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HEALTH AND POLLUTION ACTION PLAN Kyrgyz Republic May 2019 DISCLAIMERS The designations employed and the presentation of material in this project publication do not imply the expression of any opinion whatsoever on the part of the EU, the UNIDO or the USAID Secretariat concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. Designations such as “developed,” “industrialized” and “developing” are intended for statistical convenience and do not necessarily express a judgment about the state reached by a particular country or area in the development process. The mention of firm names or commercial products does not imply endorsement by EU, UNIDO and USAID. Material in this project publication may be freely quoted or reprinted, but acknowledgement is requested, together with a copy of the publication containing the quotation or reprint. © United Nations Industrial Development Organization, 2019 This publication has been funded by the European Union and the United States Agency for International Development. HEALTH AND POLLUTION ACTION PLAN Kyrgyz Republic May 2019 Completed as part of the UNIDO global project entitled Mitigating Toxic Health Exposures in Low- and Middle-Income Countries Funded by the European Union and the United States Agency for International Development I FOREWORD II III ACKNOWLEDGEMENTS The Health and Pollution Action Plan (HPAP) for the Kyrgyz Republic is the result of collaborative efforts and inputs from different stakeholders including Jogorky Kenesh of the Kyrgyz Republic, Government of the Kyrgyz Republic, different ministries and agencies, regional government and municipalities, intergovernmental organizations, international financial institutions, embassies, development agencies, academia, private sector and civil society under the facilitation of the United Nations Industrial Development Organization (UNIDO). In particular, we wish to thank Mr. Ekmat Baipakpaev, Member of the Jogorku Kenesh of the Kyrgyz Republic, and Mr. Arsen Ryspekov, Deputy Director of the State Agency for Environmental Protection and Forestry of the Kyrgyz Republic, for their crucial support. Furthermore, we wish to express our appreciation for the valuable contributions provided by Institute for Preventive Medicine under the Ministry of Health, the Department of Disease Prevention and State Sanitary and Epidemiological Surveillance under the Ministry of Health, Kyrgyz Hydromet under the Ministry of Emergency Situations, Bishkek Mayor’s Office, Regional Government of Issyk-Kul Oblast, Issyk-Kul Laboratory under the State Agency for Environmental Protection and Forestry under the Government of the Kyrgyz Republic, the FinWaterWEI II Project in the Kyrgyz Republic, and the NGO “Move Green”. We also thank the European Union and the United States Agency for International Development for providing the financial support. Graphic design: Adelaida Contreras IV TABLE OF CONTENTS Forword I III Acknowledgements IV Table of content VI List of tables and figures VII Abbreviations Introduction 1 Pollution and Health 1 Health and environment framework in the Kyrgyz Republic 4 Health and Pollution Action Planning (HPAP) Process in the Kyrgyz Republic: 8 Activities and Timeline Summary of health impacts from major pollution challenges 12 Pollution impacts data from IHME 2016 GBD Study 12 Pollution impacts provided from available national data 17 Economic costs of pollution in the Kyrgyz Republic 27 Summary of Key Strategic Documents Relevant to Air Pollution in Bishkek 28 and Water Pollution in Issyk-Kul Oblast Development Program of the Kyrgyz Republic for the Period 2018-2022: “Unity, 29 Trust, Creation” National Development Strategy of the Kyrgyz Republic for 2018-2040 30 Action Plan of the SAEPF under the GKR on Ecological Improvement in Bishkek 33 for 2018-2022 The Issyk-Kul Ecological and Economic Sustainable Development Concept until 33 2020 V TABLE OF CONTENTS (CONT.) Ongoing projects relevant to health and pollution in the Kyrgyz Republic 35 Project Proposals 39 Reducing harmful pollutants from transport in Bishkek 39 Upgrading water quality monitoring of Lake Issyk-Kul 52 Annex 1: Contact list 65 Annex 2: About The Global Alliance on Health and Pollution 70 Origin and Design of the HPAP Program 70 Annex 3: Global Burden of Disease Data 73 VI LIST OF TABLES AND FIGURES List of Tables List of Figures Table 1: Participation of 3 Figure 1. Percentage of all 2 Table 8. Data on the 21 the Kyrgyz Republic in deaths in 2015 that were incidence of selected international conventions caused by pollution diseases among adults related to the environment, and adolescents, Bishkek Figure 2. Percentage of 13 pollution and health (by (patients registered for annual deaths attributable year of adoption) the first time in their lives, to communicable and non- Table 2: Key national 6 adults and adolescents) communicable diseases environmental legislation (1990-2016) Table 9. Data on quality 23 of the Kyrgyz Republic (by of drinking water in water Figure 3. Percentage 14 year passed) distribution networks and of total annual Table 3: Timetable of 10 open water sources by DALYs attributable to HPAP process in the Kyrgyz physical, chemical and communicable and non- Republic microbiological indicators communicable diseases in the Kyrgyz Republic for (1990-2016) Table 4. Summary of 16 2017 annual deaths from Figure 4. Percentage 15 Pollution in Kyrgyz Table 10. Data on the 24 of all annual deaths in Republic incidence of selected Kyrgyz Republic caused by diseases in the Issyk-Kul leading risk factors Table 5. Maximum 18 region (Registered patients Figure 5. Percentage of 15 Allowable Concentrations for the first time in their annual deaths attributable (MACs) for various lives, children under 14 to pollution vs. HIV/AIDS, atmospheric air pollutants years old) in the Kyrgyz Republic Malaria and Tuberculosis (mg/m3) Table 11. Data on the 25 (combined) incidence of selected Table 6. Number of days 18 diseases in adults and during which MACadc and adolescents, Issyk-Kul MACmsc were exceeded region (Patients registered in Bishkek per month for the first time in (2017) their lives, adults and Table 7. Data on the 19 adolescents) incidence of selected Table 12. Ongoing 36 diseases in children, projects relevant to health Bishkek (Patients and pollution in the registered for the first Kyrgyz Republic (as of 15 time in their lives, children November 2018) under 14) VII ABBREVIATIONS ADB Asian Development Bank ALRI Acute Lower Respiratory Illness APMP Ambient Particulate Matter Pollution CD Communicable Diseases CFU Colony Forming Units CO2 Carbon Dioxide COPD Chronic Obstructive Pulmonary Disease DALY Disability Adjusted Life Year DDPSSES Department for Disease Prevention and State Sanitary and Epidemiological Surveillance of the Ministry of Health DFID Department for International Development of the United Kingdom EBRD European Bank for Reconstruction and Development EIA Environmental Impact Assessment EIB European Investment Bank EU European Union EUR Euro GAHP Global Alliance on Health and Pollution GBD Global Burden of Disease GDP Gross Domestic Product GNI Gross National Income GSDR Global Sustainable Development Report HAP Household Air Pollution HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome HPAP Health and Pollution Action Plan IFCA Investment Facility for Central Asia IHD Ischemic Heart Disease IHME Institute for Health Metrics and Evaluation KR Kyrgyz Republic GKR Government of the Kyrgyz Republic ILO International Labour Organization VIII LIMS Laboratory Information Management System LMO Living Modified Organisms MAC Maximum Allowable Concentration MACaac Maximum average annual concentration MACadc Maximum average daily concentration MACmsc Maximum single concentration MES KR Ministry of Emergency Situations of the Kyrgyz Republic MW Megawatt NCD Non-Communicable Diseases NEHAP National Environmental Health Action Plan NGO Non-Governmental Organization NOx Nitrogen Oxides OECD Organization for Economic Co-operation and Development PM Particulate Matter SAEPF State Agency for Environmental Protection and Forestry SDGs Sustainable Development Goals SECO State Secretariat for Economic Affairs of Switzerland SER State Environmental Review SSF Shareholder’s Special Fund UN United Nations UNDP United Nations Development Programme UNDP-SIWI Stockholm International Water Institute UNECE United Nations Economic Commission for Europe UNEP United Nations Environment Programme UNICEF United Nations Children’s Fund UNIDO United Nations Industrial Development Organization USD United States Dollar VOC Volatile Organic Compound WHO World Health Organization 1 INTRODUCTION INTRODUCTION POLLUTION AND HEALTH The impacts of pollution on health have always been recognized, although the size of the impacts has consistently been underestimated. A recent report by the Lancet Commission on Pollution and Health1 rectifies this erroneous impression and quantifies pollution’s impacts on human health. The Commission finds that pollution is now one of the biggest drivers of death and disease in the world, causing 16% of all deaths globally. The overwhelming majority of the disease burden from pollution (92%) falls on people in low- and middle-income countries. Pollution’s impacts are felt most acutely by communities that are poorly equipped to address the problem and recover from its impacts. Pollution has severe implications for sustainable development, exacerbates
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