Speech – Why environmental protection matters for public health – new evidence and frameworks for policy makers

25 September 2013, Brussels, Belgium

Dear Genon [Jensen], ladies and gentlemen, distinguished guests,

It is with great pleasure and joy that I am addressing you today on the occasion of the tenth anniversary of the Health and Environment Alliance (HEAL) – an important organization bringing together a large number of associations representing the academic, civil society, environment and public health communities around a common goal.

This goal – addressing the complex, yet essential interactions of environment and health – is among the key areas of concern for WHO, as it is one of the most important determinants of health. Where we live and work, how we manufacture, how we consume, eat, drink or entertain ourselves are major factors contributing to the creation or destruction of health.

Environmental health is the origin of public health. Even in ancient times, people understood the importance of providing safe water and food, adequate shelter and clean air for ensuring prosperity and growth. Later on, in the nineteenth century and applying modern epidemiological methods, John Snow demonstrated the essential need to address the risks in our environment if we are to protect and promote people’s health.

Since then, our knowledge and understanding of the interactions between people, their health and their environments, natural or manmade, has expanded beyond imagination. We learned a long time ago that controlling vectors that transmit microorganisms prevents infectious diseases. But today we also know that a large part of cardiovascular diseases are directly caused by the fine particulate matter in the air that we breathe, and that environmental pollution with mercury or lead severely affects mental health and human intellect. Noncommunicable diseases are the leading health concern today, and one quarter of the burden of diseases is attributed to environmental determinants. We have also learned that the environment is not only a source of threats to our health, but that, for example, good urban planning – providing proximity to green spaces for recreation or provision of safe infrastructure for walking or cycling – enhances our health and well-being. We understand that the world around us is not only a hazard but also a source of extended life and increased health. So addressing the environmental determinants of diseases is public health at its best: it ensures longer, healthier and happier life for all of us.

We have also learned that the environment and nature are precious resources that are not unlimited and that the greatly accelerated human activity in the past 60 years is putting to the test. The realization that, through our existence and our pursuit of growth, prosperity and pleasure, we are capable of irreparably damaging and depleting those essential resources, representing basic conditions for the health and well-being of current and future generations, brought environmental protection and public health together.

In the WHO European Region, this understanding and the concern for the health of people today and tomorrow brought together a strong alliance of Member States and other stakeholders in the European environment and health process. In 1989, the adoption of the European Charter on Environment and Health at the First European Conference on Environment and Health, was an historic milestone in the history of European public health, placing environment and health where they belong – together.

Throughout this process, over the past 20 plus years, both the scientific basis and policy in this area have developed tremendously. The Environmental Health Action Plan for Europe and, later on, the Children’s Environment and Health Action Plan for Europe (CEHAPE) adopted at the Fourth Ministerial Conference on Environment and Health in Budapest, Hungary – of which I have fond memories as one of the hosts – supported effective action at country level and drew attention to the particular vulnerabilities of children to environmental determinants. The Fifth Ministerial Conference, in Parma, Italy in 2010, expanded this agenda by highlighting environment and health inequalities, the interactions of environmental and social determinants of health and reinforcing the understanding that geographic, social, economic and environmental inequalities are interrelated and significant in this part of the world, and that they are simply not acceptable.

The European environment and health process also recognized early on that effective action has to follow the motto, “working locally and thinking globally” by recognizing not only that a lack of safe water or sanitation in one place should concern all of us but also that issues such as climate change or the safe management of chemicals cannot be addressed properly unless each one of us does his or her part of the work in the places where we live and work.

In 2012, WHO’s European Member States adopted Health 2020 as the new policy framework and strategy for health in the 21st century. One of its four priorities is creating resilient communities and supportive environments. Health 2020 rests on the understanding that further gains in health, building on the achievements over the past century, can only be achieved by addressing the underlying determinants of health, social and environmental; by addressing inequalities; by improving good and effective governance; by working together with all sectors of society; and by strengthening essential public health in the Region. The centrality of health as a human right goes hand in hand with the concept of environmental justice here. Environment and health action in Europe will greatly benefit from Health 2020, but this strategy will also depend on the future success of the environment and health process.

Ladies and gentlemen,

In the changing world in which we live, working in collaboration across sectors is essential. In a world of interdependency, we need each other to succeed.

We also need the full and meaningful engagement of everyone. This is where HEAL and organizations like yours play a central role. In the globalized and open world of today, things don’t work without people’s wide involvement, or without the meaningful involvement of organizations representing a great variety of stakeholders. This means taking citizens from a role as recipients of public health to one of being active participants in public health policy-making and action.

The European environment and health process, from its very beginnings, recognized those important prerequisites and ensured that all stakeholders sit at the table and play an appropriate role. With that, this process was a pioneer once again.

But you may expect me to give you a word of wisdom on where we should go and focus our attention in the future.

I am not a fortune teller, but evidence tells us that air quality, climate change, the safe management of chemicals, and sufficient, reliable and safe sources of water, food and energy are the great public health challenges of today and tomorrow in a world marked by population growth, urbanization, longevity and economic growth and prosperity. It is also obvious that the core responsibility of public health is to ensure safe, equitable and health protecting and promoting conditions in this rapidly changing world. Addressing those environmental determinants is among the key interventions for preventing cancer, cardiovascular and the other noncommunicable diseases that dominate the health agenda. On the environment side, the daunting task of understanding the challenge of sustainable development and “getting it right” for future generations is the most important question of all.

This is where the environment and health come together again. And this is where we must all come together in unity with our seemingly diverse roles and responsibilities.

I wish HEAL many more years of good work and fruitful engagement with WHO, and I wish you all, ladies and gentlemen, a very pleasant day.

Thank you.