International Course on Health and the Environment

This course is an initiative of the Portuguese Council for Health and Environment in partnership with the NOVA National School of Public Health aiming to increase awareness about the impact of environmental determinants on public health, and the most effective mitigation and adaptation measures, to make health systems resilient to these changes.

Our objective is to enable all health professionals, from students to decisionmakers, at a world level, to become more involved and to lead the common effort to ensure a future with a healthier and sustainable environment for healthcare services and its professionals contributing to reducing their impact.

 

On July 28, 2022, the United Nations decreed a new right, the right to a clean, healthy, and sustainable environment, however, we know, that it no longer exists. We have grown from one billion people to eight billion in 220 years and, since 1970, we have exceeded the planet's capacity to regenerate. Nine out of ten children, globally, breathe air that exceeds the pollution limits established by the World Health Organization. The planet has already suffered a temperature increase of 1.2º C and 2023 was the hottest year ever recorded. In Canada, also in 2023, an area of forests equivalent to 17 million football fields has already burned. In Libya, 11,300 people died from floods. Currently, there are already 55 million people affected by drought and it is estimated that 75% of the world's population could be affected by 2050. On average, 150 species become extinct daily, and one million species are at risk of extinction. If current policies do not change, the forecast is that the planet's temperature will increase by 2.7º C in 2100. This is not catastrophism, it is reality, aggravated by the fact that we may already be surpassing points of no return, capable of causing a cascade of events, unpredictable and irreversible.

 

Warming is caused by the growing levels of greenhouse gas emissions: from 1970 to 2020 the emission of greenhouse gases doubled. Under the Paris Agreement, it is necessary to reduce greenhouse gas emissions by approximately 50% by 2030, relative to 2010 levels, to limit the increase in global temperature to 1.5°C above the pre-industrial levels. On the other hand, it is known that the health sector is responsible for 4.4% of greenhouse gas emissions and must increase its resilience to face the current epidemiological transition and the greater risk of unexpected events.

 

The UN Secretary-General, António Guterres, said: “The era of global warming is over, we have entered the era of global ebullition”. Pope Francisco declared in the Apostolic Exhortation LAUDATE DEUM, on October 4th: “This world that welcomes us is falling apart and perhaps approaching a breaking point”. We live in the Anthropocene era, in which human action has an impact on the planet that can become uncontrollable.

 

Its consequences are already having a significant impact on people's health, with environmental factors being responsible for a quarter of the global mortality.  Cardio and cerebrovascular diseases, diarrhea, respiratory infections, asthma, chronic obstructive pulmonary disease, and cancer are the most impacted diseases by these changes. It is estimated that more than five million deaths can be attributed to extreme temperatures. Diseases related to water quality and food safety are on the rise. The degradation of the environment and ecosystems is increasing migratory movements, conflicts, and mental illnesses. The increasingly frequent occurrence of cyclones, floods, droughts, and fires is the cause of many victims. The ecology of vector-borne diseases is also changing and the trend towards reducing the prevalence of these diseases, which we were achieving, is likely to reverse. Currently, these diseases, which include Malaria, Dengue, Zika, West Nile Virus infections, and Chikungunya, are already responsible for the deaths of around 800,000 people annually, globally. The risk of pandemics caused by zoonoses (diseases that animals transmit), which are responsible for almost 100% of pandemics, is increasing.

 

Health professionals, like all other citizens, do not have the right to compromise the future of the next generations, which are the generations of our children and grandchildren. In addition to being caregivers, we are also advocates for patients and enjoy a high level of trust from the public that we cannot discard. We have an ethical obligation to fight against climate change and environmental degradation. This includes advocating the adoption of measures that reduce greenhouse gas (GHG) emissions and environmental emissions, bringing together key health-related organizations to jointly intervene on the issues of climate change, environmental emissions, and their impact on health, identify and publish sustainable practices, promote awareness, education and research in this area, advocate the need for the health sector to reduce its ecological footprint and help the health system to be more resilient to the current epidemiological transition and the increased risk of unexpected events.

 

Despite the extreme importance of these topics, they have not yet been introduced into the pre- and post-graduate training of health professionals, in most countries. This course will introduce these themes to address this lack of awareness.

 

THE NOVA NATIONAL SCHOOL OF PUBLIC HEALTH

 

The Universidade NOVA de Lisboa (UNL, Portugal) is a public higher education whose mission is to serve the society at the local, regional and global level, through the progress and dissemination of knowledge and understanding between cultures, societies and people, through excellency in R&I, education and provision of services based on a strong sense of community, and consistently features in the top rankings of universities founded less than 50 years ago (e.g. QS World Ranking). UNL is a part of EUTOPIA European University. It has more than 20.000 students, and 2300 academic and research staff. It hosts 40 R&I Units of Excellence (54,5M in Horizon Funding, 20 ERC Grants, 28,7% research income).

More information in: https://www.unl.pt/en/nova/mission-and-strategic-plan

 

The NOVA National School of Public Health (NOVA NSPH) is dedicated to education, research, and the provision of services to the community in the field of public health, conducting high-quality research with national and international relevance, of multidisciplinary nature, in health promotion and health inequalities, socio-behavioural sciences, occupational and environmental health, health management and economics, epidemiology and statistics, innovation, and public policies. In the last 3 years, NOVA NSPH has received 5M€ from international competitive funding (total: 437M€ over 18 projects). In 2022, NSPH-UNL joined three new European consortia (Horizon), with a total funding of 412M€. It is one of the Management Units of the interinstitutional R&I excellence centre - Comprehensive Health Research Centre (CHRC), whose mission is to advance R&I, and training in health promotion, prevention and chronic disease management, efficiency of healthcare services, and digital innovation.

The NOVA NSPH develops research of quality and excellence with national and international relevance. The School leads and participates in competitive research projects, in a research culture guided by current and future challenges in public health, with focus on innovation and social impact. The production of evidence at the service of improving the health and well-being of populations and strengthening health systems is a distinctive feature of the School, with the priority being to translate evidence into adapted and replicable solutions in different contexts.

More information in: https://www.ensp.unl.pt/school/presentation/

 

 

THE PORTUGUESE COUNCIL FOR HEALTH AND ENVIRONMENT

The Portuguese Council for Health and Environment (CPSA) was born in October 2022, as an initiative of medical doctors, motivated by the conviction that, in addition to being caregivers, medical doctors, and health professionals, in general, must also be advocates for patients. When we know that currently one in four people, globally, die due to environmental factors, it is our ethical obligation to get involved in the fight against climate change and environmental degradation. Furthermore, we cannot deny the next generations, which are the generations of our children and grandchildren, the right to a clean, healthy, and sustainable environment.

Our objectives are to give a common voice to health organizations to intervene jointly on issues related to health and the environment; to contribute to reducing the ecological footprint of the healthcare sector; to identify, publish, and implement good environmental sustainability practices in the various sectors of activity; to promote awareness among citizens and health professionals and their training; to enable the health system to respond to the epidemiological transition induced by climate change and environmental degradation and to unexpected public health events; and to encourage research in these areas.

The CPSA has already been joined by 74 of the most important health organizations, currently being the most transversal alliance in the health sector area.

More information in: https://cpsa.pt/apresentacao/

 

 

Target Audience

Human health professionals, animal health professionals and students, including doctors, veterinarians, pharmacists, dentists, psychologists, nutritionists, health technicians, nurses, managers, and all other health-related professionals.

 

Objectives

At the end of the course, participants will be able to:

• Identify the main environmental determinants of global health
• Identify and characterize the severity of climate change, biodiversity loss, pollution, overpopulation and depletion of natural resources
• Learn how to mitigate and adapt to these changes
• Recognize the ecological footprint oh the health sector and how to reduce it
• Understand how health systems can increase their resilience to respond to the actual epidemiological transition and the increased risk of unexpected events
• Know how health professionals can act to promote mitigation and adaption measures to climate change and environmental risk factors

 

 

 

Methodology

 

Online course with 12 sessions on Tuesdays of one hour and a half. Each session will have three (20 min.), or four (15 min.) lectures, followed by interactive discussion (30 min.). All sessions will be recorded and available to the participants on our Moodle platform. The recorded sessions will have Portuguese and Spanish subtitles. There will be a 13^th session for those who want to undergo the evaluation.

 

Program

Module 1

Environmental changes and their impact on health

Session 1 - April 2

Environmental Determinants of Health

Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

Introduction

Luís Campos (CPSA) /João Queiroz e Melo (CPSA)/Susana Viegas (NOVA NSPH)

Climate change
Filipe Duarte Santos (CNADS)

Biodiversity loss and degradation of ecosystems
Francisco Ferreira (FCT-NOVA)

Depletion of natural resources
Carlos Alexandre (UE)

 

Session 2  - April 9

Health impact of environmental changes: infectious diseases

Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

Water-related diseases 
Kamal Mansinho (CHLO)

Food-related diseases
Ricardo Assunção (EMSHS)

Zoonoses
Kamal Mansinho (CHLO)

Vector-borne diseases
Henrique Silveira (IHMT-NOVA)

 

Session 3 - April 16

Health impact of environmental changes: air and chemical pollution
Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

Air pollution 
Pedro Martins (NMS)

Chemical pollution and health impact
Susana Viegas (NOVA NSPH)

Microplastics 
Joana Correia Prata (UA)

 

Session 4  - April 23

Health impact of environmental changes: climate catastrophes

Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

Wildfires
António Jorge Ferreira (FMUC)

Droughts
Susana Viegas (NOVA NSPH)

Heat strokes
Paulo Nogueira (FML)

 

Session 5  - April 30

Health impact of environmental changes: organ and systemic diseases

Moderators: Luís Campos (CPSA)/João Queiroz e Melo (CPSA)

 

Cardio  and cerebrovascular diseases
Daniel Caldeira (SPC)

Cancer
Mário Fontes e Sousa (CHLO-CUF)

Maternal and Child diseases
Rute Neves (SPP)

Mental Diseases
José Palma Oliveira (FPUL)

 

Module 2

Mitigation and adaptation strategies, the ecological footprint of the health sector, and the health professionals' responsibility

 

Session 6 - May 7

Mitigation and adaptation strategies

Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

Overview
Joana Portugal Pereira (COPPE/UFRJ)

The role of the circular economy
Sofia Santos (ISEG)

The role of the law
Paulo Magalhães (FDUP)

 

Session 7 - May 14

The ecological footprint of the health sector: specific areas I

Moderators: Luís Campos (CPSA) / Marilia Silva Paulo (NOVA NSPH)

 

Causes of the ecological footprint of health: Overview
Luís Campos (CPSA)

Electricity, Gas, heat and cooling
Nuno Jorge (CHLN)

Building, transport, computers, electronic and optical equipment
José Chen (NOVA NSPH)

Food
José Lima Santos

 

Session 8 - May 21

The ecological footprint of the health sector: specific areas II

Moderators: Luís Campos (CPSA) / Marilia Silva Paulo (NOVA NSPH)

 

Operating theatre and anesthetic gases
Tiago Fernandes (SPA)

Haemodialysis
Ivo Laranjinha (SPN)

Clinical Pathology Laboratories
Maria José Sousa (SPPL)

 

Session 9 - May 28

The ecological footprint of the health sector: specific areas III

Moderators: Luís Campos (CPSA)/ João Queiroz e Melo (CPSA)

 

Waste management
Paulo Sousa (SUCH)
Pharmaceutical care process
Helder Mota Filipe (OF)
Medical devices, rubber, and plastic products
João Queiroz e Melo (CPSA)

 

Session 10 - June 4

Good environmental sustainability practices in healthcare organizations

Moderators: Luís Campos (CPSA) /  João Queiroz e Melo (CPSA)

 

Novo Nordisk
Paula Barriga (Novo Nordisk)
Association of Distributors of the Pharmaceutical Industry
Nuno Flora (ADIFA)
CUF Saúde
Catarina Gouveia (CUF)

 

Session 11 - June 11

How to increase the resilience of the health system?

Moderators: Luís Campos (CPSA) /  João Queiroz e Melo (CPSA)

 

Global approach and the role of the professionals
Luís Campos (CPSA)
Preparing for the epidemiological change of pathologies and climate catastrophes
Mine Durusu (EFIM)
The role of Telemedicine and Digital Technology
Micaela Monteiro (CUF)

 

Session 12 - June 18

Health and Environment at the International Level

Moderators: Luís Campos (CPSA) / Susana Viegas (NOVA NSPH)

 

NHS
Nicky Philpott (NHS)
European Climate and Health Observatory 
Eline Vanuytrecht
WHO
Maria Neira (WHO)

Closing of the course
Luis Campos (CPSA) / João Queiroz e Melo (CPSA) / Susana Viegas (NOVA NSPH) /  Marília Silva Paulo (NOVA NSPH)

 

Session 13 - June 25

Evaluation

 

 

 

 

 

Course Coordinators

                     
João Queiroz e Melo                 Luis Campos                  Marília Silva Paulo                      Susana Viegas

(CPSA)                                   (CPSA)                              (NOVA NSPH)                               (NOVA NSPH)

 

 

Lecturers

António Jorge Ferreira (FMUC)	Carlos Alexandre (UE)	Daniel Caldeira (SPC)
Eline Vanuytrecht	Francisco Ferreira (FCT-NOVA)	Filipe Duarte Santos (CNADS)
Helder Mota Filipe (OF)	Henrique Silveira (IHMT-NOVA)	Ivo Laranjinha (SPN)
Joana Correia Prata (UA)	Joana Portugal Pereira (COPPE/UFRJ, IST/ULisboa)	José Chen (NOVA NSPH)
José Palma Oliveira (FPUL)	Kamal Mansinho (CHLO)	Maria José Sousa (SPPL)
Maria Neira (WHO)	Mário Fontes e Sousa (CHLO- CUF)	Micaela Monteiro (CUF)
Mine Durusu (EFIM)	Nicky Philpott (NHS)	Nuno Jorge (CHLN)
Paulo Magalhães (CIJ-FDUP)	Paulo Nogueira (FML)	Paulo Sousa (SUCH)
Pedro Martins (NMS)	Ricardo Assunção (EMSHS)	Rute Neves (SPP)
Sofia Santos (ISEG)	Tiago Fernandes (SPA)	Christopher Millett (NOVA NSPH)

Lecturers biographies and c.v.’s availabe at www.cpsa.pt

 

 

Supporting partnerships

Associação Médica de Língua Portuguesa de Macau (Macau)

European Federation of Internal Medicine (EUS)

Foro Internacional de Medicina Interna (Latin-America)

Hospital Medicine Society (US)

Ordem dos Médicos de Angola  (Angola)

Ordem dos Médicos de Cabo Verde  (Cape Verde)

Ordem dos Médicos de Moçambique (Mozambique)

Sociedad Peruana de Medicina Interna (Peru)

Sociedade Brasileira de Clínica Médica (Brazil)

Sociedad Peruana de Medicina Interna

 

 

 

Calendar

From April 2 to June 18, 2024

 

Sessions Schedule

Sessions will be on Tuesday from 5 PM to 6:30 PM (UCT+1 – Lisbon time).

 

Registration

From Feb 19th to March 31th, 2024

 

Fees

The fee to attend the course will be 160 EUR (170 USD).

This fee will be reduced to 80 EUR (85 USD) for the following participants: students, members of the Portuguese Council for Health and Environment associates (https://cpsa.pt/associados), members of international partners, and participants from specific regions and countries: Latin America, and the Caribbean countries, African countries, Asian countries (except China, Japan, South Korea, and Taiwan).

 

certificates

A certificate of attendance will be issued to those participants who attended more than 80% of the sessions. This course will also be credited with three ECTS to those who want to perform a final evaluation.