The rapid growth of the world economy during the last 50 years has contributed substantially to improvements in the quality of life in general. Overall life expectancy has increased and most of the world's population today live in healthier conditions than people in earlier ages. Yet this development, to cope with the increasing demands of an expanding world population, has not been achieved without the corresponding cost to the ecosystem. Global economic growth has been accompanied, inevitably it seems, by looming threats to both human health and the environment. Most of our natural resources, such as minerals and fossil fuels, are being rapidly exhausted. Of course, the non-renewable resources cannot be replaced; but even the ability of our renewable resources to regenerate is also being affected.

However, poverty is also a root cause of environmental degradation in many parts of the world. Unhygienic living conditions, poor sanitation and inadequate supply of clean water, indoor air pollution, and many types of land degradation are caused by economic stagnation, or rather by unbalanced economic growth. Here the challenge is to accelerate equitable income growth and promote access to the necessary resources and technologies.

Sustained and equitable development remains the greatest challenge facing the global community. Despite good progress over the past generation, more than one billion people still live in acute poverty and suffer from grossly inadequate access to resourc es be it education, health services, infrastructure, land or credit. The essential task of development is to provide opportunities for these people to realize their potential.

It is for this reason that we need an integral concept of development which aims at balanced development, social justice, and an improved quality of life in which health is a major policy component. We have to protect the environment and maintain a healthy and humane community. This is the thrust of our seventh five-year Development Plan. This holistic approach is the hallmark of our development efforts. Economic objectives, environmental protection and social goals must not be in conflict or undermine each other. They should be integrally linked. Thus we foster the kind of growth that is friendly to the environment rather than one which would destroy it; growth which promotes distributive justice instead of wealth accumulation by the few.

The environment has a huge influence not only on health but also productivity and growth prospects. Thus investment in cleaner environment is necessary. A two-fold strategy is required. First, the positive links between efficient income growth and the environment need to be aggressively exploited. This calls, among others, for the removal of distortionary policies that encourage the overuse of natural resources; for investment in education, agricultural extension and research, and sanitation and clean water; and for open trade and investment policies, which encourage technological innovation and transfer. Second, strong policies and institutions need to be put in place and it is also essential that trade-offs be clarified in a ra tional manner and for cost-effective policies to be designed.

The paradoxical challenge before us is to generate individual economic opportunities, as well as the national wealth necessary for economically healthy societies, while at the same time, lessening the environmental risks and social inequities that have accompanied past economic development. The challenge in achieving this sustainable development is to find ways to meet those needs without destroying the resources upon which future progress depends.

The harm done by general environmental pollution need no further commentary. Some 1.3 billion people are exposed to suspended particulate matter at levels which exceed WHO guidelines. This has been estimated to result in an excess of 300 to 700 thousand deaths per year. Biological and chemical agents in the environment contributes to the premature death of millions of people and to the disablement of hundreds of millions more every year.

Although Malaysia has enjoyed one of the least polluted urban environments in Asia, lately, however, sustained rapid economic growth has started to impose costs in terms of industrial pollution and degradation of the urban quality of life. Traffic congestion, noxious fumes and leaky waste sites are now as much part of newspaper headlines in Malaysia as in other rapidly developing countries. Unless further measures are taken, our accelerating industrialization will further strain the urban environment.

Over the past 20 years Malaysia had enjoyed considerable improvements. For example, infant mortality rates have declined and life expectancy has increased. But, prosperity, industrialisation and a faster, more demanding pace of life brings to the fore such new diseases as hypertension and coronary heart problem, diseases that worsen when the urban environment degrades due to pollution. In addition, urban pollution leads to new forms of illness, for example, high concentrations of particulate matter and sulphur dioxide in the air exacerbate respiratory dysfunctions. Lead in the atmosphere is particularly harmful to children and can affect their intellectual development. Polluted waste systems attack the digestive tract and exposure to hazardous waste increases the risk of cancer. These diseases impose substantial health costs both in terms of productivity loss due to morbidity and mortality as well as direct treatment costs.

Certain environmental issues have transborder health implications. They include the long-range transport of air pollutants, the transboundary movement of hazardous products and wastes, stratospheric ozone depletion, climatic change, ocean pollution and threats to biodiversity. There are serious environmental health problems that are shared by both developed and developing countries, affecting hundreds of millions of people who suffer from respiratory and other diseases caused or exacer bated by biological and chemical agents, including tobacco smoke, in the air, both indoors and outdoors. Hundreds of millions are also exposed to unnecessary chemical and physical hazards in their homes, workplace, or wider environment.

The problem is most acute in the developing countries where it has been estimated that approximately four million infants or children die every year from diarrhoeal diseases, largely as a result of contaminated food or water; two million people die from malaria each year and approximately 250 million are infected; and that hundreds of millions suffer from debilitating intestinal parasitic infestations.

The challenge to think globally on environmental issues, and act locally through health promotion programmes is already with us. Health promotion now provides quality of life programmes as well as social change strategies for environmental management. Responsibility for linking health and environment has been the basis of success for health promotion in the past. It is surely the way of the future.

We will have to shift our response away from short term or crises responses to initiating long term change inherent in both the new public health and sustainable development approaches. Sustainable development and public health need to be intertwined for optimal health development and to ensure a healthy economy, environment and people. Both have a future orientation and act on causes, not effects. Sustainable development thus provides a rationale for developing consistent strategies in health and in environment. There is a powerful synergy between health, environmental protection, and sustainable development. Individuals and societies who share the responsibility for achieving a healthy environment and managing their resources sustainably must become partners in ensuring that global cycles and systems remain unimpaired.

With that, I now officially declare open this International Conference on Environment and Public Health.

Thank you