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While the year 2024 is going to be a grand electoral year in the history of modern liberal democracy, the risks that democracy could witness grave tremors are getting higher.

The tech and AI mastery of the high tech superpowers—China and the US—is not only contributing to tech bipolarity, economic rivalry, and geopolitical tensions, but also in democratic antagonism. They are exploiting technology and digital capabilities to contain or dictate each other and are involved in ‘techno-geopolitics’, while the big tech and social media are engaged in ‘disinformation’ and ‘data colonialism’. 

Democracy is in danger not only because of authoritarian rulers, or ethnic (muscular) nationalism, or the risk of disinformation, or influence of AI, but also due to general voters. The voters’ rational behavior/decision could play a significant role in preserving the essence and affluence of liberal democracy as every elector is responsible in making democracy sparkling and functional.

Kathmandu has always struggled to manage its waste. Hopes were pinned on the city mayor Balen Shah’s plans to segregate waste at source. But around 200 vehicles still dump garbage at Banchare Danda every day. Much of the collected waste—around 1,200 tons daily—ends up in the landfill. Those who work in waste management say Banchare Danda is fated to go the Sisdol way. What we now have is only a temporary respite to the city’s trash problems as the focus continues to be on dumping. 

However, experts say this could change if Nepalis become conscious of what they throw and how. Kiran Shrestha of Action Waste Pvt. Ltd. says the weight and bulk of trash have been steadily increasing as Nepalis toss things that needn’t be thrown away. Clothes, books, utensils, and electronics, among other things, are regular items in the trash Action Waste collects from its designated areas of Anamnagar and Seto Pul in Kathmandu.

On the surface, many people seem to have adopted eco-friendly lifestyles. Millennials increasingly favor brands that promote sustainability. Though the market for eco-friendly products is yet to become mainstream, there is no dearth of businesses that promote sustainability. Unfortunately, most consumers are buying and thus throwing more stuff as they try to switch to greener alternatives.

A passing trend 

“Sustainability has become a passing trend in Nepal and that’s worsening our trash problem,” says Anjana Malla, founder of Deego Nepal, a brand that provides eco-friendly alternatives for daily use items. Malla says there’s a lack of slow and responsible consumption. People easily tire of what they have and they want something new, even though old items work perfectly well. 

“If you are throwing away, say, a water bottle just because it’s made of plastic and getting a glass one in its place, you are creating more waste. That isn’t the principle of sustainability. That’s not being eco-friendly,” she says. What you can and should do is use what you have for as long as you can and then invest in eco-friendly options when you have to replace something. 

But that is not what is happening. Rupak Parajuli, the owner of Hempko, a business that provides sustainable and eco-friendly products, says there are very few conscious consumers. Most buy things on a whim. He believes this mindset, where the emphasis isn’t on the durability of a product but rather on its attractiveness, is the reason behind the increasing volume of waste.

It’s not unusual for people to have multiples of everything. We buy things as they look attractive or they are cheap. Most of these items often sit unused in forgotten corners of our homes. The products expire or the novelty wears off and we get rid of them. Parajuli says we are driven by materialistic aspirations. The more you have, the more you want, and the more you eventually throw away. 

Intention-action gap 

“We blame the government for our inefficient waste disposal system but we must first look at our own problematic behavior,” says Parajuli. We look for an easy way out, choosing to replace something rather than repair it. We want newer models of items that we already have. It doesn’t help that the market is saturated with products of all kinds. Parajuli adds that people are aware of the importance of leading a sustainable lifestyle and the intent is there too but there is a gap between intention and action. 

Nitesh Sharma, founder of Dhaaso, an upcycling company, says people like the idea of being eco-friendly and sustainable. But they also prefer the fine finish of factory-made products and the convenience of disposable items. Dhaaso was launched eight years ago and Sharma laments that it is still difficult to educate people about the need to upcycle to keep something from being sent to the landfill. 

“Our customers know Dhaaso upcycles and that our products are made from discarded materials. It can never be as good as mass-manufactured products. But we’ve still had five order cancellations in the past week,” says Sharma, adding that there’s a disconnect between ideals and aspirations. 

As Nepal imports most things, fixing them is sometimes impossible. The required parts aren’t easily available. This also contributes to a lot of waste. At the moment, there is enough scrap in Kathmandu junkyards to last 20 to 30 years, says Sharma. Buying locally made products could change this but people tend to prefer either branded goods or cheap Chinese knockoffs. 

Kushal Acchami of Samsara Creation says we need a comprehensive approach to waste management, one that highlights the necessity of reusing what we have to serve different purposes. Manu Karki, founder of Eco Sathi Nepal, says people aren’t being creative with household items which is why every slightly damaged piece makes its way to the dumpster. 

“You can use a chipped ceramic jug or a mug as a planter. You can repurpose an old bottle into a vase. You can turn bits of fabric into pot holders,” she says. But people either don’t have the time or don’t want to put in the extra effort. “The result is a use-and-throw culture that doesn’t align with the principles of sustainability,” adds Acchami. 

The way out 

Nepal lacks the resources for large-scale recycling. There are some companies, like Doko Recyclers and Khalisisi, that provide recycling facilities but they don’t handle large volumes of waste. Raghavendra Nahto, co-founder of Doko Recyclers, says his company handles less than a percent of the waste Kathmandu generates daily. In the past five years, says Mahto, little has changed in the way Kathmandu manages its waste. 

Reducing waste at source is the only way to tackle the growing problem of waste management, he says. He believes we need a national-level campaign to make people aware of the implications of their wasteful behavior. Parajuli, on the other hand, thinks programs in schools and colleges on the importance of being eco-friendly can bring slow change in the way we shop. “We need to have more conversations on sustainability and how we can incorporate it into our current lifestyle. We need a movement,” he says. 

Three basic ways to embrace sustainability 

1. Use what you have 

According to Karki of Eco Sathi Nepal, many people think being eco-friendly means not using plastic. So, they get rid of plastic bottles and containers. The basic principle of sustainability is to prolong the life of what you have. Plastic, she adds, isn’t the villain here. Our mentality that we must get rid of them anyhow is the problem. 

Giving away what you don’t need instead of putting it in the dustbin can also help, says Malla of Deego Nepal. “We can donate the things we don’t need if they are in good condition. After all, one man’s trash could be another man’s treasure,” she says.  

2. Don’t buy single-use items

Disposable cups, water bottles, plates, and straws are all very convenient to use but they create a lot of waste. Malla says people these days use disposable plates and cutlery even when hosting parties at home. Restaurants too are wasteful. Most of them have tie-ups with various water bottling companies and serve mineral water instead of regular tap water. It generates a lot of unnecessary plastic waste at the end of the day. “Individuals and businesses both need to be mindful of this. Unfortunately, most businesses are purely commercial and not very ethical,” she says. 

3. Be a conscious consumer  

Before buying anything, ask yourself if you need it. Oftentimes, we buy stuff as we are bored or they look appealing. But a new notebook isn’t going to change your life. Neither is a new bag going to significantly uplift your ensemble. So, consider your purchases. When you inevitably have to replace something, look for eco-friendly alternatives. 

“Shopping local is one of the ways in which people can embrace sustainability. When you buy products that are made in Nepal you are already reducing your carbon footprint,” says Parajuli of Hempko.

The tobacco epidemic stands as one of the most significant public health challenges the world is confronting. Annually, tobacco claims the lives of over 8m individuals, with approximately 1.2m of these fatalities attributed to second-hand smoke exposure.

In the haze of discussions surrounding the health risks of tobacco use, the environmental toll of this pervasive habit often goes unnoticed. As the global population grapples with the consequences of tobacco consumption, a shadow looms over the very Earth we inhabit. This article seeks to unveil the intricate web of environmental challenges woven by the tobacco industry and its implications for our planet.

The tobacco production cycle exhibits a notably destructive impact. From cultivation and manufacturing to consumption, tobacco inflicts widespread environmental degradation and health hazards. 

Deforestation and agriculture

One of the least acknowledged impacts of tobacco use lies in the vast swathes of land cleared for cultivation. Each year, around 600m trees are felled to produce 6trn cigarettes. Approximately five percent of the annual global deforestation is attributed to tobacco farming. This deforestation significantly amplifies carbon dioxide emissions in the environment, contributing to adverse climate change impacts. Deforestation to make way for tobacco crops eradicates biodiversity and disrupts delicate ecosystems. The use of chemical fertilizers and pesticides further compounds the environmental toll, leaving a lasting mark on the lands where tobacco takes root. The cultivation of tobacco plants necessitates substantial quantities of chemicals, many of which prove detrimental to the environment and farmers' health. This exposure to harmful substances can lead to various illnesses, such as respiratory problems, skin disorders and neurological issues among those involved in tobacco farming.

Water scarcity and pollution

The cultivation of tobacco places an extraordinary burden on water resources, intensifying water scarcity in regions where it thrives. Annually, approximately 22bn tonnes of water is utilized in global tobacco production. Notably, tobacco production demands up to eight times more water than cultivating tomatoes or potatoes. The runoff of pesticides from these tobacco fields presents a substantial risk to nearby water sources, endangering aquatic ecosystems and the well-being of both the environment and local communities.

Cigarette butts, the most visible remnants of tobacco use, are a significant source of environmental pollution. Slow to decompose and laden with toxic chemicals, they pose a threat to soil and water, leaving a long-lasting imprint on the environment. Cigarette butts contain hazardous substances such as arsenic, lead, nicotine and ethyl phenol. When these butts are discarded, these substances leach into aquatic environments and soil. While the precise environmental impact of this waste remains unquantified, the substantial volume of discarded butts raises concerns about potential leachates affecting the quality of drinking water.

A cloud of environmental cost

The journey from farm to cigarette involves energy-intensive processes and the consumption of vast resources. The paper production for cigarette packaging, often derived from deforested areas, contributes to environmental degradation. The weight of non-biodegradable packaging waste adds to the already substantial burden on the planet. They contribute to an annual production of 767,000 kg of toxic waste, while 4.5trn cigarettes scatter across our cities, parks, beaches and waterways, contaminating both land and water.

Stubbing out the planet’s health

Beyond the ecological toll of deforestation and manufacturing, the plastic pollution from tobacco wrappers exacerbates urban environmental challenges. Discarded wrappers clog drains, pile up on th streets and contribute to the global plastic crisis. Cities face blockages and increased municipal waste management challenges, further emphasizing the need for sustainable alternatives. Moreover, discarded cigarette butts stand out as the most prevalent type of plastic waste globally.

Smokeless tobacco products are usually wrapped in a plastic packet, which poses an environmental impact. In Nepal, usually during the rainy days, major cities face a similar kind of drainage blockage resulting in flooding and disrupting daily activities. 

Air pollution 

During the intricate process of curing tobacco leaves, a cascade of harmful chemicals is released into the air, becoming a significant contributor to air pollution in regions dominated by tobacco cultivation. This airborne pollution transcends the boundaries of the tobacco fields, casting a shadow over communities and posing a direct threat to the health and overall well-being of the people residing in these areas.

Tobacco cultivation contributes to air pollution. Additionally, the act of smoking cigarettes itself significantly impacts air quality. Combusting cigarettes releases over 7,000 chemicals, with at least 69 known to be carcinogenic and many possessing poisonous properties.

A study conducted in Italy revealed that cigarettes emit particulate matter into the air at a rate 10 times higher than that of a diesel engine. The combined emissions from cigarette smoke and tobacco cultivation directly contribute to climate change.

The hazards of secondhand smoke are widely recognized, emphasizing the importance of considering it not only as a public health concern but also as an environmental issue.

Global impact and social responsibility

The link between the tobacco industry and environmental degradation cannot be ignored. As consumers, it is imperative that we consider the environmental consequences of our choices. Advocacy for corporate responsibility and sustainable practices within the tobacco industry is crucial for mitigating its global impact.

Tobacco is cultivated in 125 countries, involving around 33m farmers, often receiving direct support from tobacco companies. This labor-intensive, low-yield crop demands substantial pesticide use. According to UNICEF, if the land were utilized for food production instead, it could potentially benefit 20m hungry people.

Beyond the smoke rings

In the quest for a healthier world, we must not only address the health risks associated with tobacco use but also confront the environmental consequences. It is time to unmask the hidden toll of tobacco on our planet and collectively work towards a more sustainable and responsible future. The most impactful strategy is to cease smoking altogether and, concurrently, to launch awareness campaigns discouraging the initiation of smoking.

Unveiling the concealed toll that the tobacco industry exacts on our planet, it is incumbent upon us to collaboratively forge a more sustainable and responsible future. Governments, through measures such as environmental taxes on cigarettes, can play a pivotal role, as evidenced by the positive step of enacting an environmental tax as  taken by nations like Benin, Chad and Gambia. Such proactive measures not only serve to discourage the consumption of environmentally harmful products like cigarettes but also contribute to revenue generation for the government. The imposition of environmental taxes aligns with broader global efforts to address public health concerns and mitigate the impact of climate change. By adopting such policies, governments demonstrate their commitment to creating a sustainable and healthier future for their citizens.

The recent initiatives taken by local authorities in Nepal, particularly by the Kathmandu Metropolitan City, to ban plastic-wrapped tobacco products are commendable beginnings. Nevertheless, the Supreme Court has issued a verdict to halt its implementation until the court takes a final decision. The government has the opportunity to take further steps by introducing environmental taxes on tobacco products, prohibiting the use of plastic wrappers and facilitating the transition of tobacco farms to cultivate alternative crops.

At an individual level, supporting policies banning single-use plastics, encompassing cigarette filters, smokeless tobacco pouches and disposable electronic cigarettes takes us toward a cleaner, healthier planet. In dismantling the smoke rings that shroud the environmental impact of tobacco, we embark on a collective journey toward a sustainable and responsible future. 

Safe water, sanitation and hygiene (WASH) is critical in public health. There is growing evidence that millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses. Lack of safe WASH services not only have adverse socio-economic and cultural impacts on people’s lives, but also weaken health systems and threaten health security at large.

While there are significant efforts from governments and civil society to strengthen, scale up and sustain inclusive and resilient WASH services, it is yet to explore how people’s health, their social-wellbeing and future resilience benefits in different socio-cultural, economic and political contexts. More attention is needed to improve access to WASH services in healthcare facilities, schools, families and public places and harness the community engagement toward Universal Health Coverage (UHC).

Provision of safely managed and sustained WASH services can greatly contribute to better health, nutrition and education in the families and communities. Shifting the locus of WASH services from infrastructure delivery, it is high time to establish inclusive, sustainable and resilient WASH systems where people’s voiced experiences, needs and choices are socio-culturally addressed in local policies, strategies and interventions.  

More significantly, WASH-related diseases and risks are wide-ranging, and these are exacerbated by a range of factors such as climate change, population growth, migration and urbanization. The infectious diseases and risks, among others, include diarroheal disease, neglected tropical diseases, maternal and neonatal sepsis and infections from unsafe healthcare waste management.

Undoubtedly, the health risks will have profound impacts on people’s social well-being and their quality of life. At the individual level, it undermines dignity and personal safety with the prevailing fear, anxiety and stress.  In the healthcare facilities, healthcare seeking behavior, safety and morale of the service providers are largely affected due to the poor provision of WASH services.   

According to WHO, 42 percent of healthcare facilities lack hand hygiene facilities at the point of care and 40 percent do not have systems to segregate waste around the world. Good hand hygiene is one of the most effective ways to reduce healthcare-associated infections and can reduce the risk of diarrhoeal diseases. Compared to hospitals, smaller facilities like clinics, health centers and health have limited access to water and sanitation services.

Therefore, integrating WASH into health systems can increase synergies and impacts on health programs such as maternal, neonatal and child health, nutrition, neglected tropical diseases, infection prevention and control, and many others. Therefore, such an integration is more likely to reduce the burden of multiple diseases and help break the vicious cycle of disease and poverty. Understandably, infectious diseases are most common among poor and marginalized populations having limited access to safely-managed WASH services.

Among WASH in health initiatives, integrating hygiene behavior change into routine immunization is a historic progress in Nepal. With the technical support from WaterAid Nepal and other implementing partners, hygiene promotion through routine immunization initiative is a nationwide scaled-up model of integrating hygiene behavior change in health systems that aims to empower mothers of children under 15 months of age in adapting key hygiene behaviors. With this intervention, evidence suggests that there is significant reduction in diarrhea and other WASH-related diseases.

Additionally, poor management of menstrual health and hygiene has a negative impact on adolescent girls and women. Still, many girls have to miss school due to menstrual cramps, heavy bleeding and fear of leakage. Therefore, a comprehensive package of WASH services is necessary for better health and education outcomes.

We continue to face healthcare waste that exposes health care workers, waste handlers, patients and their families and the community to preventable infections, toxic effects and injuries. There are critical needs of ensuring safe waste management practices in hospitals and healthcare facilities by promoting WASH in healthcare facilities in partnership with other technical agencies and relevant experts. 

Considering the critical needs of WASH in urban areas, city-wide inclusive sanitation (CWIS) is gaining priority in recent years. Recently convened ‘National Citywide Inclusive Sanitation Conclave 2023’ offered a good platform for stakeholders to share their experiences and learning in the area of WASH, and advocate for local governments to invest more in addressing WASH-related issues and challenges.

As we see, there is a growing emphasis on the sustainability of WASH services, including the need to promote community-led approaches to WASH service delivery. Despite some remarkable progress, there is an urgent need to significantly increase political commitment and ownership to deliver reliable, resilient and inclusive WASH services at scale. More concerted efforts are needed to strengthen multi-sector engagement and partnerships to increase investments in the area of WASH systems strengthening for better health outcomes at all levels.

The author is a health policy analyst