardous waste.
- Replace outdated waste facilities with new ones that can reduce associated health risks and halt the dispersion of pollutants.
- Circular and 3R-centric approach (Reduce-Reuse-Recycle) to waste management is critical to reduce the harmful impact of waste on human health and nature.
Marine Environment
- Direct discharge of untreated sewage into coastal zones, offshore oil exploration and extraction, and microplastics have impacted the health of the Arab population.
- Arab countries produce an estimated 12 billion m3 per year of wastewater. Only 60% treated. Half of the treated water is re-used. All the remaining is discharged, mainly in the sea.
- Untreated sewage can lead to the spread of pathogens that cause disease in humans.
- Oil exploration, extraction and transport cause major pollution to the marine environment, and has led to heavy metal contamination of fish that are subsequently consumed by humans.
- More research is needed to explore the direct impact of the state of the marine environment on human health in the Arab region, with a focus on pathogens, toxin transfer to humans and antimicrobial resistance.
Climate Change
- Direct impacts of climate change include cardiovascular diseases, respiratory diseases, heatstroke, injuries and fatalities.
- A 1°C increase in average temperature is expected to lead to a 3 percent increase in mortality from all causes.
- Public health issues are generally missing in national climate change adaptation strategies.
- The region is largely lacking national adaptation plans that address legislative and advisory responses, based on projected health risks, to heat waves, extreme weather events, air pollution and infectious diseases.
- Arab countries need to gain a better understanding of the various factors influencing the impact of climate change on health in order to design effective mitigation and adaptation strategies, catered to country-specific situations, with direct and clear effects on the Arab population’s health.
Overall, exchange of expertise in health and environment-related disciplines across the Arab countries is needed, with regional cooperation intensified, encompassing emergency preparedness to face health and environmental disasters. Establishing a primary health care system, including health education, is an urgent task. Ultimately, regional strategies setting common goals to achieve the SDGs are required.
The AFED report demonstrates that a healthy environment is a prerequisite to healthy people.
Photo Caption: Keynote speaker Marco Lambertini, Adnan Badran, Basel Al-Yousfi, Najib Saab, Fadlo Khuri, Rima Habib, Jihane Hassan, Khalid Al-Ohaly, President of Arabian Gulf University with a group from the university in Bahrain, Farid Chaaban and Hassan Dhaini