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«Final Conference Report EUR/04/5046267 January 2005 ORIGINAL: English E CONTENTS Page Introduction Proceedings Opening session Session 1 – The ...»

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Fourth Ministerial Conference

on Environment and Health

Budapest, Hungary, 23–25 June 2004

Final Conference Report

EUR/04/5046267 January 2005 ORIGINAL: English






Opening session

Session 1 – The environment and health situation in Europe – an assessment

Session 2 – Implementing the London Declaration commitments – progress made.

Showcase of good examples

Opportunities for and challenges to intersectoral collaboration

Relevance of action at the subnational level

Use of information and communication strategies

Resources to attain sustainable and healthier transport

Session 3 – The impact and future of the Environment and Health process in Europe.............. 5 Alán Pintér Award

Session 4 – Housing and health

Session 5 – Tools for policy-making – Towards an environment and health information system to support environment and health decision-making across Europe

Session 6 – Tools for policy-making – Dealing with uncertainty: can the precautionary principle help protect the future of our children?

Keynote address by Ms Margot Wallström

Session 7 – Children’s Environment and Health Action Plan for Europe

Session 8 – Special session between ministers and representatives of civil society on implementation of health and environmental policy: Effective policies, practical tools and functioning partnerships to protect our children’s health

Media awards

Session 9 – Extreme weather events and human health

Keynote address by Mr Pavel Telička

Session 10 – Conference Declaration

Session 11 – Adoption and signing of the CEHAPE and the Conference Declaration............. 17 Annex 1. Conference programme

EUR/04/5046267 page 1


The Fourth Ministerial Conference on Environment and Health was the latest milestone in a series of conferences held in 1989 in Frankfurt on policy formulation, in 1994 in Helsinki on planning and in 1999 in London on action in partnership. The theme of this conference was “the future for our children”.

A total of 1169 people participated in the Conference, including 38 ministers of health and ministers of environment from 50 Member States of WHO’s European Region, representatives of 11 international organizations (including United Nations agencies), representatives of four Member States of other WHO regions (Argentina, Brazil, Canada and the United States of America), a delegation of representatives of the Healthy Planet Forum1, representatives of 10 civil society groups and 138 observers.

The Conference elected as joint chairs Dr Mihály Kökény, Minister of Health, Social and Family Affairs of Hungary, and Dr Miklós Persányi, Minister of Environment and Water of Hungary.

The joint vice-chairs were Ms Zsuzsanna Jakab, State Secretary of the Ministry of Health, Social and Family Affairs of Hungary, and Mr István Ory, State Secretary of the Ministry of Environment and Water Management of Hungary. Ms Siobhan McEvoy (Ireland) and Ms Susan Potting (the Netherlands) were elected as Rapporteurs. The Conference programme is given in Annex 1.

Proceedings Opening session The opening session was addressed by Dr Katalin Szili, Speaker of the National Assembly of Hungary, who declared the Conference officially open at the end of her statement. Dr Lee JongWook, Director-General of WHO, then delivered a speech and was followed by Dr Mihály Kökény, Minister of Health, Social and Family Affairs of Hungary, Dr Miklós Persányi, Minister of Environment and Water of Hungary, and Dr Marc Danzon, WHO Regional Director for Europe. Following his statement, Dr Danzon led the election of officers for all sessions. The opening ceremony of the Conference concluded with a celebration of dance and song by the indigenous Roma people.

Session 1 – The environment and health situation in Europe – an assessment

The joint vice-chairs of this session were Ms Marion Caspers-Merk, Deputy Minister, Federal Ministry of Health and Social Security of Germany, Ms Liisa Hyssälä, Minister of Social Affairs and Health of Finland, and Mr Alun Michael, Minister for Rural Affairs and Local Environment Quality of the United Kingdom.

The introductory speaker was Professor Giorgio Tamburlini, Scientific Director of the ‘Burlo Garofolo’ Institute of Child Health in Trieste, Italy, while the keynote address was made by Mr 1 The Healthy Planet Forum was a four-day event for civil society groups and other organizations from across Europe held in Budapest in parallel with the Ministerial Conference.

EUR/04/5046267 page 2 Patrice Robineau, Acting Deputy Executive Secretary, United Nations Economic Commission for Europe (UNECE).

In his introductory address, Professor Tamburlini gave a brief overview of the current knowledge on the causal links between environmental risk factors and child health. He presented the magnitude of the effects of these risk factors on children’s health, explaining the methodology and results of the WHO environmental burden of disease study prepared for the Conference, that clearly demonstrated why children deserve special attention in environment and health. Professor Tamburlini also identified the knowledge gaps that still existed and recommended increased research to fill them, along with further action to promote safer and healthier environments through effective policy-making.

Mr Robineau’s keynote address looked at the challenges in the areas of environment and health.

He acknowledged that, in recent times, there had been a growing awareness of environment and health but said that more still needed to be done to allow further implementation of the necessary action. Mr Robineau explained how, at regional level, a significant integrated approach had already been adopted, thanks to the collaboration between WHO and UNECE. This had enabled ministries of health and environment to come together. As a prime example, Mr Robineau described the intersectoral collaboration that had allowed environmental performance reviews to be carried out in countries in transition. These had demonstrated that the worst health conditions were found in the Caucasus and central Asia. The reviews had resulted in recommendations for action which were then discussed by UNECE with the country concerned before being adopted.

The key challenge – to ensure their implementation – was still a real one. UNECE was also strong at drawing up international law, including most recently the Protocol on Water and Health (still to be ratified before it could come into force), the Protocol on Strategic Environmental Assessment (signed in Kiev in 2003), and the Transport, Health and Environment Pan-European Programme (THE PEP). He concluded that the collaboration between UNECE and WHO stretched beyond legal instruments and that the two individual political processes – the Environment for Europe process and the Environment and Health process – would continue to work together ensure a healthier environment in the Region.

Nine contributions were made from the floor during this session, of which six were by ministers,

two by other country delegation members and one by a nongovernmental organization (NGO):

Ireland representing the European Union, Austria, Belarus, Bulgaria, Hungary, Portugal, Turkey, and the United Kingdom, and the European Public Health Alliance. The main points raised addressed the health situation resulting from the environment in the European Region and the progress achieved in implementing the commitments made at the Third Ministerial Conference on Environment and Health in London in 1999. Reference was also made to the need for the Environment and Health process in Europe to continue beyond the Budapest Conference, in order to help improve the environment and health situation in Europe. As a dynamic process, it would need to be constantly monitored and evaluated since it could have negative as well as positive impacts. Another important message was that the development and implementation of national environment and health strategies had been a means of achieving high political commitment on environment and health. Implementation of the London Conference commitments, such as those in the areas of water and health, and transport, environment and health, had provided positive stimuli for improvement. Some countries such as Bulgaria and Portugal devoted the main part of their presentations to water and health, and the development and progress of their action plans, also referred to by Turkey.

EUR/04/5046267 page 3 Session 2 – Implementing the London Declaration commitments – progress made. Showcase of good examples This session was structured as a roundtable discussion. It was chaired by Professor Thomas Zeltner, Director, Federal Office of Public Health of Switzerland. Other panellists included Mr Zaal Lomtadze, Deputy Minister of Environment and Natural Resources Protection of Georgia, Mr Olavi Tammemae, Deputy Minister of Environment of Estonia, and Dr Michael Vít, Deputy Minister of Health of the Czech Republic.

The discussion was introduced by a brief presentation on the transport, health and environment process from London to Budapest, focusing in particular on THE PEP, its objectives, priority areas of work and the challenges and opportunities for its future implementation. The presentation was made by Ms Francesca Racioppi on behalf of the joint WHO-UNECE secretariat of THE PEP.

Mr Franklin Apfel facilitated the discussion, inviting panellists to reflect on different aspects of transport, health and environment. The main points that emerged during the discussions are outlined below.

Opportunities for and challenges to intersectoral collaboration Consensus between the transport, health and environment sectors on the necessity to act as • well as on the actions to be taken facilitated collaboration between them. In the field of road traffic safety, for instance, regulation of issues such as speed, drunken driving and risk-taking behaviour by young drivers, and the enforcement of the road safety regulations were areas where collaboration between the relevant authorities was particularly necessary and relatively easy to establish.

The existence of a regulatory framework facilitated the mobilization of resources for • implementation activities.

There was a need to raise awareness of the benefits of more sustainable and healthier • transport as well as to improve the public perception of the magnitude of the problems at stake. As an illustration of the difference in public reaction to news, the Deputy Minister of Health of the Czech Republic referred to the news of an outbreak of meningococcal infection that had alarmed the public much more than the far greater health problem posed by road traffic injuries. Furthermore, as people’s attitudes were shaped very early in life, the role of education and awareness-raising activities among children and young people was particularly crucial.

The relevance was particularly emphasized of the Protocol on Strategic Environmental Assessment as one of the existing policy instruments that could facilitate cross-sectoral collaboration and raise health and environmental considerations on the transport agenda.

Relevance of action at the subnational level Increasing consistency should be sought in the relationships between the transport, health • and environment sectors at national and subnational (e.g. regional and local) levels, as subnational transport policy developments could evolve along different lines from national developments in the absence of effective coordination between the different levels of administration. International cooperation could play a role in supporting the efforts towards EUR/04/5046267 page 4 coordination: at the pan-European level, THE PEP provided a framework for bringing the three sectors together and for promoting close cooperation between them.

The special role of local planning in promoting more sustainable transport was stressed, as • it was at that level that decisions concerning investment in infrastructure for cycling and walking were taken and implemented. For example, in Estonia, opportunities for developing cycling infrastructure were being sought as part of programmes to rehabilitate existing road infrastructure at the local level.

Use of information and communication strategies Effective intersectoral collaboration was also dependent on the availability of reliable • information and data. For example, in Georgia, car ownership was increasing very rapidly and although reported mortality from road traffic injury was still low in comparison with other countries, caution was needed in interpreting the data, as they could merely reflect a low level of motorization rather then the existence of effective road safety policies. The availability of reliable information and the capacity to interpret it correctly was therefore of great importance in identifying emerging issues and guiding the policy response, especially under rapidly changing conditions.

There was a need to improve communication and exchange of information between the • health sector and other relevant sectors, as well as to develop more effective communication strategies targeting specific population groups, such as young people and decision-makers. For example, it was reported that in Switzerland, while there was widespread understanding and support in the middle levels of the administration for the need to promote more physical activity through walking and cycling, more needed to be done to ensure that the issue was also taken up by high-ranking officers and top decisionmakers, resulting in stronger support and political leadership.

Resources to attain sustainable and healthier transport One issue of major concern was the lack of adequate resources to support sustainable • development. That stemmed to a large extent from the difficulty of reconciling the longterm vision and commitment that sustainable development required with the time horizon of politics, which was often driven by short-term policies and the need to achieve rapid successes. To help overcome the problem, there was a need for new and stronger partnerships and alliances.

The discussion among the panellists was further enriched by five contributions from the floor:

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