Addressing the Global Burden of Environmental Disease Through Strategic Initiatives and Research
By Adeline Lopez
Released in October 2017, the Lancet Commission on Pollution and Health Report addresses the health impacts and economic costs of water, air, and soil pollution across the world. The report estimates that 9 million premature deaths, accounting for 16% of all deaths worldwide, can be directly linked to pollution. The report estimates that more than $4.6 trillion every year are associated with pollution.
NIEHS and environmental health science (EHS) researchers are working to promote the implementation of the report’s recommendations into relevant programs and initiatives. They are also working to align with the report’s strategic objectives to better address challenges associated with addressing the global burden of disease (GBD).
Commission Report Serves as a Launch Pad for Strategic Initiative
NIEHS grantee Howard Hu, M.D., recently organized a two-day workshop on the GBD – Pollution and Health Initiative in early March 2018. The goal of the workshop was to bring together GBD Project members and environmental health experts to leverage the Commission Report and create a strategic framework for the initiative.
“This workshop gave us an opportunity to discuss an initiative that capitalizes on the GBD Project to improve estimates of the GBD resulting from pollution,” said Hu. “These estimates will help decision makers prioritize pollution control in ways that will optimize the health and productivity of different populations.”
Attended by many NIEHS grantees and EHS researchers from diverse fields, the workshop included several sessions exploring topics such as air pollution, lead, neurodevelopmental toxicants, climate change, health policy, and economics.
“The main challenge for this initiative is expanding the GBD work to include pollutants that haven’t been assessed yet, to estimate population exposures to pollutants without measured data, and to account for subclinical health impacts that may burden certain populations,” Hu noted. “Fortunately, new approaches for each of these challenges are at hand.”
Along with Hu, some of the key co-organizers of the workshop included Phil Landrigan, M.D., chair of the Lancet Commission on Pollution and Health; Rich Fuller, president and CEO of Pure Earth and member of the Lancet Commission on Pollution and Health; and Chris Murray, M.D., D.Phil., director and co-founder of the GBD Project and director of the Institute for Health Metrics and Evaluation at the University of Washington where the GBD Project is based.
According to NIEHS Deputy Director Rick Woychik, Ph.D., who participated in the workshop, Hu has been a driving force in bringing together multidisciplinary expertise to address the rising GBD. “The workshop was an excellent opportunity for the EHS community to bring the pressing issues we are working on to the table and discuss the many challenges of how to bring our knowledge of environmental toxicants into the calculations that are being used to estimate the GBD,” he said.
“This workshop highlighted the fact that EHS researchers have to work more closely with the scientists, mathematicians, economists, and statisticians that are currently involved in calculating the GBD,” Woychik noted. “NIEHS and its grantees have the ability to bring their knowledge forward and fill the current gaps in how the GBD is calculated.”
Looking to the Commission Report to Inform NIEHS’ Strategic Plan
According to NIEHS and NTP Director Linda Birnbaum, Ph.D., the Lancet Commission Report underscores the importance of NIEHS’ mission – generating new knowledge about how the environment contributes to human health and disease and using that knowledge in pursuit of a healthier world.
“The Lancet Report articulates the underappreciated fact that pollution is the largest environmental cause of disease and death in the world today and brings to light how this preventable factor is responsible for an estimated 9 million premature deaths annually,” she noted. “The report addresses the economic costs of air, water, and soil pollution, and identities pollution’s contribution to the GBD through data translation.”
The documented link between exposure, disease, and economic implications on a global scale in the Lancet Commission Report is aligned with goal 10 of the NIEHS 2012 – 2017 Strategic Plan to evaluate the economic impact of policies, practices, and behaviors that reduce exposure to environmental toxicants by preventing disease.
Building off this Plan and the Lancet Commission Report, NIEHS began looking to the future for developing the 2018 – 2023 Strategic Plan. This process began with a survey through which the EHS community and other stakeholders provided input on scientific trends and insights. A point that was broadly expressed in the survey was the continuing need for many of the priorities and goals established in the 2012 – 2017 Strategic Plan.
“NIEHS relies on a high level of stakeholder involvement in forming the Strategic Plan,” said Birnbaum. “Based on input from the EHS community, the new plan incorporates many of the priorities and commitments of the previous plan with the goal of building on progress made, while also allowing for innovation and growth to explore new and complex problems.”
The 2018 – 2023 NIEHS Strategic Plan, which NIEHS is in the process of finalizing, comprises three interdependent key objectives. These include advancing EHS, promoting the translation of data to knowledge and action, and enhancing scientific stewardship through infrastructure and support. Importantly, through the third objective, NIEHS is promoting training and capacity-building specifically in global health.
Through the new Strategic Plan, NIEHS will provide global leadership for innovative research that aligns with the objectives of the GBD Project to measure and define the myriad of environmental factors that contribute to the GBD. Together, these efforts will advance the Institute’s mission to reduce the burden of disease and improve public health across the globe.