METROPOLIS HEALTH PLUS: Can you introduce yourself to our readers and tell us about your background? What led you to public policy and health issues?

JOELLE PANANGILA ITUMINE: I am a project manager in sustainable development and public policy, with experience in both France and the Democratic Republic of Congo. Trained in law and then in health policy and environmental risks, I have come to understand that health depends not only on the healthcare system, but also on living conditions: the environment, urbanization, sanitation, and resource management. What struck me most was realizing that health problems often originate long before the hospital—in air quality, housing, water, or food. My field experience has confirmed that people's primary concerns are their living environment.

Today, I advocate a preventive approach to public health: acting upstream, through environmental and social policies, and strengthening citizen participation to sustainably improve the well-being of communities.

At what point did you realize that the environment and health were deeply linked?

I came to understand the link between environment and health in two stages: first, during my studies, theoretically, by discovering that many illnesses are rooted in living conditions. Then, in the field, during a consultation in Fleury-Mérogis (in the Paris region), where a father spoke about his daughter's respiratory problems caused by the unsanitary conditions of their home. At that moment, I realized concretely that housing, urban planning, and environmental policies are also health policies. Since then, this conviction has guided my work: acting on the environment is already acting on health.

You state that health does not begin in healthcare facilities: can you explain this view and specify what the non-medical determinants of health encompass?

Health doesn't begin in the hospital, as medicine often intervenes only after illness has taken hold. It is built first and foremost through living conditions: housing, water, sanitation, air quality, food, education, and income. These non-medical determinants explain a large part of health inequalities. In contexts like the Democratic Republic of Congo, acting on the environment and public policies is therefore essential for the sustainable prevention of disease.

In the context of the DRC, what factors do you think most influence the health of populations outside of the medical system?

Do you think these issues are sufficiently taken into account in public policies?

In the Democratic Republic of Congo, public health is severely impacted by environmental and urban conditions. Limited access to drinking water and sanitation, inadequate waste management, poor housing quality, and rapid urbanization, particularly in Kinshasa, contribute to waterborne, respiratory, and vector-borne diseases such as cholera. Climatic events, such as heavy rains and floods, exacerbate these risks by damaging infrastructure and contaminating water sources. Urban growth puts pressure on essential services, transforming environmental vulnerabilities into immediate health vulnerabilities. These realities demonstrate that public health cannot be limited to hospital care; it also depends on urban planning, resource management, and environmental prevention. Sustainably improving health in the DRC therefore requires creating living conditions that prevent disease before it even manifests.

Waste management is often cited as a major problem. Why is it also a public health issue?

Waste management is a major public health issue because it directly influences the population's exposure to health risks. Uncollected waste promotes the proliferation of mosquitoes, rodents, and bacteria, which are responsible for diseases such as malaria, diarrheal infections, and skin infections. Leachate from decomposing waste can contaminate soil and water sources, while the gases produced degrade air quality and cause respiratory problems. Waste clogging drains exacerbates flooding and the spread of epidemics such as cholera. Therefore, investing in waste collection and treatment constitutes genuine public health prevention, going far beyond mere urban cleanliness.

Limited access to drinking water and sanitation, inadequate waste management, poor housing quality and rapid urbanization, particularly in Kinshasa, promote waterborne, respiratory and vector-borne diseases such as cholera.

Climate change is also beginning to affect Africa. Are you already seeing health impacts?

Yes, climate change is already affecting health in Africa, including the Democratic Republic of Congo, by exacerbating existing vulnerabilities. Extreme events, such as heavy rains and floods, contaminate water and contribute to waterborne diseases. Climate variations are also altering mosquito habitats, increasing the risk of malaria. In cities like Kinshasa, rapid urbanization intensifies these effects, exposing populations to infections, injuries, and respiratory problems. Heat waves also impact vulnerable people and food security. These phenomena demonstrate that health, the environment, and development are interdependent, and that policies must integrate health prevention and climate adaptation.

In a context like that of the DRC, where certain economic activities have a direct impact on the environment and living conditions, how can companies concretely integrate the health of populations into their corporate social responsibility policies?

In the DRC, public health can be concretely integrated into corporate social responsibility (CSR) by going beyond one-off philanthropy. It is essential to first recognize that their activities directly impact air, water, waste, living conditions, and working conditions in communities. Specifically, they can: improve waste and wastewater management around their sites, reduce polluting emissions, support access to drinking water and sanitation, and develop health and environmental education programs for employees and communities.

CSR is also becoming a tool for prevention and dissemination of good practices in health and the environment. Investing in the health of populations strengthens economic stability, the resilience of territories, and creates a lasting link between economic development, environmental protection, and collective well-being.

Beyond her recognized professionalism, Joëlle Panangila Itumine is distinguished by an inspiring presence and serene determination. Her intellectual rigor, combined with a profound humanist conviction, fuels a constant commitment to health and collective well-being.

As a young woman committed to these issues, what is your perspective on the role of women in health and environmental policies?

Women, and especially young women, play a central role in prevention and social change, as they are often on the front lines of managing water, food, hygiene, and children's health. Their close connection to daily realities makes them natural agents of health and environmental change, capable of disseminating beneficial practices at the household and community levels.

Young women also bring innovation and commitment, using digital tools and citizen mobilization to connect local issues to global dynamics. However, they still face obstacles: limited access to education, funding, and decision-making positions, as well as social norms that hinder their legitimacy. To fully unleash their potential, it is essential to support their initiatives, recognize their expertise, and facilitate their active participation in health and environmental policies.

What should be the priorities for improving environmental health in the DRC? If you had to propose one priority reform or action, what would it be?

To improve environmental health in the DRC, the priority should be to shift from a curative model to a prevention-based one. The key reform would be to institutionalize health-environment prevention as a strategic pillar of development. Three major actions could structure this approach:

·         Systematically integrate a health dimension into urban planning and infrastructure projects, with impact assessments that include health, not just the environment.

·         Create a permanent inter-ministerial body for health, environment, and urban planning, to coordinate policies and avoid silos between ministries.

·         Make urban sanitation a national budgetary priority, on par with roads or energy, in order to ensure a healthy environment for all.

The objective is clear:structurally reduce disease production, decrease inequalities, strengthen population resilience and transform environmental vulnerabilities into opportunities for sustainable development.

Greenhouse gas (GHG) emissions from industrial and urban activities are often discussed from a climate perspective. But can they also be considered a public health issue, and what role should businesses play in reducing these impacts?

Greenhouse gas (GHG) emissions are also a public health issue, as they degrade air quality and promote respiratory, cardiovascular and chronic diseases, particularly affecting children, the elderly and exposed populations.

In Kinshasa, traffic, waste burning, and polluting energy sources exacerbate these risks. Businesses have a key role to play: reducing greenhouse gas emissions by improving energy efficiency, adopting clean energy sources, managing waste more effectively, and integrating health impact assessments into their decision-making. Taking action against greenhouse gas emissions protects both the climate and health, while contributing to more breathable and resilient cities.

The concept of "One Health," which links human, animal, and environmental health, is gaining increasing importance in health policies. Do you think this approach could help countries like the Democratic Republic of Congo better prevent certain health crises?

The "One Health" approach, which links human, animal, and environmental health, is particularly well-suited to the DRC, where many health crises arise at the intersection of these three dimensions. It allows for anticipating risks rather than intervening only during crises, by strengthening prevention through integrated surveillance and coordination between institutions. Its effectiveness will depend primarily on improved local cooperation and operational data sharing.

And in conclusion…

It is crucial for decision-makers to understand that public health is not limited to hospitals. Every decision in urban planning, infrastructure, or the environment is a health decision. Environmental prevention must become a strategic pillar to reduce future crises, inequalities, and costs, and to make the quality of life a true asset for the country.

For young Africans, engagement is not reserved for experts. It involves connecting scientific knowledge, local realities, and innovations to build appropriate solutions. Africa has the opportunity to invent a preventive, integrated, and resilient model for health and the environment, provided it commits to this endeavor with rigor, creativity, and determination.