Jacques Denis Tsanga, Minister of Water and Forestry, in charge of the Environment and Sustainable Development of Gabon, started out by welcoming the participants to the conference. He then recalled the motivations that had led to the Libreville Declaration in 2008. "The Libreville Declaration was motivated by the more than 23% of deaths in Africa, or more than 2,400,000 deaths per year, that are attributable to preventable risk factors relating to environmental degradation which in particular affects the poorest, and most vulnerable," he said.

Minister Tsanga went on to indicate the steps taken by his country to comply with the provisions of the Libreville Declaration. He pointed out that Gabon has started strengthening its system to monitor of the impact of health and environmental and to identify emerging risks in order to better manage them. This is done through the project entitled, "Integrated health-environment monitoring and strengthening of the legal and institutional framework for the sound management of chemicals and hazardous waste in Africa". Finally, recalling that Africa "remains the continent that is increasingly exposed to natural disasters linked to climate change", he called for the search for "multiple and easily financeable sustainable solutions to enable current and future generations to live in a healthy environment".

Dr Matshidiso Moeti, WHO’s Regional Director for Africa, underlined how ten years after the first interministerial conference, f the delegates were back in Libreville to take stock of the progress made and agree on a new and dynamic ways to accelerate the implementation of the commitments made then.

“In 2015, more than 697 million people did not have access to basic sanitation and more than 600 million people did not have access to handwashing facilities. 404 million people lacked access to safe drinking water, 84% of whom were in rural areas. More than 850 million people use polluting solid fuels for cooking, lighting and heating” she said.

She stressed that these traditional environmental problems are exacerbated by global challenges such as climate change, uncontrolled urbanization and population growth and that these challenges occur in the context of economic and social vulnerabilities and a weak health system in most of our countries.

She informed the delegates that since 2008, the global development agenda has evolved considerably, to include the sustainable development goals (SDGs), which have given a new impetus to equity and inclusion to ensure that no one is left behind; the Paris climate agreement has also made it possible to redouble efforts to prevent human-induced climate change and its adverse effects on population health and ecosystems. She concluded by emphasizing the importance of WHO’s 13th General Work Programme 2019 -2023 which is firmly anchored in the SDGs and stresses on universal health coverage, managing health emergencies and improved health and well-being.

He smiled and giggled with glitter.

Riziki and Juma had eagerly looked forward to meeting their first baby - so when he was born, everything stopped. At least for a few days. Every milestone was a moment to cherish as they watched him smile and laugh at six weeks, sit on his own at seven months and walk at a year old. For this first-time parents, having a spacious home was a well-thought out decision to allow Zawadi, their son, unrestricted play. Before his birth, they moved into an old three-bedroom bungalow which they renovated over time. “We wanted him grow in an environment where he could freely explore,” Riziki said.

However in his second year, there were plenty of less-than-pleasant moments as the couple watched the apple of their eye fall back on his milestones. Zawadi lost his speech and his health deteriorated. The doctor’s visits failed to establish the cause of the retracted developmental milestones. He became more irritable, refused to feed and developed speech regression and convulsions. His parents were exhausted and stressed.

After a battery of blood tests, lead poisoning was diagnosed and the cause was traced to the household renovations, in particular the painting job the couple had undertaken. Lead compounds have been added routinely to paint to give it certain properties such as colour and faster drying time. “It broke our hearts that our son was so affected by exposure to lead that he suffered hearing loss,” said Riziki.

Lead builds up in the body and the World Health Organization (WHO) finds there is no known safe level of exposure. It is particularly harmful to young children. Dr Mbira Gikonyo, a consultant Ear Nose and Throat specialist at Landmark Medical Plaza in Nairobi, Kenya has treated many children for lead poisoning.

Despite the challenges countries have experienced in implementing the Libreville Declaration on Health and Environment, there are some tangible outcomes at the country level.  African countries are moving away from open burning or inefficient incineration of wastes, and adopting new technologies in waste management. Projects are being established that respond to changes in health risks as a consequence of climate change by, for example, including climate considerations in national Water Sanitation and Hygiene (WASH) programmes.  Impact can also be seen in the management of biodiversity and stricter regulations on the exploitation of natural resources. Some countries have shown a significant improvement in sanitary infrastructures, especially in schools and health centers, leading to a reduction in water-borne diseases such as diarrhoea.

Most of all, the progress and results achieved so far under the Libreville Declaration provide positive evidence of the effectiveness of intersectoral coordination, and reveal the capacity and potential role of the Declaration to translate the continent’s aspirations on health and environment into actions.

Ministers, officials and health experts from across Africa, the World Health Organisation (WHO) and the United Nations met to push forward action to halt the damaging effects of artisanal and small scale gold mining on human health and the environment today (6 November). Virtually every country in Africa has some form of artisanal and small scale mining with more than 54 million Africans estimated to be dependent on the activity for their livelihoods.

“Small scale gold mining is a crucial source of income for millions of Africans, but it is often dangerous, damaging, and in the worst cases, deadly, for artisanal miners,” said Dr Magaran Bagayoko, Director, Communicable Diseases Cluster, WHO’s Regional Office for Africa.

The artisanal and small-scale gold miners often use mercury, a highly toxic chemical to separate their gold from ore, putting their health at great risk. Alternatives to mercury do exist, but for many miners, operating independently without government support, income trumps the health and environmental risks. Many of the people involved in this hidden and often informal activity are the most vulnerable in society with women representing more than 50% of the miners.“Exposure to elemental mercury can cause life-long disability, kidney failure and speech, sight and cognitive impairment,” said Dr Bagayokoi. “Women, pregnant women and children are at particular risk.”