Development projects, migration and malaria in the GMS

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Development pojects, migation and malaia in the GMS Biegional Meeting on Healthy Bodes in the GMS 5-7 August 2013, Bangkok, Thailand D. Deye Gopinath MD MPH Wold Health Oganization Lao PDR gopinathd@wpo.who.int

Pesentation outline Malaia tends in the GMS counties Migation and economic dives Roadways, ailways, hydo dams and plantations Issues of development pojects and malaia Possible enty points fo engagement

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Malaia Tends in the GMS Numbe of Confimed Malaia Cases: 2002-2012 1,000,000 10,000 100 1 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Cambodia China Lao PDR Vietnam Thailand Myanma 10,000 Numbe of Confimed Malaia Deaths: 2002-2012 1,000 100 10 1 Cambodia China Lao PDR Vietnam Thailand Myanma

The Mekong malaia map is shinking and concentated on the bodes zeo < 1 1-10 > 10 Malaia paasite incidence in the GMS, 2002 Malaia paasite incidence in the GMS, 2010 Mekong Malaia Monogaph III

GMS Migation pattens, economic coidos, biodivesity consevation aeas and malaia Migation outes Souces: 1. Asia Migant Cente & Mekong Migation Netwok (2002). 2. Save the Childen 3. IOM Lao (2009). 4. IOM Myanma (2010). Powe Point Pesentation; 5. N.litthai. Migant population in the GMS - Total :300mil Intenal:? Int l labo migants: Regula: 1-2mil Iegula: 3-4mil Coss bode: 250,000/day 2D_BCI_GMS_BCL-EC

1. Infastuctue and ual development displacement o elocation of villages migation to and fom the aeas by labo migants, including intenal and extenal migants. 2. Defoestation fo logging and faming Illegal logging fo timbe faming, especially fo cash cops such as coffee, cashew nut, ubbe and oil palm equie a constant lage numbe of lowpaid wokes seasonal o cicula migants with a mix of intenal and coss-bode labo migants Migation and cuent dives in the GMS 3. National development plans and demogaphics 4. Political factos affecting migation 5. Natual disastes 6. Socio-economic situation

Roadways Hydo Dams? Impact on malaia Agicultual Plantations Railways

Outcomes of apid development on malaia Road and ailways, hydo dams, Plantations, mining etc Change in vecto ecology Influx of foeign wokes Local population displacement Pedominant mosquito species Mosquito biting times Change in malaia paasite species atio Dug esistant paasites Self medication Incease in substandad antimalaials and monotheapies Highland to lowland, low immunity and no potection against malaia Loss of taditional occupation, moe foest based activities, engaged in development pojects

Roadways East-West and Noth-South Economic Coidos and oadways now facilitate easie and moe dynamic movements of people in the GMS Asian Highway Netwok GMS Economic coidos - Southen Economic Coido (SEC) - East-West Economic Coido (EWEC) - Noth-South Economic Coido (NSEC) http://www.unescap.og/ttdw/common/tis/ah/database.asp

HIV/AIDS inteventions in oad constuction pojects

Roadways and malaia Route AH-3 (NR3): 251 km Houeixay (Lao-Thai bode) to Boten (Lao-Chinese bode) Thailand Myanma: Tennisaim ange Dawei Sea Pot 2011, D. Bouasy Hongvanthong, Lao PDR Jul 12th 2013, 7:51 by T.J. BANGKOK, ELEPHANT CRY HILL, DAWEI

Railways Railways may be an effective oute fo the popagation of the human malaia paasite Tans Asian Railway (TAR) GMS Railways Singapoe-Kunming ail link (SKRL)

Connecting GMS counties: Vientiane Action Plan 2004 2010: Pioity outes in the Singapoe Kunming Rail Link (SKRL). Estimated Geate Mekong Subegion Rail Passenge and Feight Demand Pojections and Cost of Constuction by Route Route Taffic Foecast Passenges (million) Cost Estimate Feight (million tons) ($ billion) 2014 2025 2014 2025 1 1.8 3.2 6.8 25.7 1.09 2 1.6 2.4 6.3 23.8 5.32 3 2.9 4.4 6.3 23.8 2.29 4 3.7 6.3 6.3 23.8 6.28

ASEAN Stategic Tanspot Plan 2011-2015 ASEAN Stategic Tanspot Plan (ASTP) 2011-2015, stategic actions to be implemented in the peiod to suppot the ealisation of the ASEAN Economic Community (AEC) by 2015 as well as the new pioity of enhancing egional connectivity identified in the Maste Plan on ASEAN Connectivity (MPAC).

Hydo Dams

GMS - Demand fo electic powe Coss-bode tade has inceased the pace of hydopowe development. Regional Indicative Maste Plan fo Powe Inteconnection diven by ADB, Wold Bank and dono assistance pogams in the GMS enegy secto It is estimated that the electic powe demand in the whole Mekong Region will incease by an aveage of about 7 pecent annually to 2022. In ode to meet such shap gowth in demand, cuent electic geneating capacity is expected to quaduple by then. The Cuent Status of Envionmental Citeia fo Hydopowe Development in the Mekong Region - A Liteatue. Compilation Pete King, Jeemy Bid, Lawence Haas Mach 2007

Hydo dams and malaia isk aeas Lao PDR HD Souce: MRC, Vientiane, Lao PDR, Septembe 2008 Pf incidence: CMPE 2008 H y d o d a m s 200 9-2010 201 1-2012 201 3-2015 N o d a t a I n t e p o l a t e d P f i n c i d e n c e a t e ( 10 k m a d i u s ) 0 > 0 < 1 1-10 10-100 100-500 500-100 0 CMPE 2009 1500 1000 500 0 Malaia cases 2011 1 2 3 4 5 6 7 8 9 10 11 12 _17_Attapeu Souce: CMPE

Envionmental Impact Assessments (EIAs) - Too ealy o too late - Pivate secto investment is usually fast tacked - Mitigation measues: Diffeent laws and egulations in each county

Rubbe Plantations Led to changes in agicultual pactices in SEA; ubbe poduction has inceased in Myanma, Laos, Thailand, and Vietnam (Tends Biotechnol. 2007, FAO 2003) Mon wokes making thei way to Tad s ubbe plantations Pix by WHO/ Nat Sumon In 2011, 7 povinces along Thai-Cambodian bode, malaia cases among ubbe plantation wokes accounted fo between 10-20% of total malaia cases epoted. http://malaiacontainment.wodpess.com/2011/04/12/mon-ubbe-tappes-eceptive-to-peventive-messages/

The plants matue 7 yeas afte planting a need to undestand the phases of gowth of ubbe plantations and its elation to malaia isk.

Extactive industies in a distict Malaia outbeak villages Gold mine Hydo dam planned Rubbe plantation Hydo dam unde constuction 1500 1000 500 0 Confimed malaia cases 1 2 3 4 5 6 7 8 91011121 2 3 4 5 6 7 8 91011121 2 3 4 5 6 7 8 91011121 2 3 4 5 6 2010 2011 2012 2013 Souce: NMCP

A stong need to incopoate these events and pedictions into futue planning and contol:.. the potential fo malaia e-emegence should eceive substantially moe attention fom economic, agicultual, and envionmental planning bodies.....undestanding the influence of land use change on malaia occuence is citical fo shaping futue suveillance and contol stategies Tevo Petney et al

Ministy of Planning and investment Ministy of Labou Road/Rail ways ASEAN sec ASEAN Mekong Basin Development Coopeation (AMBDC) GMS - GMS Ministeial Meeting GMS Subegional Tanspot Foum, Economic Coidos, CLV ministeial meetings ADB -GMS Pogam, JIBC, WB National - Ministy of tanspot/public woks Hydo Dams ADB, Wold Bank - GMS Pogam - Regional Maste Plan fo Powe Inteconnection Mekong Rive Comission (MRC) National - Ministy of Enegy & Mines - Ministy of Natual Resouce and Envionment Agicultue/Plantations National - Ministy of Agicultue, Foesty Reseach Institutes - National Agicultue and Foesty

Thank You

Additional slides

Multisectoal engagement: Malaia: What has been tied, what woked and what not in GMS 1. Both ad hoc/esponsive and planned engagement with majo poject developes to engage in malaia peventive and cuative inteventions among thei wokfoce - esponses fom developes : Could ty: A simple economic agument (cost benefit): eduction in malaia case = poductivity cost? $$ and cents, used in public and pivate secto planning Developing/stengthening safeguads famewoks HIAs, EIAs, SIAs as an essential pat of any pivate secto led/funded development poject, contactual /MoUs with economic, agicultual, and envionmental, labou planning bodies etc.

Multisectoal engagement: Malaia: What has been tied, what woked and what not in GMS 2. High level platfoms engaged Pime Ministe s office, povincial govenos, majo fundes/donos/bilateals/militay - esponsive/inteested, complicated, needs a champion Could ty: * Regional entities engaged (ASEAN, ADB, GMS ministeial meetings, CLV etc) commitments fo health/malaia in the long tem * Reaching out to multisectoal agencies gov. planning bodies foesty, planning and investment, labou, etc to include economic, social, population migation info etc fo malaia planning. Requies fomal ageements/ pocesses * Coss bode stakeholde involvement - some pogess now with militay, Twin cities poject etc