Building Capacity in Small-Scale Mining Communities: Health,Ecosystem Sustainability,and the Global Mercury Project

The Global Mercury Project (GMP) is an initiative of the United Nations in collaboration with numerous government and nongovernment organizations to promote knowledge and capacity building on the links between small-scale gold mining practices and health, ecosystem, and social factors, and to implement interventions that reduce mercury pollution and exposure caused by mining activities in developing countries. Knowledge regarding the use of mercury and the dynamics of complex environmental, health, socioeconomic, and cultural conditions in and surrounding small-scale mining sites is particularly needed for the purpose of developing appropriate community-based measures to reduce mercury-related problems. GMP strategies aim to build upon local knowledge and practices to train miners on the use of cleaner and affordable technologies of mining and mineral processing in order to minimize negative impacts. The initiative is especially proactive in facilitating transdisciplinary and participatory models of community interaction, involving local, regional, and international stakeholders in each of the strategy design, community assessment, and community intervention phases. The six participating countries are Brazil, Indonesia, Lao People’s Democratic Republic, Sudan, Tanzania, and Zimbabwe. This article outlines GMP’s objectives and scope of activities and also highlights achievements, challenges, and opportunities for future development.     

Ecosystem Approaches to Human Health and Well-being: Reflections from Use in a Mining Context

This article briefly discusses the evolution of ecosystem approaches, and illustrates the use of ecosystem approaches to assess human health and well-being in a mining context. It discusses the various elements that help distinguish such approaches from other approaches. Well-being here is understood broadly in terms of its “constituents” and “determinants,” of which health is an important constituent. Ecological, health, and social assessments highlighted a number of impacts from mining activity in Goa, India. These generated a list of issues of concern that were validated by stakeholders—community, industry, and government—which served as a basis for the development of tools to track mining-induced changes in health and well-being. The article concludes by reflecting on some of the challenges posed by the use of ecosystem approaches to assessing human health and well-being.     

Assessing Global Adoption of One Health Approaches

Transdisciplinary One Health (OH) approaches have been rediscovered as a promising tactic for addressing complex health risks at the human-animal-ecosystem interface. However, there is little evidence of widespread adoption of OH approaches as the new operating normal for addressing these complex health issues. We have used a transformational change model as an evaluation tool and part of an overall assessment of the global adoption of OH approaches. This assessment establishes a point of reference for measuring progress toward OH approaches being the new operating normal. Global adoption of OH approaches will require more strategic efforts to build the case (value proposition), recruiting a broader pool of One Health champions, solidifying partnerships and unifying OH efforts.     

From Multiple Voices to a Common Language: Ecosystem Approaches to Human Health as an Emerging Paradigm

The International Forum on Ecosystem Approaches to Human Health, held in Montreal, May 18–23, 2003, was one product of a new paradigm or framework linking health, ecosystems, and sustainable development that emerged in recent decades. This profile aims to provide a backdrop for the contents of this supplementary issue by outlining some of the key principles of the Ecosystem Approaches to Human Health (Ecohealth) framework. It also discusses some of the activities supported by the Ecosystem Approaches to Human Health Program Initiative of the International Development Research Centre (IDRC) to build on the success of the Forum. In doing so, the intention is to frame the 2003 Forum as one in a series of opportunities to reflect and learn from precedents of research and practice from an ecohealth perspective and to foster the development of a community of practice on Ecohealth (COPEH). The profile not only places the contents of the supplement and the Forum within a larger context, but also provides an overview of other IDRC activities that are building capacity for future research and practice, and are strengthening the emerging COPEH.     

Sustainability of Virulence in a Phage-Bacterial Ecosystem

Virulent phages and their bacterial hosts represent an unusual sort of predator-prey system where each time a prey is eaten, hundreds of new predators are born. It is puzzling how, despite the apparent effectiveness of the phage predators, they manage to avoid driving their bacterial prey to extinction. Here we consider a phage-bacterial ecosystem on a two-dimensional (2-d) surface and show that homogeneous space in itself enhances coexistence. We analyze different behavioral mechanisms that can facilitate coexistence in a spatial environment. For example, we find that when the latent times of the phage are allowed to evolve, selection favors “mediocre killers,” since voracious phage rapidly deplete local resources and go extinct. Our model system thus emphasizes the differences between short-term proliferation and long-term ecosystem sustainability.The replication strategies of phages fall into two major categories: virulent and temperate. A temperate phage has the ability to integrate its DNA into the host chromosome, where it is then replicated along with the bacterial DNA during cell division. This strategy allows the phage to slow down or completely stop exploitation of the bacteria, thus reducing the risk of driving its host to extinction. A virulent phage lacks this ability, and it is not fully understood how they manage to coexist with their bacterial prey (4, 19). Consider, for example, the highly effective T4 phage. For the sake of argument, let us assume a burst size of 100 offspring upon lysis. On average, not more than a single phage out of each burst of 100 should survive to infect another bacterium, or else the phage would rapidly outgrow the bacteria and drive them to extinction. The half-life (t_1/2) of a free T4 phage particle has been measured to be approximately 10 days in LB at 37°C (6). Therefore, on average, at least t_1/2 × log₂(100) ≈ 2 months should pass between infections to prevent runaway phage growth—a time span that seems highly unreasonable for many of the environments where phage and bacteria interact, such as soil or biofilm. Even a more considered calculation, inserting the above half-life measurement into more realistic Lotka-Volterra-like predator-prey models (9) does not change the conclusion that T4 and other virulent phages appear to be far too effective predators for coexistence to be feasible. It is, however, an undisputed fact that virulent phages and bacteria have coexisted for eons and do so still, everywhere around us and inside us. One possible explanation for this puzzle is that bacteria constantly evolve resistance to existing phages and that the phages evolve to attack resistant bacteria in a continuous arms race. This “Red Queen” argument (23) has, however, been criticized on the grounds that the rates of evolution of phages and bacteria are not symmetric (17, 12). Recent measurements support this: in soil, phages appear to be “ahead of the bacteria in the coevolutionary arms race” (24). We therefore wish to explore mechanisms other than bacterial resistance that may promote coexistence between virulent phages and bacteria.Historically, phage-bacterial ecosystem models have ignored the issue of space, utilizing zero-dimensional approaches, such as ordinary differential equations (e.g., see references 1, 5, 13, 14, 15, and 21). However, many real phage-bacterial ecosystems are found in environments with a complex spatial structure, such as soil, biofilms, or wounds in animal and plant tissue. Schrag and Mittler (20) showed that coexistence between virulent phage and bacteria is feasible in a chemostat but not in serial cultures, due to the heterogeneous nature of the environment in the chemostat. Further, experiments done by Brockhurst et al. (3) indicate that reduced phage dispersal can prolong coexistence for virulent phage and bacteria in spatial environments by creating ephemeral refuges for the bacteria. Kerr et al. (10) introduced a simple cellular automaton to model fragmented populations of phage and bacteria in which coexistence was more easily achieved when migration was spatially restricted. Thus, the main extension to the simple predator-prey framework that we examine will be to add a spatial dimension.We construct and compare two phage-bacterial ecosystem models: one model where the phage and bacteria exist in a two-dimensional space, such as the surface of an agar gel (referred to as the “spatial model”), and the other model where the phage and bacteria are repeatedly mixed, mimicking serial cultures or a well-mixed broth (referred to as the “well-mixed model”). We show that space does indeed enhance coexistence. We then move on to explore other mechanisms that phage could incorporate into their behavior to further enhance coexistence. These can broadly be classified as “hardwired” (where every phage follows the same deterministic strategy) versus “adaptive” (where each phage potentially behaves differently, thus allowing the population to explore different options).We have chosen to look at three specific mechanisms as examples of these categories: (i) phage effectiveness would be reduced if they were unable to register whether they were infecting live, infected, or dead bacteria (a hardwired behavior); (ii) phage could prolong their latent time, concurrently increasing burst size, depending on the number of multiple infections (also a hardwired behavior, but a more “active” sort, where each phage senses and responds to information from the environment; T4 is known to use such a lysis inhibition strategy), and (iii) phage offspring could have altered latent times due to mutations in the holin genes (an adaptive behavior). We will compare each of these mechanisms in the spatial and well-mixed models to investigate whether the heterogeneity possible in a spatial environment affects the outcome.     

Weight-of-Evidence Approaches for Assessing Ecosystem Impairment

It is challenging determining whether an ecosystem is impaired. The complexity of direct and indirect interactions between physical, biological and chemical components with their varying temporal and spatial scales generally renders use of multiple assessment approaches mandatory, with a consequent need to integrate different lines-of-evidence. Integration generally involves some form of weight-ofevidence (WOE). WOE approaches reported in the literature vary broadly from subjective and qualitative to quantitative. No standard approach exists and no accepted guidelines exist describing how a WOE process should be conducted. This review summarizes the advantages, limitations, and uncertainties of different WOE approaches, critical issues involved in selecting and executing different lines-ofevidence, and the process for subsequent characterization of the likelihood of impairment.     

Towards Enhancing Community Health in El-Fayoum,Egypt, Using Ecosystem Approaches

Ecosystem degradation caused by factors such as improper natural resources management and contamination with agricultural, industrial, and domestic wastes often results in the creation of an unhealthy ecosystem, a main cause for the prevailing poverty and poor health in many parts of rural Egypt. In collaboration with members of the community in some villages of El-Fayoum province, an interdisciplinary research team is currently employing an ecosystem approach to arrive at an understanding of community health problems with a view to develop resource management interventions and policies aimed at enhancing community health and well-being. Participatory rural appraisal (PRA) and knowledge, attitudes, and practices (KAP) techniques were used to measure the perceptions of the community’s men and women of their health and environmental priorities, and to test their current state of knowledge and awareness of the health-related issues. The results indicate that these perceptions were gender-sensitive and were different from those of Ministry of Health. Spatial and temporal monitoring and assessment of the ecosystem components revealed considerable land and water resources degradation. Presence of water pools and waterways in the vicinity of the residential areas enhanced the risk of water-associated diseases. Although, the disease-carrying vectors of schistosomiasis and malaria were detected in the waterways, the incidence of the two diseases was relatively low in the main village in contrast to the situation in the nearby hamlets. Prevalence of schistosomiasis was substantially higher in these hamlets (20–30% compared to 2–3% in the main village). Such a highly infected community represents a continuous pool of reinfection of the waterways, an issue that needs to be further examined to determine its relation to the hamlets’ specific ecosystem characteristics. A high incidence of hepatitis C and soil transmitted-intestinal parasites were markedly detected. It is concluded that in addition to natural resources degradation, other potential health risk factors were identified including socioeconomic, cultural, and institutional factors. Further studies are being conducted to explore these potential risk factors and their links to human health and well-being.     

Sustainability of Current Agriculture Practices, Community Perception, and Implications for Ecosystem Health: An Indian Study

In order to support agribusiness and to attain food security for ever-increasing populations, most countries in the world have embraced modern agricultural technologies. Ecological consequences of the technocentric approaches, and their sustainability and impacts on human health have, however, not received adequate attention particularly in developing countries. India is one country that has undergone a rapid transformation in the field of agriculture by adopting strategies of the Green Revolution. This article provides a comparative analysis of the effects of older and newer paradigms of agricultural practices on ecosystem and human health within the larger context of sustainability. The study was conducted in three closely situated areas where different agricultural practices were followed: (a) the head-end of a modern canal-irrigated area, (b) an adjacent dryland, and (c) an area (the ancient area) that has been provided with irrigation for some 800 years. Data were collected by in-depth interviews of individual farmers, focus-group discussions, participatory observations, and from secondary sources. The dryland, receiving limited rainfall, continues to practice diverse cropping centered to a large extent on traditional coarse cereals and uses only small amounts of chemical inputs. On the other hand, modern agriculture in the head-end emphasizes continuous cropping of rice supported by extensive and indiscriminate use of agrochemicals. Market forces have, to a significant degree, influenced the ancient area to abandon much of its early practices of organic farming and to take up aspects of modern agricultural practice. Rice cultivation in the irrigated parts has changed the local landscape and vegetation and has augmented the mosquito population, which is a potential vector for malaria, Japanese encephalitis and other diseases. Nevertheless, despite these problems, perceptions of adverse environmental effects are lowest in the heavily irrigated area.     

Health Research Funding in Mexico: The Need for a Long-Term Agenda

Background

The legal framework and funding mechanisms of the national health research system were recently reformed in Mexico. A study of the resource allocation for health research is still missing. We identified the health research areas funded by the National Council on Science and Technology (CONACYT) and examined whether research funding has been aligned to national health problems.

Methods and Findings

We collected the information to create a database of research grant projects supported through the three main Sectoral Funds managed by CONACYT between 2003 and 2010. The health-related projects were identified and classified according to their methodological approach and research objective. A correlation analysis was carried out to evaluate the association between disease-specific funding and two indicators of disease burden. From 2003 to 2010, research grant funding increased by 32% at a compound annual growth rate of 3.5%. By research objective, the budget fluctuated annually resulting in modest increments or even decrements during the period under analysis. The basic science category received the largest share of funding (29%) while the less funded category was violence and accidents (1.4%). The number of deaths (ρ = 0.51; P<0.001) and disability-adjusted life years (DALYs; ρ = 0.33; P = 0.004) were weakly correlated with the funding for health research. Considering the two indicators, poisonings and infectious and parasitic diseases were among the most overfunded conditions. In contrast, congenital anomalies, road traffic accidents, cerebrovascular disease, and chronic obstructive pulmonary disease were the most underfunded conditions.

Conclusions

Although the health research funding has grown since the creation of CONACYT sectoral funds, the financial effort is still low in comparison to other Latin American countries with similar development. Furthermore, the great diversity of the funded topics compromises the efficacy of the investment. Better mechanisms of research priority-setting are required to adjust the research portfolio to the new health panorama of Mexican population.