1. International Conference on Sustainable Development Beijing, March 2, 2007 Summary and Recommendations Teresa Serra The World Bank

2. Health Impacts of Air Pollution Mostly an urban problem, but expanding in small cities and townships Exposure to suspended particles (PM10) of key concern Burden of premature mortality and morbidity estimated at about 1.2- 3.8% of GDP –methodology has been “localized” –based on Chinese exposure-response functions –computed for 660 individual cities (including small and medium-sized)

3. Health Impacts of Water Pollution 1/3 of the rural population lack piped water Clear association with the incidence of diarrhea in children under 5 Exposure to heavy metals associated with incidence of cancers Burden of disease and premature death is estimated at 1.9% of GDP Lack of better data on chronic exposure and disease incidence restrict further assessment

4. Health Impacts Differ Across regions –Northern China bears a double burden Highest per capita exposure to air pollution Most severely polluted water basins (aggravating chronic water scarcity problems) Across income groups –The poor are disproportionately affected Poor provinces are more affected by air pollution on per capita basis 1/3 of households in lower income quartile rely primarily on surface water (more vulnerable to pollution) and present higher prevalence of diarrhea

5. Non-Health Impacts of Air and Water Pollution Water pollution reduces effective availability of water, chronic problem especially for the North –puts pressure on groundwater resources –increases future costs of extraction, risks of seawater intrusion, and land subsidence Other non-health impacts of water pollution include –crop loss due to wastewater irrigation –fishery loss –material damage These impacts cost China about 195 billion RMB annually (about 1.3% of GDP)

6. Aggregate Impacts on GDP Total cost of air and water pollution to the Chinese economy in 2003: –2.7% using adjusted human capital approach –5.8% using value of a statistical life approach Interventions to reduce pollution are likely to yield positive net benefits

7. Policy Interventions (1) Setting priorities based on economic analysis –ECM can be used to evaluate the benefits of specific pollution control policies and select cost-effective interventions Targeting high-risk areas and groups –focus on North China is essential, given double burden from air and water pollution + significant income disparities –investment in increasing access to safe water to poor is likely to have high pay-off

8. Policy Interventions (2) Responding to people’s concerns –reducing environmental health risks is not seen as a luxury good that can wait by people in China –both high and low-income urban populations are willing to pay for a clean environment –disclosure of information, awareness-raising and willingness-to-pay reinforce each other Addressing the information/knowledge gap –data on pollution levels, health and non-health impacts, and associated economic costs has improved –but more is needed to support informed decision making –enhance sharing of multi-sectoral data and conducting joint analyses

9. Policy Interventions (3) Developing an environmental health action plan –SEPA and MOH are already working jointly –coordination across other sectors will also be essential –priority should take into account mortality and morbidity impacts –focus on high risk geographical areas –target the poor (least able to cope)

10. Xie Xie! SEPA and partners –Ministry of Water Resources Resources –Ministry of Health –Center for Disease Control –Ministry of Agriculture Donors –Governments of Norway and Finland Peer reviewers –Tsinghua University –Harvard University –World Bank Researchers –China Academy for Environmental Planning –Policy Research Center for Environment and Economy –Medical College of Peking University –China National Monitoring Center –Fudan University –Chongqing Academy of Environmental Sciences –ECON –CICERO –Resources For the Future –Independent consultants