Fifth Ministerial Conference on Environment and Health: Address to Plenary Session 6, The Future of the European Environment and Health Process

Ms Zsuzsanna Jakab, WHO Regional Director for Europe

12 March 2010

Honourable Ministers, Excellencies, Distinguished Colleagues, Ladies and Gentlemen,

In the first session of this Conference, two days ago, we had a remarkable review of the progress done in the environment in Europe over two decades.

So what are the lessons learned from the past years?

The European environment and health process greatly contributed to the progress that has been achieved so far and that we have been reviewing in this Conference.

At its onset in 1989 in Frankfurt, the disease prevention approach was adopted in the European Charter, clearly stating that the environment should be managed as a positive resource for human health and well-being. It also recognized the importance of international collaboration in solving urgent environmental problems affecting health, and the WHO European Centre for Environment and Health was established.

Five years later, in Helsinki, we agreed on the Environment and Health Action Plan for Europe (EHAPE) as an international framework; this led to the development of national environment and health action plans, which were a major step forward in the implementation.

In London, in 1999, the first legally binding instrument of the process was adopted – The Protocol on Water and Health – which was followed by the Charter on Transport, Environment and Health.

The Budapest Conference in 2004 strategically shifted the focus of the European environment and health process from addressing environmental factors separately from health issues, to one that looked at the health impacts arising from the environment. We also adopted the Children’s Environment and Health Action Programme for Europe, which included Regional Priority Goals to improve the health of future generations in a changing environment.

The Parma Conference has focused on continuing and new issues. These include climate change, especially in the context of ongoing and unfinished global negotiations; inequalities in environment and health within the larger context of social, economic and gender determinants of health; and improved cross-sectoral and cross-border collaboration and implementation. We also set measurable targets for the first time.

So, in the course of two decades, the process went from defining the link between health and environment, through quantifying the burden of disease attributable to the environment, developing non-binding commitments and binding legal instruments, to setting targets and looking at the wider health and environment context of our work.

Dear Colleagues,

The European environment and health process has been unquestionably an outstanding example of multiple sectors, gathered around health and environment, working towards a common goal.

If we want to make an impact on environment and health in the coming decades as we have done until now, we have to develop and embrace new concepts. We also need structures for cross-sectoral, national and international collaboration that will further strengthen the development and implementation of evidence-based policies. And those structures have to be flexible so that they can adapt to future needs as well, taking into account multiple and diverse stakeholders and partners.

Finally, health and environment are not, and should not be, value-free policy areas. The principles of just and equitable societies, of the right to health and well-being and environmental justice have to be an integral part of building synergies between those two sectors. Ensuring the consistent application of those values is a primary role of governments in partnership with their citizens.

Only this approach will enable us to gain more health in Europe and to build a new public health and new environmental policy for the future.

Ladies and Gentlemen,

This ambitious agenda can only be sustained and promoted further if all mechanisms of policy-making and implementation are linked together across different levels and across sectors and countries in a logical and sustained manner. It will be possible only if an appropriate political commitment is sustained between ministerial conferences.

The fundamental element of the future process is a functioning coordination of efforts by the health and environment sectors, together with other sectors, stakeholders and partners. It is at the local and national levels that the change can be implemented and where it makes the difference. Where they don’t exist, Member States are urged to set up the national environment and health mechanisms most appropriate for their specific national circumstances to ensure the implementation of the commitments that we are making here today and those that we still need to deliver from the past.

The leading officials of these national mechanisms should regularly meet at the regional level, to exchange experiences, to discuss progress and the challenges to the implementation of the commitments made.

This will take place within the European Environment and Health Task Force, as the leading regional body for implementation and monitoring of the process. The Task Force will ensure communication between national and international levels and also among Member States. It will facilitate collaboration among partners and stakeholders from the governmental and nongovernmental sectors on the international level. And it will regularly review scientific evidence in order to advise on new challenges, policies and solutions.

The Task Force will include representatives of other key stakeholders and partners, such as the European Commission, the European Union and United Nations agencies and nongovernmental organizations.

The Task Force will have a chair and a co-chair, with a one-year mandate.

One of the Task Force meetings will be a high-level mid-term review meeting. It will be attended also by chief medical officers, deputy ministers or state secretaries, and senior environmental administrators with the objective of ensuring involvement and decision-making at this level of governance. That meeting will review both the technical progress and the environment and health process.

Further details on the composition, governance and terms of reference of the Task Force are provided in the Conference document “The European environment and health process (2010–2016): institutional framework”.

At the same time, there is an obvious and uncontested need to establish a strong political mechanism at the ministerial level. This committee would ensure proper and full accountability to Member States and the two sectors through the existing governance mechanisms through WHO and the United Nations Economic Commission for Europe (UNECE).

Finally, what has been proposed for the future of the process is the establishment of the European Environment and Health Ministerial Board, which will be able to represent and advocate for environment and health more strongly and broadly among a larger group of stakeholders, and to move the environment and health agenda forward and towards a comprehensive approach within the larger health and environment policy for Europe.

The European Environment and Health Ministerial Board will have a strong political profile and stature, consisting of four ministers of health and four of environment, and European Commission and United Nations representatives, ensuring geographic and sectoral representation. It will be chaired by two ministers. There will be a strong operational link between the Task Force and the Ministerial Board, sharing information in both directions.

The Ministerial Board will be accountable to the WHO Regional Committee for Europe and to the Committee on Environmental Policy of UNECE, to ensure the link to the two bodies that are the source of legitimacy for the European environment and health process.

The terms of reference and the rules of procedure of both bodies will be developed to ensure the political relevance, effective leadership and linkages of the whole environment and health process.

And last, but not least, the next cycle of the process will be closed with the Sixth Ministerial Conference in 2016.

Distinguished Delegates,

As soon as I was elected as the WHO Regional Director for Europe, I embarked on a consultative process with Member States and partners preparing this part of the Parma commitments. Most of you have taken advantage of being part of the dialogue, and have provided numerous good suggestions. There has been a lot of support for this new way, and the final discussions and negotiations have taken place during this Conference.

Brave objectives for a better future for our people require bold and forward-looking decisions. The world is constantly changing and we should not be shy about changing our ways of working. Thoughtful change can ensure efficiency, effectiveness, transparency and impact.

You may be asking yourselves about our collective ability to ensure a smooth operation of the process in the future. On my part, I can guarantee full support and engagement from the WHO Regional Office for Europe as the secretariat to the process in the years to come. I have made my priorities clear and public, known to all, and the environment and health are one of the key areas of my attention within the larger agenda of health in all policies, social determinants, gaining health and strong partnerships.

My personal commitment and that of the secretariat are without doubt. From you, I am asking to endorse the proposal for the future of the process, which will ensure the continued success of our unique work in the next 20 years.

Thank you.