BOOKS & ELETRONIC MEDIA

In focus: health — an ecosystem approach

Nadia Hamel

Population Health PhD Programme, Institute of Population Health, University of Ottawa, Ontario K1N6N5 (email: nadiah@uottawa.ca)

by Jean Lebel
Publisher: Ottawa: International Development Research Centre; 2003
ISBN 1-55250-012-8. Price: CAD15
(disponible en français)

Jean Lebel argues that it is impossible to exclude the growing global population from the ecological equation. The relations between people's health and the quality of the environment in which they live are widely recognized. These interactions are complex, however, and researchers need ways to encompass more than just biophysical parameters.

In recent years, calls for action in the areas of research and decision-making have supported a strategy that links health to the environment. During the last decade major meetings have reinforced this view; they include the United Nations Conference on Environment and Development in Rio de Janeiro in 1992, the Johannesburg World Summit on Sustainable Development in 2002 and the Montreal International Forum on Ecosystem Approaches to Human Health in May 2003.

Lebel focuses on the research supported by Canada's International Development Research Centre (IDRC) on the ecosystem approach to human health — "ecohealth". Since 1996, their programme has aimed at improving human health and well-being while maintaining a healthy environment. The idea is to look at ways to improve people's health by managing their local resources better, rather than focusing all efforts on the health services.

Analysing the practical implications of this approach, Lebel provides useful information and examples. One case he dwells on is Mexico's commitment to eliminating the use of DDT, which is a threat to the ecosystem although humans have depended on it to fight malaria. He describes how the research team worked successfully with the community in Oaxaca to find effective alternatives. The three methodological cornerstones of this research framework are emphasized in all the projects described: transdisciplinarity, community participation, and gender equity. Integrated research strategies include community participation in defining the problems. The process builds local capacity and makes good use of local knowledge.

However, these brief accounts often leave the reader hungry for more details. Fortunately, this book is part of IDRC's Ecohealth web site (www.idrc.ca/ecohealth) where more case studies, research reports and articles are available. Notwithstanding this virtual supplement, the publication would be more complete and satisfactory if it included such information.

Lebel writes in an informative and interesting way, which makes his book suitable for anyone involved in international public health, whether specialists or generalists. The richness of the book reflects IDRC's long and varied experience in sustainable and equitable development (70 projects in 30 countries). Although it argues for the ecohealth approach, it also discusses the difficulties the researchers faced. In general, it makes a valuable contribution to developing a vision and tools that decision makers can use, in collaboration with communities, to formulate good health and environmental policies.