Food for thought: can Meatless Monday save the planet?

World-renowned researchers, physicians, government officials, and industry leaders are meeting today in Berlin to discuss the state of global health.  Amidst presentations and discussions about non-communicable diseases, global health security, and priority issues in conflict zones, the attendees of the World Health Summit will gather together to break bread.  The menu might look a little different this year, as the Summit will jump on the Meatless Monday bandwagon.

The brainchild of Sid Learner, in partnership with Johns Hopkins Bloomberg School of Public Health, Meatless Monday was established in 2003 to reduce reliance on red meat, improve chronic disease, and protect the environment.  Meatless Monday is now active in 44 countries – from Bhutan to Togo.

Could wider adoption of Meatless Monday or less reliance on meat as a diet staple prove a boon for food scarcity, health, and reduction of green house gases?  When so much of the world suffers from malnutrition, is this fad a luxury or a necessity?

The ills of large-scale factory farming are well established.  These facilities, known in the US as concentrated animal feeding operations (CAFO), can each produce up to 1.6 million tons of manure a year, more waste than a U.S. city.  Unlike human waste infrastructure, there is no mandated system for the storage or sanitization of animal waste which can be rife with E. coli, antibiotics and other hormones, animal blood, and organic and inorganic compounds dangerous to human health.  Improper or overextended systems for storing untreated manure can cause run off or leaching into ground water.  Degrading animal waste can also affect local air quality and attract insects.

It isn’t just the immediate health effects of factory farming – such as increased incidence of childhood asthma in communities near CAFOs – but the cumulative effects that contribute to global warming.  A 2006 report of the Food and Agricultural Organization of the United Nations found that CAFOs deleterious outputs could account for 18% of global emissions.  The list is literally and figuratively exhaustive: from the methane gas emitted from the aforementioned manure, the oil used to transport carcasses to processing plants and on to stores, the electricity used to keep the meat cool, and the emissions and energy needed to harvest the crops that feed the livestock and pumps for water.  Dig a little deeper and consider, as suggested by two World Bank Scientists, the following:

Should you include all the knock-on emissions from clearing forests? What about the fertiliser used to grow the crops to feed to the animals, or the emissions from the steel needed to build the boats that transport the cattle; or the “default” emissions – the greenhouse gases that would be released by substitute activities to grow food if we were to give up meat? And is it fair to count animals used for multiple purposes, as they mostly are in developing countries, from providing draught power to shoe leather or transport, and which only become meat once they reach the end of their economic lives?

All told, these activities add up to 32.6 billion tons of carbon dioxide annually, or 51% of global greenhouse gas emissions.  Even at its lowest estimate of 15%, greenhouse gas emissions from livestock are equal to exhaust emissions from every vehicle – plane, train, and automobile – in operation today.

How much less meat would we need to eat to keep rising temperatures below the 2-degree Celsius mark that could spell big trouble for life as we know it?  Industrialized countries currently consume more than twice the amount of meat considered healthy.  Americans eat three times as much.  While meat consumption in developing countries is a fraction of those listed above, an increased call for meat has been seen as countries become more urban.   Meat consumption in developing countries has tripled compared to developed nations in recent decades.

While the simple solution is to eat less meat, the type of meat might also be important.  Raising beef requires nearly 30 times more land and 11 times more water than pork, chicken, dairy or eggs.  Three staple crops – potatoes, wheat, and rice – require up to six times fewer resources than pork, chicken, dairy or eggs.

If industrialized countries were to consume less red meat, global malnutrition could be addressed. Only 55% of the world’s crops feed people, the rest are reserved to feed livestock or to make biofuel.  The conversion of calories from grain to meat leaves much to be desired.  One hundred calories of grain produce a mere 3 calories of beef.  Just switching from grain-fed beef to pasture-raised beef, chicken, pork, eggs, and dairy products could free up much more food to feed the world.

It may be that time is running out to make smarter food choice before climate change makes the decision for us.  Currently, 4% of global croplands experience drought each year but could reach as high as 18% by the year 2100.  Even at the current rate, droughts have the capacity to devastate regions and industries.  A recent study found that an extra 500,000 deaths will be attributable to a decrease in nutrient-rich food in 155 world regions by the year 2050.  Rather than malnutrition related to caloric intake, these deaths will be due to lack of vitamins from fruit and vegetables. The majority of these deaths will likely occur in already impoverished countries of Asia and Africa.

If you are reading this blog, you can probably afford to have some lentils or a nice vegetarian burrito for dinner.  While you sup, feel free to check out these great articles by Maryn McKenna.  The first imagines a world without antibiotics – a huge issue especially as it pertains to the food industries over-use. The second examines a Dutch company that is mass producing antibiotic-free boiler hens.

Environmental monitoring data as “development”: The far-reaching effects of the Beijing embassy’s air quality monitor

When we think of “development” or “development projects,” environmental monitoring technologies are not typically the first things that come to mind. While data is (rightfully) gaining importance in the global health and development landscape, we usually default to primary health care interventions, vaccination drives, or agricultural technologies. However, in a guest editorial in Wired last week, former USAID advisor David Roberts puts forth the American Beijing Embassy’s PM2.5 monitor as precisely that:

As the former Regional Strategic Advisor for USAID-Asia, I have seen first-hand that doing international development is incredibly difficult. Billions of dollars are spent annually with at best mixed results and, even with the best intentions, the money often fails to move the needle. That is why I was so inspired by the story of the US embassy’s low-cost, high-impact development project. They tapped into the transformative power of democratized data, and without even intending to, managed to achieve actual change.

He goes on to tell the story of how, in 2008, embassy staff installed a rooftop air-quality monitor for the price of “a nice car.” The monitor was linked to a Twitter account that automatically tweeted air quality readings every hour. The catch (which is why I question framing it as a “development project”) is that the readings were originally only intended for American expats and travelers – the Great Firewall (that is, China’s nationwide internet restrictions) blocks access to Twitter and other social media – including Facebook, YouTube, and pretty much any blogging platform out there – by its citizens. (Having developed a major smartphone addiction during my time in South Korea, being blocked from just about everything I wanted to access during one day in Shanghai last March drove me batty. But I digress.) Internet users can only access such technologies via a VPN service – commonly used by expats, but much less so among Chinese nationals.

Predictably, however, a few savvy Chinese netizens got ahold of the information anyway.

can't stop the signal

They began distributing it through China’s own (permitted) social media channels, retweeting the readings on Sina Weibo (Chinese Twitter) and incorporating the readings into homegrown air-quality apps. The Chinese government starting taking heat from its own citizens about poor air quality, a ongoing social tinderbox reignited by the availability of impartial (read: not official Chinese government numbers) data. Predictably, the government got upset and ordered the US embassy to remove the device, claiming that the dissemination of the information was somehow “illegal.”

Given the Chinese government’s sensitivity on environmental issues—and it’s irritation at anything viewed as foreign meddling in domestic affairs—it shouldn’t be surprising that the @BeijingAir account would eventually draw an official response. And that’s what happened on June 5, [2012] when China told foreign embassies to stop publishing their own reports on air quality in the country. (The U.S. consulates in Shanghai and Guangzhou also post readings of the air quality of those cities on Twitter.) As of now the @BeijingAir account is still up and running, and it’s important to note that the American embassy has always said that the readings—which come from a single monitoring device on the roof of the embassy—were only meant to inform Americans living in the city.

Naturally, the embassy refused, and so Big Brother was forced to set up its own monitoring stations – and to be held accountable for air quality around the country. Roberts continues to extol the virtues of the expanded “program,” which the State department has now decided to implement at embassies in other countries in Asia (much like China, some of them are rather unhappy about it).

This little air-monitor-that-could also directly inspired other like-minded efforts. In India, the US government has now begun tweeting data from air monitors at its embassy and consulates. In Mongolia, non-government groups in Ulaanbaatar, one of the world’s most polluted cities, ran with the Beijing example by monitoring and tweeting out air-quality data; some even saw the possibility of repurposing the concept for flood warnings. And aqicn.org, which started as a way to share US Embassy – Beijing’s data, has transformed into the go-to site for hourly air-quality information at 4000 monitoring stations stretching from Hanoi to Honolulu.

Honestly, this sort of phenomenon is less about “development projects” and more about the power of information in the hands of an internet-savvy populace. The Beijing air quality monitor does not look like a development project as much as an example of successful government subversion – passive-aggressive actions that boost the credibility and favorability of our image abroad at the expense of the home country’s (foreign policy at its cleverest). The air quality “revolution” in China is certainly not something the US government can take credit for – that belongs to Chinese citizens.

But then again, that is what we believe development should ultimately be about anyway, so I guess I can’t complain.


Note: This was cross-posted to my own blog.

PRI’s The World: Mysterious Kidney Disease Now Found in South Asia

I found this story particularly interesting, since I did a one-year fellowship with CDC-NIOSH on pesticide poisoning surveillance. The story examines a high incidence of kidney disease in Sri Lanka and discusses how farmers, medical professionals and government authorities have been dealing with it. The full story can be viewed here; a summary of the story, and a video, can be found below.


A form of chronic kidney disease (CKD), similar to one that has been killing sugarcane field workers in Central America, has now been observed in South Asia. The World‘s Rhitu Chatterjee reports from Sri Lanka, where thousands of rice farmers and their families are affected. Her story is part of a series, Mystery in the Fields, produced in collaboration with The Center for Public Integrity.

The afflicted show no signs of high blood pressure or diabetes – the most common causes of CKD elsewhere in the world – and yet their kidneys are failing. There is no known cure. Authorities are trying to find a cause, but their preliminary findings have not reached the people whose lives are threatened.

A new study by the World Health Organization and the Sri Lankan Ministry of Health suggests that Sri Lanka’s CKD sufferers may have been poisoned by chronic, low-level exposure to the heavy metals cadmium and arsenic. Researchers think the toxins may be coming from farm chemicals, such as pesticides and fertilizers. But while the study points to a possible cause, the study’s results have not been widely publicized.

Chatterjee speaks with rice farmers, doctors, government officials, and a representative from Sri Lanka’s farm chemicals industry. Her report examines the results of the WHO study, the secrecy that surrounds it, and the frustration of Sri Lankans who see little being done to prevent more people from falling ill.

The full report can be found here: http://bit.ly/Q9Gv1g

Occupational Health – The Need to Go Global

Guest blogger: Dr. Isobel Hoskins

I never come away from the APHA meeting without being inspired.

This year, the inspiring speech for me came right at the end. I attended the closing session almost by chance when I realised I had a little time. The theme was occupational health so as someone keen on global health I didn’t think it would be all that relevant. When the second speaker took the stand I realised how wrong I was.

Leo Gerard from the United Steelworkers Union showed how health and safety is a global issue and exactly why we need to address occupational health worldwide to match the globalisation of trade. Have you ever thought about who made the clothing you wear, the conditions they work under and the impact that has on their health?

He showed a short video about the Triangle fire – a fire that happened in 1911 in New York at a garment factory. Fire broke out in the factory and panicked workers rushed to the two exits only to find them blocked by fire or locked. The workers couldn’t get out and in desperation some even threw themselves from the upper floors to escape the fire. 146 of them died. This event was one of the drivers of health and safety regulation in theUSA. Those workers were low paid and not allowed to unionise and so negotiate their conditions.

Fast forward to 2010. Gerard described a fire at a garment factory in Bangladesh and guess what? The exits were locked. 29 people died trying to get out, some threw themselves from the upper floors. No regulations prevented this accident in Bangladesh and there was no union to help protect the low paid workers.

Nothing has changed except the geography.

In the rush of globalization, developed country companies are getting round regulation at home by exploiting places where there is none. What does this mean for regulation at home? It means it is under pressure. We could lose all that has been gained since the Triangle fire. In the race to the bottom and the lowest prices, people’s health is being put on the line.

Trade regulations preventing import into the US of goods made in sweatshops or by children, for example, could be a way of forcing global companies to adopt safe working conditions, said Gerard. Having stronger more global unions is another way. Leo’s union the United Steelworkers Union has just gone global – forging partnerships and mergers with other unions worldwide.

Individually I think we can make a difference as well- reading the label and knowing the reputation of companies you buy from could help prevent exploitation. Consumers have power….

Triangle fire: http://en.wikipedia.org/wiki/Triangle_Shirtwaist_Factory_fire
Bangladesh fire: http://www.guardian.co.uk/world/2010/dec/14/bangladesh-clothes-factory-workers-jump-to-death

Dr Isobel Hoskins manages the Global Health database at CABI.

The Danger in Overlooking Environmental and Occupational Health

A black-and-white photo of a gold mine in the 19th century.
Flickr, U.S. National Archives

I often get quizzical looks from public health professionals when, after explaining that I am interested in international health, I tell them that I got my MPH in Environmental Health. For example, while riding the shuttle from the airport to the Convention Center for the APHA Annual Meeting this past November, I struck up a conversation with an Environmental Health professor. She seemed puzzled when I told her that I was a member of the International Health section and then explained that my MPH focus (and my current job) was in environmental and occupational health. She then (very politely) invited me to the Environmental Health Section’s social hour.

While I certainly appreciated the invitation, I remain puzzled (and slightly frustrated) that there is relatively little discussion of environmental and occupational health issues in international health. The field is dominated by discussion of the Big Three diseases (HIV/AIDS, malaria, and TB), sanitation, tropical worms, MCNH issues, malnourishment, and poverty. While these are all very important issues deserving of attention and funding, EOH should by no means be left out: after all, every human being is affected by the environment around him or her, and nearly all of us hold some kind of occupation to put food on the table.

One story in particular caught my eye a few weeks ago. Nearly 300 children in Zamfara state in northern Nigeria have died from lead poisoning due to mining activity over the last two years; another 742 are currently being treated for high blood lead levels. Lead poisoning fall squarely under environmental health – my cubicle neighbor is a nurse for the Texas Childhood Lead Poisoning Prevention Program – but this story had all of the trappings of a “classic” IH scenario: poor people in small villages in a developing country, Doctors without Borders, and sick African babies.

Mining is a significant issue, and a heated debate, in the field of development. Proponents of mining include the World Bank, which maintains that mining provides jobs, government revenues, and local economic benefits, and that it can provide sustainable development to communities with appropriate regulation. Critics argue that the pollution and environmental damage generated by mining operations outweigh the benefits, that it exploits local communities, and that the revenues are largely kept by local elites and foreign shareholders. And we all know that resources are too often followed by bloody conflict: civil wars in Sierra Leone, Angola, and Liberia, and armed conflict in the DRC, are just a few examples that come to mind. There are a number of health ramifications as well: constant exposure to rock dust makes miners more susceptible to tuberculosis, which they can spread to their families. Artisanal gold mining in particular, which supplies at least one fourth of the world’s total gold supply, is one of the most significant sources of the release of mercury into the environment.

Despite the hazards and health risks, however, the issue gets relatively little attention compared to the traditional global health villains of sanitation and infectious disease. This is unfortunate because all of the same factors play into mining in impoverished communities: residents and farmers take up mining and mineral extraction to improve their livelihoods because it pays better and provides more security than subsistence farming. There are issues of sustainability, ownership, exploitation, and corruption. Somit Varma, director of the Oil, Gas, Mining & Chemicals Department of the World Bank/IFC, has said that “the social and economic characteristics of small-scale mining fully reflect the challenges of the Millennium Development Goals, including: health, environment, gender, education, child labour, and poverty eradication.”

Advocates are becoming more vocal in drawing attention to “non-typical” international health issues, including cancer and mental illness. We should add environmental and occupational health issues to that list as well. While these issues are inevitably more complicated to prevent, screen for, and treat than the Big Three or NTDs – after all, you can’t pass out condoms or implement DOTS for lead poisoning or silicosis – they still impact the world in a major and often devastating way and are still deserving of our attention.