Fifth Ministerial Conference on Environment and Health: Opening address
Ms Zsuzsanna Jakab, WHO Regional Director for Europe
10 March 2010
Honourable Ministers, Excellencies, Distinguished Delegates, Ladies and Gentlemen,
Welcome to the Fifth Ministerial Conference on Environment and Health. After months of hard work and preparation, we are finally gathered together to discuss how we can continue to make the WHO European Region a healthier place to live, work and play.
For the last 20 years, since the European environment and health process was first started in Frankfurt, we have made political commitments, identified new targets, used new instruments to drive action at national and international level and continued to motivate each other by exchanging experiences and know-how.
Member States have not only contributed to this role directly by active participation but also indirectly by providing funding for the WHO European Centre on Environment and Health in Rome and Bonn, and also previously in Bilthoven. Through their support for these centres, they have significantly increased the capacity of the WHO Regional Office for Europe to serve the Member States with top-level technical advice and support.
We have actively involved traditional and new stakeholders in advocacy, programme implementation, progress reviews and result monitoring to ensure a process that has ownership by all.
Today, as I look out at all of you sitting in this beautiful hall, I know that your presence here today is testament to everything we have achieved during this process. And progress is visible and tangible in many areas. Let me give you three examples.
- Mortality rates from diarrhoeal diseases among young children have been reduced by five times in recent years largely through improved access to clean water and sanitation.
- Traffic-related deaths have fallen by 40% since the early 1990s.
- After a switch across most of the continent to unleaded petrol, and a 90% subsequent cut in lead emissions, lead levels in children’s blood have dropped.
Our many partners and stakeholders are also witnesses to what we have achieved. You may already be aware that the European environment and health process has gone global and that other WHO regions such as the Region of the Americas in Argentina, the Western Pacific Region in Manila, and even the African Region have recognized our combined efforts and are following in our footsteps. They are here today, following our discussions, and trying to find answers to the public health problems we all face. The European Commission and its agencies such as the European Environment Agency and the European Centre for Disease Prevention and Control, the United Nations Economic Commission for Europe and nongovernmental organizations work with us more closely and trust in our political direction. These are all good signs.
However, let us also remember why we are here. The job is not yet done and we need to be aware that we have some distance to go. The burden of disease in the European Region from environmental determinants of health is still substantial. Globalization, population movements, climate change and – most recently – the global financial crisis have put a heavy burden on health systems in all countries of the Region. These and other challenges need more powerful and more comprehensive policy responses – especially in the area of tackling air pollution, providing access to clean water and sanitation – to ensure that diseases are prevented and health outcomes are improved.
Ladies and Gentlemen – the evidence we have is powerful.
- Over 92% of the urban population still live in cities where the WHO air quality guideline for particulate matter is exceeded.
- In many countries, 80% of children are regularly exposed to second-hand tobacco smoke in the home and outside of the home.
- Across the Region, more than 20% of people live in houses subject to damp and mould.
Water scarcity caused by climate change and overpopulation is already leading to conflicts in many places around the world. Extreme weather events, changes in temperature, water, air, food quality and quantity will have a direct impact on prices, living standards and health outcomes across the European Region. Changes in air pollution and aero-allergen levels, and the altered transmission of infectious diseases could also have a serious impact on the health of our populations.
I am sure you will also agree with me that it is a tremendous cause for concern that inequalities in environmental risk exposure are still growing. Today, WHO is publishing the first ever study pulling together evidence on this subject from across the European Region. This study reveals that there are very significant inequalities with regard to the social distribution of environmental exposure and related deaths and disease. These inequalities are evident both between countries and within countries.
This unequal distribution of environmental risk is related to both economic aspects – such as income, social status, employment and education – but also to non-economic social characteristics such as gender, age and ethnicity. Vulnerable segments of society can be disproportionately more exposed to avoidable environmental hazards, in some cases twice as exposed, or even worse.
Socially disadvantaged groups bear the greatest burden of environmental risk exposure but we also know that health risks, disease incidence rates and environmental exposure risks follow a clear social gradient across the whole of the society. These disconcerting trends and statistics – and the evidence that preventive policies do work – form a very strong basis for a renewed strategic alliance between the environment and health sectors.
Distinguished Colleagues,
We cannot close our eyes to these facts when our research suggests that – if we could get the policies right – the overall burden of disease could be reduced by almost 20%. In other words, one fifth of over 1.7 million years of life lost every year could be avoided by improving our natural and man-made environments.
Well-tested environment and health interventions could save 1.8 million lives a year in the European Region. We could gain a total of 6 million years of healthy life in children and adolescents, by improving policies on air, water, chemicals and transport; and we could reduce gastrointestinal disorders and diarrhoeal diseases by 26%, by providing safe water and sanitation to more households.
Ladies and Gentlemen,
I know we can do better. We must act and we must act now. This Conference should be an important milestone in the history of the European environment and health process. I strongly believe that public health and health equity considerations provide a very strong, politically convincing and evidence-based argument in support of reforms in many environmental policies.
We will need a real paradigm shift in the way we think about disease prevention, health promotion and the environment. We need an approach that is all-embracing and comprehensive, and one that takes health and health inequity issues into consideration in all environmental policy areas, including by integrating health accountability mechanisms into the policies.
I would go even further and say that health and health inequity considerations should be mainstreamed into all public policies and national development programmes, in particular into the transport and industry sectors. Sustainability, well-being and social justice should be given as much priority on government agendas as the issue of tackling climate change or that of generating economic growth.
Social determinants of health are crucial for the understanding of health inequities, and they hold the key to finding lasting solutions to mitigate these acute social problems. We won’t be able to reduce health inequities and move closer to fairer societies without more powerful legislation, more comprehensive poverty reduction and social support programmes, and without developing national strategies aimed at tackling health inequalities.
Ladies and Gentlemen,
Let us ensure more collaboration across sectors, and adapt our ways of working to match the evolving global policy environment and the changing governance mechanisms. We can no longer ignore the fact that the increasingly complex 21st-century challenges demand 21st-century solutions. Let us choose to make use of new ways of advocating, managing and responding to public health challenges at all levels.
Let us focus on the synergies, and maximize the impact of joined-up policies, by working simultaneously at the international, national and local levels.
Let us capture the opportunities that present themselves, and let’s not allow the sometimes difficult circumstances to slow us down. There are many opportunities for social and economic growth through investments in cleaner and healthier technologies. There are many opportunities through investments in green jobs. It is only through a proactive and inclusive policy development and advocacy process that we can convince other parts of government and society that health is not a hopeless public expenditure, but is a resource for better economies, better quality of life and, ultimately, the way towards more just and more equitable societies.
Distinguished Delegates,
The European environment and health process has been a great inspiration for me personally – due to its capacity to engage new partners and to adapt itself to the changing global environment.
As many of you know, it is my deep conviction that we need a new vision for European health policy – a vision that can inspire and guide governments and a wider range of stakeholders. We need a new, comprehensive and value-based strategy – one that makes health a horizontal governmental responsibility. I have pledged to adapt the Regional Office’s work to the changing European and global context and – during my tenure here – I intend to focus primarily on addressing noncommunicable diseases, socioeconomic determinants of health, health information and health systems. The European environment and health process is embedded in all these areas.
I would like to engage in a deeper dialogue with partners, and capitalize on the synergies that exist between the various national and international actors with a public health mandate. I would like to make the WHO Regional Office for Europe the lighthouse of public health. But in doing so, I know that there is need for a stronger and more strategic partnership with the European Commission and its agencies at the European level, and even more importantly, at the country level.
I am committed to continuing a “constructive conversation” with all other key partners, especially the United Nations Economic Commission for Europe and other United Nations agencies, the Council of Europe, the World Bank, the Organisation for Economic Co-operation and Development, the Global Fund, nongovernmental organizations, the private sector, academic and research organizations and many more.
May I take this opportunity to acknowledge the important role of the European Environment and Health Committee, whose members have been working in partnership for many years, overseeing coordination and follow-up of the outcomes of the ministerial conferences. I should also like to thank Dr Corrado Clini and Dr Jon Hilmar Iversen, who through their able chairmanship of the European Environment and Health Committee have brought us to where we are today. I would also like to thank the Italian Government for hosting us in Parma this week. We know that you have done much to make this a successful event and we are grateful for this.
Together, through our commitment, improved collaboration on different levels of governance, and new ways of doing business, we can drive this process forward and achieve results that make us all proud. For my part, in my capacity as WHO Regional Director for Europe, I will make it my priority to strengthen the European environment and health process further.
I will be building on the foundations that were laid by my predecessors, to whom I will be forever grateful. I would like to pay particular tribute today Dr Jo Asvall who served as WHO Regional Director for 15 years. Jo sadly passed away last month after fighting with an illness for over two years. Jo Asvall was an extraordinary leader in European public health, tireless in his fight for the rights of others. In his last speech to the Regional Office six weeks ago, he told us the following: “Be courageous and be willing to take risks – and be sure you have the Constitutional mandate to lean on.”
These words are valid for all of us and should inspire us all. We are here at this Conference, because in our various capacities we have been given the mandate to improve the health status of a total of 890 million citizens, to ensure their right to health and to uphold the values that form the basis of our efforts – human rights, universality, solidarity, equity, participation and access to quality health care. Only through working together – and by taking risks – will we be able to translate these values into tangible health benefits for our societies.
Ladies and Gentlemen,
You have shaped and nurtured the process and kept it going despite many setbacks and difficulties. Let us leave this Conference with a clearer direction and a stronger vision about what still needs to be done, in order to protect the most vulnerable populations from the unhealthy environments that they are still exposed to.
I am confident that we will achieve important results at this Conference and I very much look forward to hearing your contributions and engaging with all of you. I wish you all a fruitful debate and a pleasant stay in Parma.
Thank you.
