Notes from the Field: The Beginnings of a Health and Pollution Action Plan in Madagascar

Madagascar is taking exciting steps to reduce on pollution, protect the country’s natural beauty, and promote the health of all Malagasy people. The government of Madagascar recently approached the Global Alliance on Health and Pollution (GAHP) to help them develop a sustainable and impactful Health and Pollution Action Plan (HPAP).

This past April, after weeks of research and preparation, GAHP joined high-level officials from the ministries of the environment, ecology, and forests (MEEF), health, mining, agriculture, industry, and energy for a series of meetings and technical workshops to begin HPAP. The participation of senior representatives from the World Bank, USAID, UNDP, UNICEF, and other NGOs and international agencies also brought important perspectives during our week together. These initial steps embodied a truly cross-sectoral effort to identify pollution priorities in the country and set a timeline for future work.

And what was born of this effort? The beginnings of a Health and Pollution Action Plan (HPAP) that is uniquely tailored to the needs and capacity of Madagascar. Our investment in a collaborative process and commitment to community ownership has laid a strong foundation for successful pollution policies and programs.

The uniform support of this initial HPAP convening received press coverage throughout the country, but even more thrilling is what is yet to come. Stakeholders formed an HPAP working group and during a “validation meeting” in September, HPAP will officially be adopted by the government.

The people of Madagascar face many pollution problems and as HPAP continues to develop it will respond to the priorities identified by communities. There are many opportunities to make a long-term impact, including: identifying toxic pollution sites; addressing lead present in household groundwater pumps; and, providing alternatives to dangerous income-generating activities like informal recycling of used lead-acid batteries (pictured above). In the coming months, GAHP will work with local and international stakeholders to ensure that the HPAP prioritizes the protection of water resources and promotes alternative, sustainable ways for the Malagasy people to support their families.


In a country with many development and health needs, constant communication and consensus-building among stakeholders to mobilize resources is extremely important. GAHP looks forward to doing our part to promote these conversations and opportunities for learning. Even more so, we’re excited about a future for Madagascar that is free from pollution.

A huge thank you to Andrew McCartor, Director of Global Policy & Planning at Pure Earth, for sharing your photos and experiences. 

Conference Recap: “Sharpening Focus on Health Challenges Through Global Commissions”

On April 28th-30th, 370 global changemakers from 25 countries gathered for the inaugural annual meeting of the Planetary Health Alliance. GAHP was thrilled to join experts discussing the future of efforts to address the human health impacts of manmade environmental change.

As part of this landmark event, Dr. Philip Landrigan, a co-chair of the Global Commission on Pollution and Health, led an inspiring session on “Sharpening Focus on Health Challenges Through Global Commissions.”

Watch below! (Beginning at 25:56-41:57)

Hello From Bellagio

GAHP is currently holding a meeting at the Rockefeller Conference Center in Bellagio, Italy, with  representatives from seven countries as well as the World Bank, European Commission, United Nations Environmental Programme, WHO, Clean Air Asia, the Global Alliance for Clean Cookstoves, and other key development agencies. Among the topics being discussed: the upcoming report from the Global Commission on Pollution and Health to be published in The Lancet, the role of the Health Pollution Action Planning Process, and a roadmap to forward the global pollution fighting agenda.

Achieving The #GlobalGoals And Addressing Pollution Go Hand In Hand

Here’s the down & dirty on pollution. It is one of the leading causes of death globally, with 92% of deaths occurring in low and middle-income countries. People in the poorest, most marginalized communities often bear the constant toxic assault of polluted air, soil, and water. Due to the myriad number of ways pollution affects the health and livelihoods of people around the world, coordinated efforts to fight pollution are key to achieving the Sustainable Development Goals (SDGs), also known as the Global Goals.

Latest estimates by the Institute for Health Metrics Evaluation put pollution-related deaths at 9 million every year. That’s like all in the people in Manhattan or Bangkok or Bogota dying every year, year after year. Millions more, especially children, experience illness or disability from exposure to toxic pollution.

This has clear implications for achieving SDG 3: Good Health and Well-being. Moreover, these health impacts have huge consequences for lost work hours, lower wages, and the ability to achieve SDG 1: No Poverty and SDG 8: Decent Work and Economic Growth. A recent Pulitzer Center series on delves into this link between toxic work environments, livelihoods, and health.

A March 2017 WHO report reveals that children comprise 1.7 million of all pollution-related deaths. Children born with birth defects from exposure to pollution or who develop disabilities also face challenges in attending school. Efforts to achieve SDG 4: Quality Education must be responsive to the needs of these children and supportive of efforts to fight pollution. Women are also particularly vulnerable to the adverse effects of toxic chemicals on their reproductive health and the increased risk of exposure to toxic environments. For these reasons, addressing pollution is integral to achieving SDG 5: Gender Equality.

Though much is known about health burdens of pollution, pollution-related mortality estimates don’t even include places where soil is contaminated by toxic chemicals like mercury from gold mining, lead smelting, mining wastes, e-waste burning, pesticide dumping, and massive garbage dumps that sicken waste pickers, emit methane, and add to global warming. If people’s food supplies are threatened by contaminated soil, it will be very difficult to achieve SDG 2: Zero Hunger or SDG 15: Life on Land.

Wells and other community water sources are also threatened by pollution. Countries won’t be able to achieve SDG 6: Clean Water and Sanitation or SDG 14: Life Below Water without regulating and protecting these life-sustaining resources. And yet, regulation is only one part of the equation to fight pollution. Innovation and investments in sustainability are also key to making progress towards SDG 7: Affordable and Clean Energy. Good jobs resulting from investment in infrastructure for solid waste management, sanitation, and water treatment are just one of the many benefits to fighting pollution and are directly related to SDG 9: Industry, Innovation, and Infrastructure.

The positive impacts of increased access to safe food and water, as well as increased incomes, can all help to break cycles of poverty and achieve SDG 10: Reduced Inequalities and SDG 11: Sustainable Cities and Communities.

Yet the responsibility for fighting pollution does not fall on LMICs alone. Demand for cheap goods and lack of support for responsibly produced products in developed countries drives many of the toxic practices in developing countries. Attention to the drivers of pollution is a must to reach SDG 12: Responsible Consumption and Production.

Furthermore, we cannot ignore that pollution is a leading cause of global warming and developed countries bear much of the responsibility for climate change due to industry – either directly or through the export of our polluting industries to countries with weak regulation and little enforcement capability. Coordinated, inclusive, and just responses to pollution will therefore also be necessary to achieve SDG 13: Climate Action and SDG 17: Partnerships for the Goals.

Conversely, trends towards increased citizen unrest due to the negative effects of pollution will continue without these partnerships and investments to fight pollution. If we continue to stress our resources and pollute our environments, it will be very difficult to achieve SDG 16: Peace, Justice, and Strong Institutions.

The good news is lifesaving, affordable solutions exist! The Global Commission on Pollution and Health, convened by The Lancet, Mt. Sinai and the Global Alliance on Health and Pollution (GAHP), is releasing a landmark report on pollution in The Lancet in the summer of 2017. The report, authored by more than 50 experts, lays out the health and economic impact of all forms of pollution, air, water, soil and chemical wastes and provides a set of solutions for nations to create a roadmap for cleaning up.

Join the #WeCanFightPollution SDG Campaign today!

For more updates follow:
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Together, #wecanfightpollution!

New Pollution Info-Sessions Series Launches With Global Experts Offering Solutions Every Two Weeks

Announcing the launch of the GAHP’s Pollution Info-Sessions–a new educational series in which experts from around the globe share their insights on pollution-related topics, followed by a Q&A.

  • Pollution Info-Sessions take place every second Thursday of the month at the same time (8 a.m. EST).
  • To attend, just dial in via phone or online. Get access info here, or scroll below.
  • Each presentation in the series will be recorded and made accessible on YouTube, and linked to this page (see below).
  • Check the events page or the Pollution Info-Sessions page for a schedule of upcoming Pollution Info-Sessions.

Attend Pollution Info-Sessions:

Join from your computer, tablet or smartphone.

You can also dial in using your phone.
United States (Toll Free): 1 866 899 4679
International: +1 (571) 317-3117
Access Code: 945-502-973

Watch past Pollution Info-Sessions here:

Pollution Info-session # 1 – How to Remediate Lead Contaminated Sites Thursday, Jan 26, 2017, 8:00 a.m. EST
Presenter: Mr. John Keith

Watch a recording of Pollution Info-Session #1 on YouTube

This session introduces the different sources of lead contamination and health effects, reviews seven strategies for the remediation of such sites, and presents some of the most cost-effective strategies for remediation, including several Pure Earth projects. The presentation ends with a discussion of lessons learned.

Mr. John Keith is an environmental executive and engineer with over 40 years experience in industry and government. He has directed many contamination remediation projects in the U.S. and throughout the world. In 2010 he spent 3 months in Zamfara, Nigeria, as the project manager for Pure Earth/Blacksmith Institute, remediating severe lead contamination in seven remote villages.

He served as Director of Operations for Pure Earth in 2011-2012, and since entering semi-retirement, serves as Senior Technical Advisor. He has provided expert advice for many Pure Earth projects, including efforts in Vietnam, Indonesia, Somaliland, Zambia and several former Soviet Union countries, working mostly on lead and pesticide contamination projects.

Pollution Info-session #2 – The Chemistry of Environmental Mercury
Thursday, February 9, 2017, 8:00 a.m. EST
Presenter: Dr. Jack Caravanos

Watch a recording of Pollution Info-Session #2 on YouTube

The complicated chemistry of environmental mercury: Mercury exists in many forms as a liquid, solid and gas. To make matter worse, each form has different solubilities, vapor pressures and environmental pathways. Once in the body, each form impacts different organs systems. Some forms are deadly while others seem innocuous. What this means is that assessing the human health effects from mercury releases and exposures is complicated. This presentation will describe the chemistry of mercury and how it moves through the environment and our bodies.

Dr. Jack Caravanos is Professor of Global Environmental Health at NYU’s College of Global Public Health and Director of Research at Pure Earth. He originally trained in chemistry and now specializes in assessing environmental contamination and human health effects of toxic agents.

Pollution Info-Session #3: Overview Of AuthorAid – A Researcher Network
Date: Thursday, Feb 23, 2017, 8:00 AM EST
Presenters: Mrs. Jennifer Chapin & Mrs. Sandra Page Cook

Watch a recording of Pollution Info-Session #3 on YouTube

Mrs. Page-Cook will talk about the Journal of Health and Pollution and the close collaboration with INASP. Mrs. Chapin will provide an overview of AuthorAID: the website, mentoring platform, online courses, embedding work and recent work supporting women researchers. She will also present the other work they do at INASP on access to e-resources, supporting libraries and supporting evidence-informed policymaking.

Mrs Jennifer Chapin 
coordinates the communication of research at INASP, managing the AuthorAID programme to support the capacity of researchers in developing countries to communicate their research to different actors, and to increase the quality and quantity of their research publications. Before joining INASP in 2016, Jennifer spent the previous four years at the Institute and Faculty of Actuaries in London, a role which included developing research best practice and quality assurance, supporting the development of actuarial research with 300 researchers worldwide.

Mrs Sandra Page Cook is the Managing Editor of the Journal of Health and Pollution at Pure Earth.

Pollution Info-Session #4: Is Mercury Really Needed In ASGM?
Date: Thursday, March 9, 2017, 8:00 AM EST
Presenter: Mr. Ludovic Bernaudat

Watch a recording on YouTube


This session presents the basic characteristics of the sector, explains why mercury is used and showcases good examples of non-mercury extraction and in which conditions it is more efficient, therefore sustainable.

Mr. Ludovic Bernaudat is an environment specialist with 17 years of experience in research and development projects with a strong focus on mercury. He has co-lead the inception of the Artisanal and Small-Scale Gold Mining area of the UN Environment Global Mercury Partnership since its inception in 2007. He holds a MSc in Environmental Sciences.

Need help? Have a suggestion?

Contact Lucie at

  • If you have any difficulties accessing the GoToMeeting session.
  • If you need a PDF of the presentation to follow along using just the phone line.
  • If you have a solution or pollution topic you’d like to share or learn more about.

Upcoming Pollution Info-Sessions

New Lancet Editorial

A new editorial on air pollution published by The Lancet explores the need for cooperation and calls for transformative efforts to reduce its burden of disease. It lists the work being done by the global Commission on Pollution, Health and Development as a crucial component of any global solution. Read the full editorial here or reproduced below:


Air pollution—crossing borders
Published July 2016 in The Lancet

A silent killer responsible for more deaths than the number from HIV/AIDS, tuberculosis, and road injuries combined. A killer indifferent to political agendas and that cannot be contained by borders. Air pollution is associated with around 6·5 million deaths each year globally. While premature deaths from household air pollution are projected to decline from 3·5 million today to 3 million by 2040, premature deaths from outdoor pollution are set to rise from 3 million to 4·5 million in the same period. Transformative action is needed to mitigate this death toll.

There is a dearth of information available on the health effects and economic impact of environmental pollution. Proven solutions are available, but implementation remains a challenge that requires coordinated efforts across sectors and nations. A report by the World Wildlife Fund’s European Policy Office, Climate Action Network Europe, the Health and Environment Alliance, and Sandbag has, for the first time, quantified the cross-border health effects of air pollution from coal use in electricity generation in the European Union (EU), estimating total associated economic costs of up to €62·3 billion. The report aims to promote debate on the rapid phase-out of coal-burning power generation and calls for action at the national and EU level. Toxic particles created by burning coal can be carried beyond the borders of the countries where the power plants are situated. In France, where coal burning is low, 1200 premature deaths a year are caused by air pollution from the Czech Republic, Germany, Poland, Spain, and the UK. The cross border nature of coal pollution highlights the need for governments to work together to urgently phase out coal burning.

The need for cooperation is reiterated in a special report on from the International Energy Agency (IEA), which campaigns for global action to overcome the negative environmental effects of energy use. The report cites energy production as the most important source of air pollution coming from human activity and presents strategies to tackle energy poverty in developing countries, reduce pollutant emissions through post-combustion control technologies, and promote clean forms of energy.

The Clean Air Scenario presented by IEA uses benchmarks for air quality goals, such as WHO guideline levels, to set long-term targets. Strategies outlined for the energy sector are adapted to different national and regional settings. In developing countries in Asia and sub-Saharan Africa, a notable health impact arises from smoky environments caused by use of wood and other solid fuels for cooking; whereas power plants, industrial facilities, and vehicle emissions are the main causes of outdoor pollution in many high-income countries. Cities in particular are susceptible to becoming pollution hotspots due to concentrated populations, energy use, and traffic.

Although the report takes important steps in tailoring policies to local and national conditions, the proposals are not ambitious enough. For example, the report sets out a scenario in which the number of people being exposed to fine particulate matter levels above the WHO guideline in the EU will be less than 10% by 2040. Yet in the USA, average air pollution limits are already below national limits, having declined by 70% since 1970 despite growth in population levels and energy consumption. Setting half-hearted goals as far ahead as 2040 will only widen the gap between the USA and the rest of the world. The report recognises the need for clearly defined responsibilities, reliable data, and a focus on compliance and policy improvement to keep strategies on course. However, long-term goals can be easy to forget or conveniently ignore, particularly if the issue is allowed to slip down the political agenda. Now is not a time to become complacent, but to match the strides being made by the USA in improving air quality.

The Lancet, the Global Alliance on Health and Pollution (GAHP), and the Icahn School of Medicine at Mount Sinai, with coordination from the UN Environment Programme and the World Bank, have united to produce a Commission on Pollution, Health, and Development. The aim of the Commission is to inform key decision makers globally of pollution’s severe and under-reported contribution to the global burden of disease and to present available pollution control strategies and solutions, dispelling the myth of pollution’s inevitability and combating apathy. In a turbulent political climate, environmental pollution must not be allowed to fall by the wayside. Policies should take centre stage and nations must come together in a spirit of mutual cooperation to tackle air pollution.

Global Braintrust On Pollution Meets To Continue Work On Paradigm-Shifting Report

IMG_1992 (2)Traveling from across the globe, 20 Commissioners from the new global Commission on Pollution, Health and Development convened for two days in New York City for a detailed review and rigorous discussion of a research and policy draft report that could change the way pollution is viewed and funded by key decision-makers. The report is scheduled to be published by The Lancet in the first quarter of 2017.

This is the third face-to-face meeting bringing together the Commissioners.

“We are grateful for all the hard work and contributions by dozens of Commissioners and advisors who have been researching, writing, reviewing, analyzing data and discussing the many facets of the complex problem of pollution for close to a year now,” said Richard Fuller, Co-chairman of the Commission, President of Pure Earth, Secretariat for the Global Alliance on Health and Pollution.

The Commission comprises many of the world’s most influential leaders, researchers and practitioners in the fields of pollution management, environmental health and sustainable development. Representatives attended from the World Bank, UNEP, NIEHS, Harvard T. H. Chan School of Public Health, Consortium of Universities for Global Health, Institute for Health Metrics and Evaluation, World Health Organization, University of California, Berkeley and Her Royal Highness Princess Chulabhorn, Princess of Thailand, President and Professor, Chulabhorn Research Institute.

Also in attendance was Pam Das, Senior Editor of The Lancet, who gave an overview of The Lancet’s process in publishing major reports.

The Commission’s three goals are:

  1. to develop robust estimates of the total burden of disease attributable to all types of environmental pollution and to develop defensible estimates of the total economic costs associated with these diseases;
  2. to educate key decision makers in countries around the world, especially Heads of State, Governors and Ministers of Finance as well as international donors about the enormous scale of the health and economic effects of pollution and to urge them to take urgent action to address the problem of pollution; and
  3. to create a new paradigm for global health and international development in which planetary health, pollution control and the movement towards a circular economy are at the center of the agenda.

The Commission on Pollution, Health and Development is an initiative of The Lancet, the Global Alliance on Health and Pollution (GAHP), and the Icahn School of Medicine at Mount Sinai, with additional coordination and input from the United Nations Environment Programme and the World Bank. Commission activities are implemented by the Secretariat, currently hosted by Pure Earth.

Full house at GAHP’s UNEA2 event

IMG_20160527_122017 IMG_20160527_122230

Over 100 people attended GAHP’s event at UNEA2 on May 27 to learn more about “Pollution: The Largest Cause Of Death On The Planet – A Lancet Report In The Making.”

GAHP has convened a “global pollution brain trust” of leaders to produce a report, The Global Commission on Pollution, Health + Development, that will be published by The Lancet at the end of 2016. While findings are preliminary at this stage, the session offered a sneak peek at details of the report to give attendees an idea of the scale of the pollution problem, and the stunning results expected to be unveiled.

The event was presented by GAHP with partners including Germany, Indonesia, Philippines, Mexico, Ghana, Cambodia, Cameroon, Madagascar, Jordan, Peru, Uruguay, Togo, European Commission Director General Environment, UNEP, EB, and UNIDO.



India’s Lead Problem: More Than Just Instant Noodles

Earlier this month, there was a lead poisoning scare involving Maggi instant noodles manufactured in India. The company promptly pulled the product and samples were sent to the Maharashtra Food and Drugs Administration for testing. The results – most of the samples were found to have lead, but within the permissible limits of 2.5 parts per million.

While the story got a lot of attention, our colleagues in the India Alliance on Health (IAHP) and Pollution pointed out that “India does not have a noodle problem, it has a lead problem…”

Dr. Subhojit DeyAssociate Professor, Indian Institute of Public Health, wrote this insightful piece on behalf of IAHP, published in the Economic Times.  In it, he points out that toxic lead affects 1.5 to 2 million people in India alone.

Children are the most vulnerable, especially those under six. Dr. Dey explains how lead works once it accumulates in the body:

If lead is available, the body confuses it with more essential elements like calcium and begins using lead to make bones, muscles, brain connections etc.

Imagine having toxic lead as the building blocks in your body.  The consequences?

Existing studies estimate that Indian children under 12 have a mean blood lead level (BLL) of 10 µg/dl which is twice the levels considered in USA as level of concern or “action level”. The loss of IQ of Indian children due to such high lead levels is resulting in $236.1 billion (12.5% of India’s GDP) in economic productivity every year.

And the causes of lead exposure in India come from far more potent sources than noodles.

 Aside from fuel, lead exposure in India occurs from paints, canned food, old pipes in the drinking water system, cosmetics, indigenous medicine systems and the battery/plastic recycling industry.

As Dr. Dey concludes:

India does not have a noodle problem, it has a lead problem, and we need to deal with it.

Read the entire article – Problems of lead and human health in India – Maggi hardly ‘leads’ it


New Website for the Global Commission on Pollution, Health and Development

Commission website grabThe new Global Commission on Pollution, Health and Development now has a website at

Launched in October, the Commission brings together world leaders and key experts in the fields of pollution management, environmental health and sustainable development. Like the Stern Review on “The Economics of Climate Change” which brought the issue of climate change to the fore, the Commission report, due to be published in The Lancet next year, may be the game-changer the world needs to wake up to this global crisis of toxic pollution. Data from 2012 shows that pollution killed one in seven people worldwide.  This is the largest cause of death in low and middle income countries.

“We need to dispel the myth that pollution is inevitable. In fact, pollution is a problem that can be solved in our lifetime,” said Commission co-chairman Richard Fuller, President, Pure Earth.

The Global Commission on Pollution, Health and Development is an initiative of The Lancet, the Global Alliance on Health and Pollution, and the Icahn School of Medicine at Mount Sinai, with coordination from the United Nations Environment Programme and the World Bank.

Why do we need a Commission on Pollution?  This editorial published in The Lancet, one of the world’s most prestigious and widely read medical journals, explains the urgent need for the Commission.