Environment and healthBMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7199.1635 (Published 19 June 1999) Cite this as: BMJ 1999;318:1635
Europe's partnerships can be a model
At the time of the Peace of Utrecht in 1713 the Abbé de Saint-Pierre pondered on the ill faith of Europe. His vision was a community of nations having a common legal framework and common institutions enabling them to confront the challenges of their times. It took Europe centuries to move close to that vision. In large parts of Europe we are now able to apply democracy and the rule of law among nations as well as within them. No other region is in a stronger position to provide thatkind of leadership than Europe. The environment is one of those issues that pays no attention to national borders—and is thus one subject on which Europe should be able to show the benefits of its cross border leadership.
The environment is a key factor in determining the health of populations.1 Many European countries have seen significant improvements: the sky is blue again over the Ruhr-Gebiet, there are fish in the Thames, acid rain is declining, garbage is being recycled, and cars have cleaner engines. But serious threats are looming. Global economic activities,the escalation of travel and trade, and the changing use of technology all have significant implications for the environment. Erosion of life support systems at a global level has become a seriousand pressing public health issue. Climate change poses new and unknown threats to human health andenvironment.2
We all are affected by environmental degradation, but it is the poor—especially women andchildren—who bear the main burden. And directly linked to the environmental burden is the increased burden of ill health. The message of the World Health Report 1999is that the global community has the knowledge and the tools to address the unfinished health agenda of the 20th century.3
A key message of Our Common Future4 and the Rio Conference on the environment in 1992 was the need to address health and environmental problems in the context of economic policies and practices. The environment moved on from being a cause for the marginal few to becoming a key issue once the scientific evidence came in and the economic implications of environmental degradation were properly understood. The same approach now needs to be applied to analyse the role of sound health policies and interventions.
Focused investments in education, healthy work conditions, environmental sanitation, and a safewater supply are extremely effective in improving health and well being, as well as in increasing productivity and economic growth.5 Countries succeed becausethey have created mechanisms to ensure that health priorities and needs are clearly expressed and effectively fed into the democratic decision making process.6
In 1989 the World Health Organisation initiated a strengthening dialogue between the environment and health sectors at national and local levels. The adoption of the European Charter on Environment and Health in 1989 set the policy principles for effective environmental and health action.7 It also indicated the need for reliable technical and scientific input. This recommendation led to the establishment of the WHO European centres for environment and health in Rome and Bilthoven with the support of the Italian and Dutch governments.
In 1994 in Helsinki the second European conference on environment and health agreed that all European countries would prepare national environment and health action plans tailored to their own needs and conditions. This week the third ministerial conference on health and environment for Europe will take place in London. It brings together a wide range of partners: national and local, public and private, professionals and non-professionals.
Among the expected outcomes of the conference are the adoption and signature by the European countries of a protocol on water and health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes. Once ratified by their parliaments this commits countries to adopting effective mechanisms to provide safe water for all. It will be an important, legally binding international instrument, and the Secretariat of the World Health Organisation is proud to have supported and facilitated it in partnership with the Secretariat of the United Nations Economic Commission for Europe.
The conference will also consider adopting a charter on transport, environment, and health, with the involvement of ministers of transport. This represents a recognition of the need for a majorchange in transport policies around Europe if health is to be protected from hazards such as air pollution, accidents, noise, and lack of physical activity.
The London conference is another step in Europe's contribution to shaping a future for the peoples of Europe. It is another step in a critically important process of building democracy and effective decision making across national borders. Both health and the environment will benefit.