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Preface

Human health cannot be considered in isolation. It depends highly on the quality of the environment in which people live: for people to be healthy, they need healthy environments.

The Ecosystem Approaches to Human Health program of Canada's International Development Research Centre (IDRC) -- the result of many years of collaboration between Canada and the countries in the South -- is an innovative response to human health problems resulting from the transformation or high-risk management of either the environment or human health. This program is based on what has become known as the Ecohealth approach.

The purpose of this book is to introduce the Ecohealth approach, provide examples of how it is applied, and draw a few lessons that should encourage its use by decision-makers. This approach to human health places human beings at the centre: the aim is to achieve lasting improvements in human health by maintaining or improving the environment. Its proponents work for both people and the environment.

At IDRC, the Ecosystem Approaches to Human Health program reflects many years of evolution in support for health research. In the early days, the research supported was largely biomedical: vaccines, disease-control strategies, and contraception. Later, IDRC began to take the environment and the community into account. In 1990, the program was called Health, Society, and Environment but, although it involved specialists from different disciplines working together, it sought only to improve human health, not the environment.

IDRC created the Ecohealth program in 1996. This innovative program proposed inviting scientists, decision-makers, and community members to work toward improving the community's health by improving the environment. This was the first step in adopting a deliberately transdisciplinary approach in an IDRC program. Since then, the program has supported some 70 projects in about 30 countries in Latin America, Africa, the Middle East, and Asia.

The Ecohealth approach is anthropocentric -- managing the ecosystem revolves around seeking the optimal balance for human health and well-being, rather than simply on environmental protection. Thus, its objective is not to preserve the environment as it was before human settlements appeared. The presence of human beings creates a new dynamic whereby people's social and economic aspirations need to be considered, particularly since people have the power to control, develop, and use their environment in a sustainable way, or to abuse it. That is an original aspect of this approach.

Another original aspect is the adoption of a research process that is not restricted to scientists, so that the knowledge acquired can be integrated into people's lives. The effectiveness and sustainability of these actions are at the heart of our concerns. The challenge is meeting human needs without modifying or jeopardizing the ecosystem in the long term -- and, ideally, even improving it.

The many inquiries we have received have convinced us of the importance of presenting our ecosystem approaches to human health. That is the main purpose of this book. Also, by sharing research findings and lessons, IDRC hopes to contribute to the development of a vision and tools that decision-makers can use, in collaboration with communities, to formulate health and environmental policies.

I would like to warmly thank all the members of the Ecosystem Approaches to Human Health team at IDRC, particularly Roberto Bazzani, Ana Boischio, Renaud De Plaen, Kathleen Flynn-Dapaah, Jean-Michel Labatut, Zsofia Orosz, and Andrés Sanchez, for their contribution to this book, as well as Gilles Forget and Don Peden for their work during the first years of our program. I am also deeply grateful to all of the Ecohealth project participants throughout the world who have helped to develop ecosystem approaches to human health and are working energetically to put them into practice. This book would not have been possible without their collaboration. Finally, I am grateful to Danielle Ouellet, editor of Découvrir magazine in Montréal, who produced the first draft of the book, and to Jean-Marc Fleury and his team in IDRC's Communications Division for their patience in seeing this project through to completion.

Jean Lebel

Jean Lebel earned a master's degree in occupational health sciences and a Graduate diploma in occupational hygiene from McGill University in Montréal, as well as a PhD in environmental sciences (1996) from the Université du Québec à Montréal (UQAM). He is currently team leader of IDRC's Ecosystem Approaches to Human Health program initiative. As an environmental health specialist, he spent of much of the four years of study leading to his PhD in the Amazon region of Brazil. With a transdisciplinary research team, he studied the effects of low-level contamination, especially by mercury, on human health. In April 2001, he received the first UQAM Prix Reconnaissance from its Faculty of Sciences for the work he "has pioneered by helping developing countries preserve the balance of their ecosystems and protect the health of their citizens."

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