Moving environment and health forward
"I am a strong supporter of the Environment and Health Process,
not only because I have been involved since its inception, but also because I am a strong believer that today's complex problems cannot be solved without cross-sectoral work or in some cases whole-of-government and whole-of-society approaches."
Dr Zsuzsanna Jakab, WHO Regional Director for Europe, closed the 3-day mid-term review of the European Environment and Health Process (EHP) in Haifa, Israel, on 30 April 2015 with these remarks. The meeting was attended by over 200 participants representing 37 countries in the WHO European Region and intergovernmental and nongovernmental organizations that are stakeholders in the EHP.
The high-level meeting "was very important as it allowed us to take stock of where we are between Parma and the next Ministerial Conference: what are the achievements as well as the roadblocks that we need to break down in order to speed up the implementation and achievement of our targets", continued Dr Jakab.
Europe's progress on the five time-bound targets on water, children's environments, indoor air, chemical safety and asbestos-related diseases has been remarkable but uneven. A new report, Improving environment and health in Europe: how far have we gotten?, describes the key findings.
- Over 90% of citizens have access to better water and sanitation facilities, but 67 million people still lack access to basic sanitation, and 100 million do not have piped drinking-water on their premises. This results in 10 deaths a day from diarrhoea due to unsafe water and poor sanitation and hygiene in the Region.
- 40% fewer children under the age of 14 years died from unintentional injuries and road traffic accidents between 2000 and 2011; however, less progress was made in low- and medium-income countries than in high-income countries.
- In 2012, 38 countries banned smoking in schools, and 32 banned smoking in universities; nevertheless, the 2015 target to free children's environments from tobacco smoke has yet to be met.
- A big step to protect children from the health effects of mercury was the adoption in 2013 of the Minamata Convention on Mercury. However, a WHO survey found that only half of European countries have taken action to reduce or eliminate the risks of chemicals to children.
- Although most countries have banned the use of asbestos, almost a third still use it, and a few are asbestos producers.
- Annual increases in heat-related deaths are projected to reach 27 000 by 2050 for people over 65. Many countries have worked hard to adapt to climate change, but all too often their initiatives are not embedded in national health policies and are funded from already over-stretched budgets.
"The Environment and Health Process is kicking and alive
and can support Member States to get to the 'end game' of the environment and health challenges that hamper the development of our societies to their fullest potential", added Dr Jakab".
During plenary sessions and in an on-site exhibition in Haifa, Member States and other EHP stakeholders shared success stories and challenges to reaching the Parma time-bound targets. Much of what Europe has managed to achieve in environment and health is due to the cross-sectoral nature of this process, which brings added value to both sectors.
If more of the sectors of education, urban planning, agriculture, transport, energy and the economy came together to address inequalities, vulnerable populations, urban–rural challenges and bridging science and policy-making, not only can more lives be saved but results can be achieved that are worth astounding amounts of money. A new WHO–OECD study released in Haifa showed that the cost of the approximately 600 000 premature deaths and of the diseases caused by air pollution in the WHO European Region in 2010 is US$ 1.6 trillion.
"We will need to reconcile the complexity of the underlying global issues with your loud message that we need to deliver a strong, clear and focused political outcome for the ministerial conference",
concluded Dr Jakab.
For the next ministerial conference on environment and health, the EHP will have to take into account many of the themes and challenges of the environment and health agenda of the 21st century. It must continue its close connection with policy platforms such as the European health policy framework, Health 2020, and the post-2015 sustainable development agenda. All European countries should support it by
- continuing to institutionalize the process at both regional and national levels;
- continuing to increase the visibility of their work and using every opportunity to further the process; and
- remaining focused on finishing the unfinished business and meeting the priorities to which they committed themselves in Parma, while preparing the future agenda.