The symbiotic relationship between environmental and health is undisputed.

1. 2ndSouth Asia Judicial Conference on Environmental Justice, Bhutan, 30-31 August, 2013 ENVIRONMENT, HUMAN HEALTH AND ITS ECONOMICSPakistan’s PerspectivebyJustice Syed Mansoor Ali Shah Lahore High Court Lahore, Pakistan

2. The symbiotic relationship between environmental and health is undisputed. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

3. The World Health Organization (WHO) has estimated that thirteen million deaths annually are attributable to preventable environmental causes. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

4. The report also estimates that: • 24% of the global disease burden (healthy life years lost) and 23% of all deaths (premature mortality) are attributable to environmental factors. • the environmental burden of diseases being 15 times higher in developing countries than in developed countries 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

5. ENVIRONMENTAL HEALTH ISSUES IN PAKISTAN 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

6. Hepatitis • Hepatitis "B" and "C" have emerged as major Public Health Problems in Pakistan. • Every 13th Pakistani is potentially infected with either Hepatitis B or C. • According to estimates, there are 6 to 7 million infections of Hepatitis "B" and "C” 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

7. Hepatitis (Contd…) It is estimated that about 15 million people somehow harbor hepatitis viruses in their bodies. 2nd South Asia Judicial Conference on Environmental Justice, TajTashiHotel, Thimpu, Bhutan, 30-31 August, 2013

8. 2. Floods In August 2010, Pakistan experienced floods that affected 20 million people in 78 districts, killed 1800, damaged or destroyed about 2 million homes, 514 health facilities and inundated a land mass the size of England. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

9. Floods (Contd…) Between August and September 2010, 6.2 millionconsultations for gastroenteritis, respiratory infections, malaria and dermatologic conditions were reported to WHO from 50 of 64 affected districts. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

10. Floods (Contd…) Using surveillance data from flood-affected districts, WHO reported mounting cases of Crimean-Congo haemorrhagic fever, dengue fever, cholera, falciparum malaria, measles and polio.  2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

11. 3. Dengue Fever Dengue is a widespread mosquito-borne infection in human beings. Symptomatic dengue virus infections can present with a wide range of clinical manifestations, from a mild febrile illness to a life-threatening shock syndrome. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

12. Dengue Fever (Contd…) The cases of Dengue fever increased dramatically since the 1970s and continues to become more prevalent. This disease is believed to be due to a combination of urbanization, poor sanitation, population growth, increased international travel, and global warming 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

13. 4. Unsafe Drinking Water / Poor sanitation Due to scarcity of drinking water as well as its being contaminated abdominal pain, diarrhea, and other gastro-intestinal diseases are being promoted. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

14. Green Bench at Lahore is currently dealing with : River Ravi case- contamination of fresh water resource Urban Water Supply /Sanitation case Air pollution Land use /urbanization 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

15. Dialogue: Environmental Health vs Public Health System 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

16. RETHINKING THE SCOPE OF ENVIRONMENTAL JUSTICE 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

17. Constitutional ‘right to life’ has already been interpreted to mean “a cleaner and a healthier life” • It is now time to include “right to human health” as a fundamental right or as an integral part of right to lifeor the proposed right to a clean and healthy environment. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

18. “Enjoyment of the highest attainable standard of health is one of the fundamental right of every human being” – WHO’s Declaration 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

19. While environmental cases look into problems of unsafe drinking water, poor sanitation, over crowed cities and unregulated land use, they have so far not estimated health loss associated with these environmental issues. Health loss must be assessed and health treatment be provided. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

20. Court alongside the environmental issue (e.g., polluting industry, poor sanitation by the local authority or unclean drinking water supply) must map the adverse environmental impact on the health of the people in the area. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

21. It is the responsibility of the State to maintain safe and healthy environment. Failure of environmental governance and the consequent loss of human health is the responsibility of the State hence it must be compensated. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

22. Building on the PRINCIPLE OF POLLUTER PAYS - the concerned polluter (including the State) are responsible to compensate in the shape of providing healthcare till human health is restored in the area. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

23. This is closely connected with the assessment of “economic cost of loss associated with human health and the consequent cost of health care to be provided.” 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

24. The judicialization of human health and health care is essential and an inseparable part of environmental dispute resolution. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

25. Environmental Justice has to include in its ambit the right to human health, health care and the economics of an appropriate remedy. 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013

26. Thank You 2nd South Asia Judicial Conference on Environmental Justice, TajTashi Hotel, Thimpu, Bhutan, 30-31 August, 2013