Today, PAI—together with the Sierra Club and Rep. Barbara Lee (D-Calif.)—hosted  a Congressional briefing on integrated population, health and environment (PHE) programs. The briefing featured the work of partners Deepa Pullanikkatil of Leadership for Environment and Development (LEAD) in Malawi and Doreen Othero of the Lake Victoria Basin Commission.  

LEAD works on climate change adaptation in Malawi, to protect fragile ecosystems such as the Lake Chilwa Basin, and improve the livelihoods of 1.6 million people that live there. The Lake Victoria Basin Commission works with the East African Community (Burundi, Kenya, Tanzania, Rwanda, and Uganda) to promote and coordinate sustainable development activities in the Lake Victoria Basin, which has a population of 50 million.

Despite their packed schedules, Doreen and Deepa were kind enough to sit down and tell us a little more about PHE, the work that they do, and why it’s critical for a sustainable future.


Doreen Othero, Lake Victoria Basin Commission

Q. What does PHE mean to you?

Doreen: PHE to me is an integrated approach to sustainable development. It is an approach that integrates sectors dealing with population, health and environmental conservation issues. The ultimate goal for integrating these sectors is to achieve synergistic successes—successes that would not be achieved with traditional, one-sector approaches. Services such as family planning, maternal health, child health, nutrition, and sexual  and reproductive health, are provided to communities alongside environmental conservation services (reforestation, safe water and sanitation, safe energy). Ultimately, this should lead to improved livelihoods in beneficiary communities.

Deepa: For me, PHE is a holistic approach using a “systems” thinking to integrate population, health, and environment. LEAD has been implementing environment (E) projects, and we’ve heard from communities that there is a need for H (health) and P (population) to be integrated into those projects, in order to make the E projects more effective. Otherwise, we’ll continue chasing our E indicators, but not achieving them, because we’ve missed out on the P and the H.

Q. How does PHE promote sustainable development?

Doreen: Sustainable development to us means utilizing the resources we have today in a way that future generations will be able to use the same resources. When we define sustainable development from that perspective, we are compelled to ensure there is no overexploitation of the available resources in the basin, because future generations must also use the same resources. Most of the environmental degradation we are seeing in the Lake Victoria Basin is a result of human activity. The population has outnumbered the resources. It is very important that we get into PHE as a means of achieving sustainable development. We must check the population, but at the same time, improve the quality of the population that we have, so that people are more independent as opposed to being dependent on natural resources and exploiting them.

Deepa Pullanikattil, LEAD Malawi

Deepa Pullanikkatil, LEAD Malawi

Deepa: The motto of LEAD is “inspiring leadership for a sustainable world.” When it comes to sustainable development in Malawi, the greatest challenge is climate change. We ourselves have experienced the direct impacts of climate change – the drying of Lake Chilwa in the recent past, increasing dry spells affecting agriculture, changing rainfall patterns. It is not only a global phenomenon: we are experiencing it. With climate change comes challenges such as disease outbreaks, which affect health. And when we work with communities, we find that women are more vulnerable. In order for them to be more resilient to the impacts of climate change and participate in climate change adaptation activities, they need family planning and reproductive health services. So that is how the population angle comes in. For us, the P, H, and E together help us achieve our goals.

Q. Today, you were both on Capitol Hill talking to policymakers. What is the most important message you want them to take away about PHE?

Doreen: My most important message for policymakers—and this I have told them over and again, I have even told the presidents of the East African Community—is that PHE makes sense. It promotes efficient utilization of the scare resources that we have. It helps people to really understand the interlinkages and interrelationships between the different domains—how a change in environment will affect health, and how a change in health status will affect the environment—and  the need to address these needs together and simultaneously. PHE empowers women, empowers men, and empowers youth. It empowers women to participate meaningfully in environmental conservation, it empowers men to participate meaningfully in family planning, sexual and reproductive health (which as traditionally not been the case), and it empowers youth to engage in income generation activities. PHE really makes sense.

Deepa: Communities live integrated lives, so development should also be integrated—not in silos and sectors. If we continue development using the sectoral approach, it’s a huge missed opportunity for synergistic successes. Using an integrated approach is more value for money. That’s the message I want to get across.