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SDG GOAL 3: A REVIEW OF SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH PDF Print E-mail
Earth News
Posted by Joan Russow
Wednesday, 16 September 2015 05:58

SDG GOAL 3: A REVIEW OF SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH

By Joan Russow

Global Compliance research Project

 

 

Social Determinants Model

 

 

GOAL 3: ENSURE HEALTHY LIVES AND PROMOTE WELL-BEING FOR ALL AT ALL AGES;

 The indicators are important but what has been left out are

the means  of achieving these indicators. For years from ICESCR, through UNCED to WSSD, commitments have been made to act on the links of health and the social and environmental determinants of health.

 

NATIONAL INDICATORS FOR SDG GOAL 3:

3.1. Percentage of births attended by skilled health personnel (MDG Indicator)

3.2. Antenatal care coverage (at least one visit and at least four visits) (MDG Indicator) 3.3. Post-natal care coverage (one visit) (MDG Indicator)

3.4. Coverage of iron-folic acid supplements for pregnant women (%)

 3.5. Incidence rate of diarrheal disease in children under 5 years

3.6. Percentage of 1 year-old children immunized against measles (MDG Indicator)

3.7. Percent HIV+ pregnant women receiving PMTCT

3.8. Condom use at last high-risk sex (MDG Indicator)

 3.9. Percentage of tuberculosis cases detected and cured under directly observed treatment short course (MDG Indicator)

3.10. Percentage of children under 5 with fever who are treated with appropriate anti-malarial drugs (MDG Indicator)

 3.11. Percentage of people in malaria-endemic areas sleeping under insecticide-treated bed nets (modified MDG Indicator)

3.12. Percentage of confirmed malaria cases that receive first-line antimalarial therapy according to national policy

 3.13. Percentage of suspected malaria cases that receive a parasitological test

3.14. Percentage of pregnant women receiving malaria IPT (in endemic areas) 3.15. Neglected Tropical Disease (NTD) cure rate

3.16. Incidence and death rates associated with hepatitis

3.17. Percentage of women with cervical cancer screening

3.18. Percentage of adults with hypertension diagnosed & receiving treatment

3.19. Harmful use of alcohol

3.20. Healthy life expectancy at birth

3.21. Waiting time for elective surgery

3.22. Prevalence of insufficient physical activity

3.23. Fraction of calories from added saturated fats and sugars

3.24. Age-standardized mean population intake of salt (sodium chloride) per day in grams in persons aged 18+ years

3.25. Prevalence of persons (aged 18+ years) consuming less than five total servings (400 grams) of fruit and vegetables per day

3.26. Percentage change in per capita [red] meat consumption relative to a 2015 baseline

 3.27. Age-standardized (to world population age distribution) prevalence of diabetes (preferably based on HbA1c), hypertension, cardiovascular disease, and chronic respiratory disease

3.28. [Mortality from indoor air pollution] – to be developed 3.29. Percentage of health facilities meeting service specific readiness requirements

3.30. Percentage of population with access to affordable essential drugs and commodities on a sustainable basis

3.31. Percentage of new health care facilities built in compliance with building codes and standards

 3.32. Public and private R&D expenditure on health (% GNP) 3.33. Ratio of health professionals to population (MDs, nurse midwives, nurses, community health workers, and caregivers)

3.34. Percentage of women and men aged 15–49 who report discriminatory attitudes towards people living with HIV

3.35. Stillbirth rate

 

A REVIEW OF OBLIGATIONS AND COMMITMENTS RELATED

TO THE SOCIAL AND

ENVIRONMENTAL DETERMINANTS OF HEALTH

 

****INTERNATIONAL COVENANT ON ECONOMIC. SOCIAL AND CULTURAL RIGHTS

Article 7

The States Parties to the present Covenant recognize the right of everyone to the enjoyment of just and favourable conditions of work which ensure, in particular:

(a) Remuneration which provides all workers, as a minimum, with:

(i) Fair wages and equal remuneration for work of equal value without distinction of any kind, in particular women being guaranteed conditions of work not inferior to those enjoyed by men, with equal pay for equal work;

(ii) A decent living for themselves and their families in accordance with the provisions of the present Covenant;

(b) Safe and healthy working conditions;

3. Special measures of protection and assistance should be taken on behalf of all children and young persons without any discrimination for reasons of parentage or other conditions. Children and young persons should be protected from economic and social exploitation. Their employment in work harmful to their morals or health or dangerous to life or likely to hamper their normal development should be punishable by law. States should also set age limits below which the paid employment of child labour should be prohibited and punishable by law.

Article 11

1. The States Parties to the present Covenant recognize the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions. The States Parties will take appropriate steps to ensure the realization of this right, recognizing to this effect the essential importance of international co-operation based on free consent.

2. The States Parties to the present Covenant, recognizing the fundamental right of everyone to be free from hunger, shall take, individually and through international co-operation, the measures, including specific programmes, which are needed:

(a) To improve methods of production, conservation and distribution of food by making full use of technical and scientific knowledge, by disseminating knowledge of the principles of nutrition and by developing or reforming agrarian systems in such a way as to achieve the most efficient development and utilization of natural resources;

(b) Taking into account the problems of both food-importing and food-exporting countries, to ensure an equitable distribution of world food supplies in relation to need.

 

Article 12 ICESC

1. The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.

2. The steps to be taken by the States Parties to the present Covenant to achieve the full realization of this right shall include those necessary for:

(a) The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child;

(b) The improvement of all aspects of environmental and industrial hygiene;

(c) The prevention, treatment and control of epidemic, endemic, occupational and other diseases;

(d) The creation of conditions which would assure to all medical service and medical attention in the event of sickness.

 

 

****1984 Nations Declaration on the Right of Peoples to Peace approved by General Assembly resolution 39/11 of 12, 1984)

 

 

Convinced that life without war “peace with justice” and not just the absence of war serves as the primary international prerequisite for the material well-being, development and progress of countries, and for the full implementation of the rights and fundamental human freedoms. (United Nations Declaration on the Right of Peoples to Peace approved by General Assembly resolution 39/11 of 12, 1984)

 

SECTION I. SOCIAL AND ECONOMIC DIMENSIONS

****1992 agenda 21

. Chapter 1 PREAMBLE 1.1We are confronted with a perpetuation of disparities between and within nations, a worsening of poverty, hunger, ill health

Continuing deterioration of the ecosystems on which we depend for our well-being.

. Humanity stands at a defining moment in history. We are confronted with a perpetuation of disparities between and within nations, a worsening of poverty, hunger, ill health and illiteracy, and the continuing deterioration of the ecosystems on which we depend for our well-being. However, integration of environment and development concerns and greater attention to them will lead to the fulfilment of basic needs, improved living standards for all, better protected and managed ecosystems and a safer, more prosperous future. No nation can achieve this on its own; but together we can - in a global partnership for sustainable development. Chapter 1 PREAMBLE 1.1

 

COMBATTING POVERTY

3.2. cover demographic issues, enhanced health care and education

An effective strategy for tackling the problems of poverty, development and environment simultaneously should begin by focusing on resources, production and people and should cover demographic issues, enhanced health care and education,

While managing resources sustainably, an environmental policy that focuses mainly on the conservation and protection of resources must take due account of those who depend on the resources for their livelihoods. Otherwise it could have an adverse impact both on poverty and on chances for long-term success in resource and environmental conservation. Equally, a development policy that focuses mainly on increasing the production of goods without addressing the sustainability of the resources on which production is based will sooner or later run into declining productivity, which could also have an adverse impact on poverty. A specific anti-poverty strategy is therefore one of the basic conditions for ensuring sustainable development. An effective strategy for tackling the problems of poverty, development and environment simultaneously should begin by focusing on resources, production and people and should cover demographic issues, enhanced health care and education, the rights of women, the role of youth and of indigenous people and local communities and a democratic participation process in association with improved governance. (3.2 Combating Poverty, Agenda 21,UNCED)

3.8 e. Set up an effective primary health care and maternal health care system accessible to all;

Set up an effective primary health care and maternal health care system accessible to all;

3.8 j. Governments should take active steps to implement programmes to establish and strengthen preventive and curative health facilities, which include women-centred, women-managed, safe and effective reproductive health care and affordable, accessible services

Implement, as a matter of urgency, in accordance with country-specific conditions and legal systems, measures to ensure that women and men have the same right to decide freely and responsibly on the number and spacing of their children and have access to the information, education and means, as appropriate, to enable them to exercise this right in keeping with their freedom, dignity and personally held values, taking into account ethical and cultural considerations. Governments should take active steps to implement programmes to establish and strengthen preventive and curative health facilities, which include women-centred, women-managed, safe and effective reproductive health care and affordable, accessible services, as appropriate, for the responsible planning of family size, in keeping with freedom, dignity and personally held values, taking into account ethical and cultural considerations. Programmes should focus on providing comprehensive health care, including pre-natal care, education and information on health and responsible parenthood and should provide the opportunity for all women to breast-feed fully, at least during the first four months postpartum. Programmes should fully support women's productive and reproductive roles and well-being, with special attention to the need for providing equal and improved health care for all children and the need to reduce the risk of maternal and child mortality and sickness

(3.8 j Combating Poverty, Agenda 21,UNCED)

 

Agenda 21 - Chapter 4 Changing Consumption Patterns

4.22. Making consumers aware of the health and environmental impact of products, through such means as consumer legislation and environmental labelling;

They should also encourage the emergence of an informed consumer public and assist individuals and households to make environmentally informed choices by:

a. Providing information on the consequences of consumption choices and behaviour so as to encourage demand for environmentally sound products and use of products;

 b. Making consumers aware of the health and environmental impact of products, through such means as consumer legislation and environmental labelling;  (4.22 Agenda 21 - Chapter 4 Changing Consumption Patterns)

 

5.16.  combine environmental concerns and population issues within a holistic view of development whose primary goals include the alleviation of poverty; secure livelihoods; good health

good health; quality of life; improvement of the status and income of women and their access to schooling and professional training

Existing plans for sustainable development have generally recognized demographic trends and factors as elements that have a critical influence on consumption patterns, production, lifestyles and long-term sustainability. But in future, more attention will have to be given to these issues in general policy formulation and the design of development plans. To do this, all countries will have to improve their own capacities to assess the environment and development implications of their demographic trends and factors. They will also need to formulate and implement policies and action programmes where appropriate. Policies should be designed to address the consequences of population growth built into population momentum, while at the same time incorporating measures to bring about demographic transition. They should combine environmental concerns and population issues within a holistic view of development whose primary goals include the alleviation of poverty; secure livelihoods; good health; quality of life; improvement of the status and income of women and their access to schooling and professional training, as well as fulfilment of their personal aspirations; and empowerment of individuals and communities. Recognizing that large increases in the size and number of cities will occur in developing countries under any likely population scenario, greater attention should be given to preparing for the needs, in particular of women and children, for improved municipal management and local government.

(Agenda 21 - 5.12 Chapter DEMOGRAPHIC DYNAMICS AND SUSTAINABILITY)

5.23. special attention should be given to critical resources, such as water and land, and environmental factors, such as ecosystem health and biodiversity.

An assessment should also be made of national population carrying capacity in the context of satisfaction of human needs and sustainable development, and special attention should be given to critical resources, such as water and land, and environmental factors, such as ecosystem health and biodiversity. (Agenda 21 - 5.23 Chapter Demographic Dynamics and Sustainability)

5.29. In formulating human settlements policies, account should be taken of resource needs, waste production and ecosystem health.

(b) Raising awareness of demographic and sustainable development interactions

5.37. Special emphasis should be placed on the linkage between these programmes, primary environmental care and the provision of primary health care and services.

Understanding of the interactions between demographic trends and factors and sustainable development should be increased in all sectors of society. Stress should be placed on local and national action. Demographic and sustainable development education should be coordinated and integrated in both the formal and non-formal education sectors. Particular attention should be given to population literacy programmes, notably for women. Special emphasis should be placed on the linkage between these programmes, primary environmental care and the provision of primary health care and services. (Agenda 21 - 5.37 Chapter Demographic Dynamics and Sustainability)

5.49. good health; quality of life; improvement of the status and income of women and their access to schooling and professional training

Reproductive health programmes and services, should, as appropriate, be developed and enhanced to reduce maternal and infant mortality from all causes and enable women and men to fulfil their personal aspirations in terms of family size, in a way in keeping with their freedom and dignity and personally held values.

5.51. . Governments should take active steps to implement programmes to establish and strengthen preventive and curative health facilities

 Governments should take active steps to implement programmes to establish and strengthen preventive and curative health facilities that include women-centred, women-managed, safe and effective reproductive health care and affordable, accessible services, as appropriate, for the responsible planning of family size, in keeping with freedom, dignity and personally held values and taking into account ethical and cultural considerations. Programmes should focus on providing comprehensive health care, including pre-natal care, education and information on health and responsible parenthood and should provide the opportunity for all women to breast-feed fully, at least during the first four months post-partum. Programmes should fully support women's productive and reproductive roles and well-being, with special attention to the need for providing equal and improved health care for all children and the need to reduce the risk of maternal and child mortality and sickness.

6.1. Health and development are intimately interconnected.

The linkage of health, environmental and socio-economic improvements requires intersectoral efforts

Both insufficient development leading to poverty and inappropriate development resulting in overconsumption, coupled with an expanding world population, can result in severe environmental health problems in both developing and developed nations. Action items under Agenda 21 must address the primary health needs of the world's population, since they are integral to the achievement of the goals of sustainable development and primary environmental care. The linkage of health, environmental and socio-economic improvements requires intersectoral efforts. Such efforts, involving education, housing, public works and community groups, including businesses, schools and universities and religious, civic and cultural organizations, are aimed at enabling people in their communities to ensure sustainable development. Particularly relevant is the inclusion of prevention programmes rather than relying solely on remediation and treatment. Countries ought to develop plans for priority actions, drawing on the programme areas in this chapter, which are based on cooperative planning by the various levels of government, non-governmental organizations and local communities. An appropriate international organization, such as WHO, should coordinate these activities. (6.1 Chapter 6 Protecting and Promoting Human Health)

 

6.2. (e) Reducing health risks from environmental pollution and hazards.

The following programme areas are contained in this chapter:  (a)Meeting primary health care needs, particularly in rural areas (b)Control of communicable diseases; (c)Protecting vulnerable groups (d)Meeting the urban health challenge;(e) Reducing health risks from environmental pollution and hazards.

e. Reducing health risks from environmental pollution and hazards

(6.2e Chapter 6 Protecting and Promoting Human Health).

 

6.3. it is the very lack of development that adversely affects the health condition of many people,

Health ultimately depends on the ability to manage successfully the interaction between the physical, spiritual, biological and economic/social environment. Sound development is not possible without a healthy population; yet most developmental activities affect the environment to some degree, which in turn causes or exacerbates many health problems. Conversely, it is the very lack of development that adversely affects the health condition of many people, which can be alleviated only through development. The health sector cannot meet basic needs and objectives on its own; it is dependent on social, economic and spiritual development, while directly contributing to such development. It is also dependent on a healthy environment, including the provision of a safe water supply and sanitation and the promotion of a safe food supply and proper nutrition. Particular attention should be directed towards food safety, with priority placed on the elimination of food contamination; comprehensive and sustainable water policies to ensure safe drinking water and sanitation to preclude both microbial and chemical contamination; and promotion of health education, immunization and provision of essential drugs. Education and appropriate services regarding responsible planning of family size, with respect for cultural, religious and social aspects, in keeping with freedom, dignity and personally held values and taking in taking into account ethical and cultural considerations, also contribute to these intersectoral activities.(6.3 Chapter 6 Protecting and Promoting Human Health Agenda 21)

Objectives

6.4. Within the overall strategy to achieve health for all by the year 2000

Within the overall strategy to achieve health for all by the year 2000, the objectives are to meet the basic health needs of rural peri-urban and urban populations; to provide the necessary specialized environmental health services; and to coordinate the involvement of citizens, the health sector, the health-related sectors and relevant non-health sectors (business, social, educational and religious institutions) in solutions to health problems. As a matter of priority, health service coverage should be achieved for population groups in greatest need, particularly those living in rural areas. Within the overall strategy to achieve health for all by the year 2000

(6.4 Chapter 6 Protecting and Promoting Human Health Agenda 21

 

Activities 6.5. strengthen their health sector programmes, with special attention to rural needs, to

National Governments and local authorities, with the support of relevant non-governmental organizations and international organizations, in the light of countries' specific conditions and needs, should strengthen their health sector programmes, with special attention to rural needs, to:

(a) Build basic health infrastructures, monitoring and planning systems:

6.5 a

i. Develop and strengthen primary health care systems that are practical, community-based, scientifically sound, socially acceptable and appropriate to their needs and that meet basic health needs for clean water, safe food and sanitation;

ii. Support the use and strengthening of mechanisms that improve coordination between health and related sectors at all appropriate levels of government, and in communities and relevant organizations;

iii. Develop and implement rational and affordable approaches to the establishment and maintenance of health facilities;

 iv. Ensure and, where appropriate, increase provision of social services support;

v. Develop strategies, including reliable health indicators, to monitor the progress and evaluate the effectiveness of health programmes;

vi. Explore ways to finance the health system based on the assessment of the resources needed and identify the various financing alternatives;

 vii. Promote health education in schools, information exchange, technical support and training;

viii. Support initiatives for self-management of services by vulnerable groups;

 ix. Integrate traditional knowledge and experience into national health systems, as appropriate;

x. Promote the provisions for necessary logistics for outreach activities, particularly in rural areas; xi. Promote and strengthen community-based rehabilitation activities for the rural handicapped.

(b) Support research and methodology development: i. Establish mechanisms for sustained community involvement in environmental health activities, including optimization of the appropriate use of community financial and human resources;

(6.5 Chapter 6 Protecting and Promoting Human Health Agenda 21)

 

(b) Support research and methodology development:

 i. Establish mechanisms for sustained community involvement in environmental health activities, including optimization of the appropriate use of community financial and human resources;

ii. Conduct environmental health research, including behaviour research and research on ways to increase coverage and ensure greater utilization of services by peripheral, underserved and vulnerable populations, as appropriate to good prevention services and health care;

iii. Conduct research into traditional knowledge of prevention and curative health practices.

Objectives 6.12. (Plan of Action for Implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s).

A number of goals have been formulated through extensive consultations in various international forums attended by virtually all Governments, relevant United Nations organizations (including WHO, UNICEF, UNFPA, UNESCO, UNDP and the World Bank) and a number of non-governmental organizations. Goals (including but not limited to those listed below) are recommended for implementation by all countries where they are applicable, with appropriate adaptation to the specific situation of each country in terms of phasing, standards, priorities and availability of resources, with respect for cultural, religious and social aspects, in keeping with freedom, dignity and personally held values and taking into account ethical considerations. Additional goals that are particularly relevant to a country's specific situation should be added in the country's national plan of action (Plan of Action for Implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s).

 

1/ Such national level action plans should be coordinated and monitored from within the public health sector. Some major goals are:

a. By the year 2000, to eliminate guinea worm disease (dracunculiasis);

b. By the year 2000, eradicate polio;

c. By the year 2000, to effectively control onchocerciasis (river blindness) and leprosy;

d. By 1995, to reduce measles deaths by 95 per cent and reduce measles cases by 90 per cent compared with pre-immunization levels;

e. By continued efforts, to provide health and hygiene education and to ensure universal access to safe drinking water and universal access to sanitary measures of excreta disposal, thereby markedly reducing waterborne diseases such as cholera and schistosomiasis and reducing: i. By the year 2000, the number of deaths from childhood diarrhoea in developing countries by 50 to 70 per cent;

 ii. By the year 2000, the incidence of childhood diarrhoea in developing countries by at least 25 to 50 per cent;

f. By the year 2000, to initiate comprehensive programmes to reduce mortality from acute respiratory infections in children under five years by at least one third, particularly in countries with high infant mortality;

g. By the year 2000, to provide 95 per cent of the world's child population with access to appropriate care for acute respiratory infections within the community and at first referral level;

h. By the year 2000, to institute anti-malaria programmes in all countries where malaria presents a significant health problem and maintain the transmission-free status of areas freed from endemic malaria;

i. By the year 2000, to implement control programmes in countries where major human parasitic infections are endemic and achieve an overall reduction in the prevalence of schistosomiasis and of other trematode infections by 40 per cent and 25 per cent, respectively, from a 1984 baseline, as well as a marked reduction in incidence, prevalence and intensity of filarial infections;

 j. To mobilize and unify national and international efforts against AIDS to prevent infection and to reduce the personal and social impact of HIV infection;

k. To contain the resurgence of tuberculosis, with particular emphasis on multiple antibiotic resistant forms;

 l. To accelerate research on improved vaccines and implement to the fullest extent possible the use of vaccines in the prevention of disease.

Activities 6.13. i. Programmes to identify environmental hazards in the causation of communicable diseases;

 Each national Government, in accordance with national plans for public health, priorities and objectives, should consider developing a national health action plan with appropriate international assistance and support, including, at a minimum, the following components: a. National public health systems: i. Programmes to identify environmental hazards in the causation of communicable diseases; (6.13 i Chapter 6 Protecting and Promoting Human Health Agenda 21)

ii. Monitoring systems of epidemiological data to ensure adequate forecasting of the introduction, spread or aggravation of communicable diseases;

6.22. Indigenous people … tend to feature disproportionately in unemployment, lack of housing, poverty and poor health.

Indigenous people and their communities. Indigenous people had their communities make up a significant percentage of global population. The outcomes of their experience have tended to be very similar in that the basis of their relationship with traditional lands has been fundamentally changed. They tend to feature disproportionately in unemployment, lack of housing, poverty and poor health. In many countries the number of indigenous people is growing faster than the general population. Therefore it is important to target health initiatives for indigenous people. (6.22 Chapter 6 Protecting and Promoting Human Health Agenda 21)

6.23. The general objectives of protecting vulnerable groups are to ensure that all such individuals should be allowed to develop to their full potential (including healthy physical, mental and spiritual development);

The general objectives of protecting vulnerable groups are to ensure that all such individuals should be allowed to develop to their full potential (including healthy physical, mental and spiritual development); to ensure that young people can develop, establish and maintain healthy lives; to allow women to perform their key role in society; and to support indigenous people through educational, economic and technical opportunities.

6.26. take active steps to implement programmes to establish and strengthen preventive and curative health facilities

support women's productive and reproductive roles and well being

Governments should take active steps to implement programmes to establish and strengthen preventive and curative health facilities which include women-centred, women-managed, safe and effective reproductive health care and affordable, accessible services, as appropriate, for the responsible planning of family size, in keeping with freedom, dignity and personally held values and taking into account ethical and cultural considerations. Programmes should focus on providing comprehensive health care, including pre-natal care, education and information on health and responsible parenthood and should provide the opportunity for all women to breast-feed fully, at least during the first four months post-partum. Programmes should fully support women's productive and reproductive roles and well-being, with special attention to the need for providing equal and improved health care for all children and the need to reduce the risk of maternal and child mortality and sickness. (6.26 Chapter 6 Protecting and Promoting Human Health Agenda 21)

6.31 c i,ii.iii. Women: Strengthen, through resources and self-management, preventative and curative health services;

i. Involve women's groups in decision-making at the national and community levels to identify health risks and incorporate health issues in national action programmes on women and development;

ii. Provide concrete incentives to encourage and maintain attendance of women of all ages at school and adult education courses, including health education and training in primary, home and maternal health care;

iii. Carry out baseline surveys and knowledge, attitude and practice studies on the health and nutrition of women throughout their life cycle, especially as related to the impact of environmental degradation and adequate resources;

(6.31 c i,ii.iii Protecting and Promoting Human Health Agenda 21)

 

6.31 d I ii  Indigenous people and their communities: i. Strengthen, through resources and self-management, preventative and curative health services;

ii.   traditional knowledge and experience into health systems.

(6.31 d i ii Protecting and Promoting Human Health Agenda 21)

 

D. Meeting the urban health challenge Basis for action

6.32. For hundreds of millions of people, the poor living conditions in urban and peri-urban areas are destroying lives, health, and social and moral values.

For hundreds of millions of people, the poor living conditions in urban and peri-urban areas are destroying lives, health, and social and moral values.

For hundreds of millions of people, the poor living conditions in urban and peri-urban areas are destroying lives, health, and social and moral values. Urban growth has outstripped society's capacity to meet human needs, leaving hundreds of millions of people with inadequate incomes, diets, housing and services. Urban growth exposes populations to serious environmental hazards and has outstripped the capacity of municipal and local governments to provide the environmental health services that the people need. All too often, urban development is associated with destructive effects on the physical environment and the resource base needed for sustainable development. Environmental pollution in urban areas is associated with excess morbidity and mortality. Overcrowding and inadequate housing contribute to respiratory diseases, tuberculosis, meningitis and other diseases. In urban environments, many factors that affect human health are outside the health sector. Improvements in urban health therefore will depend on coordinated action by all levels of government, health care providers, businesses, religious groups, social and educational institutions and citizens.

 

Objectives

6.33. The health and well-being of all urban dwellers must be improved

The same rate of improvement should be achieved for environmental, housing and health service indicators

The health and well-being of all urban dwellers must be improved so that they can contribute to economic and social development. The global objective is to achieve a 10 to 40 per cent improvement in health indicators by the year 2000. The same rate of improvement should be achieved for environmental, housing and health service indicators. These include the development of quantitative objectives for infant mortality, maternal mortality, percentage of low birth weight newborns and specific indicators (e.g. tuberculosis as an indicator of crowded housing, diarrhoeal diseases as indicators of inadequate water and sanitation, rates of industrial and transportation accidents that indicate possible opportunities for prevention of injury, and social problems such as drug abuse, violence and crime that indicate underlying social disorders). (6.22 Chapter 6 Protecting and Promoting Human Health Agenda 21)

Activities 6.34. emphasize "doing with" rather than "doing for" and create supportive environments for health

Local authorities, with the appropriate support of national Governments and international organizations should be encouraged to take effective measures to initiate or strengthen the following activities:

a. Develop and implement municipal and local health plans:

i. Establish or strengthen intersectoral committees at both the political and technical level, including active collaboration on linkages with scientific, cultural, religious, medical, business, social and other city institutions, using networking arrangements;

ii. Adopt or strengthen municipal or local "enabling strategies" that emphasize "doing with" rather than "doing for" and create supportive environments for health; (6.34 Chapter 6 Protecting and Promoting Human Health Agenda 21)

 

E. Reducing health risks from environmental pollution and hazards Basis for action

6.39. In many locations around the world the general environment (air, water and land), workplaces and even individual dwellings are so badly polluted that the health of hundreds of millions of people is adversely affected. This is, inter alia, due to past and present developments in consumption and production patterns and lifestyles, in energy production and use, in industry, in transportation etc., with little or no regard for environmental protection. There have been notable improvements in some countries, but deterioration of the environment continues. The ability of countries to tackle pollution and health problems is greatly restrained because of lack of resources. Pollution control and health protection measures have often not kept pace with economic development. Considerable development related environmental health hazards exist in the newly industrializing countries. Furthermore, the recent analysis of WHO has clearly established the interdependence among the factors of health, environment and development and has revealed that most countries are lacking such integration as would lead to an effective pollution control mechanism.

2/ Without prejudice to such criteria as may be agreed upon by the international community, or to standards which will have to be determined nationally, it will be essential in all cases to consider the systems of values prevailing in each country and the extent of the applicability of standards that are valid for the most advanced countries but may be inappropriate and of unwarranted social cost for the developing countries.

(6.39 Chapter 6 Protecting and Promoting Human Health Agenda 21)

Objectives

6.40. The overall objective is to minimize hazards and maintain the environment to a degree that human health and safety is not impaired or endangered and yet encourage development to proceed. Specific programme objectives are:

a. By the year 2000, to incorporate appropriate environmental and health safeguards as part of national development programmes in all countries;

b. By the year 2000, to establish, as appropriate, adequate national infrastructure and programmes for providing environmental injury, hazard surveillance and the basis for abatement in all countries;

c. By the year 2000, to establish, as appropriate, integrated programmes for tackling pollution at the source and at the disposal site, with a focus on abatement actions in all countries;

d. To identify and compile, as appropriate, the necessary statistical information on health effects to support cost/benefit analysis, including environmental health impact assessment for pollution control, prevention and abatement measures.

(6.40 Chapter 6 Protecting and Promoting Human Health Agenda 21)

Activities

6.41. Nationally determined action programmes, with international assistance, support and coordination, where necessary, in this area should include: a. Urban air pollution:

i.             Develop appropriate pollution control technology on the basis of risk assessment and epidemiological research for the introduction of environmentally sound production processes and suitable safe mass transport;

ii.           Develop air pollution control capacities in large cities, emphasizing enforcement programmes and using monitoring networks, as appropriate;

b. Indoor air pollution:

i. Support research and develop programmes for applying prevention and control methods to reducing indoor air pollution, including the provision of economic incentives for the installation of appropriate technology;

ii. Develop and implement health education campaigns, particularly in developing countries, to reduce the health impact of domestic use of biomass and coal;

c. Water pollution:

i. Develop appropriate water pollution control technologies on the basis of health risk assessment;

ii. Develop water pollution control capacities in large cities; d. Pesticides: Develop mechanisms to control the distribution and use of pesticides in order to minimize the risks to human health by transportation, storage, application and residual effects of pesticides used in agriculture and preservation of wood;

e. Solid waste:

i. Develop appropriate solid waste disposal technologies on the basis of health risk assessment;

ii. Develop appropriate solid waste disposal capacities in large cities;

f. Human settlements: Develop programmes for improving health conditions in human settlements, in particular within slums and non-tenured settlements, on the basis of health risk assessment;

g. Noise: Develop criteria for maximum permitted safe noise exposure levels and promote noise assessment and control as part of environmental health programmes;

h. Ionizing and non-ionizing radiation: Develop and implement appropriate national legislation, standards and enforcement procedures on the basis of existing international guidelines;

i. Effects of ultraviolet radiation: Undertake, as a matter of urgency, research on the effects on human health of the increasing ultraviolet radiation reaching the earth's surface as a consequence of depletion of the stratospheric ozone layer;

 ii. On the basis of the outcome of this research, consider taking appropriate remedial measures to mitigate the above-mentioned effects on human beings;

i. Industry and energy production:

 i. Establish environmental health impact assessment procedures for the planning and development of new industries and energy facilities;

ii. Incorporate appropriate health risk analysis in all national programmes for pollution control and management, with particular emphasis on toxic compounds such as lead;

iii. Establish industrial hygiene programmes in all major industries for the surveillance of workers' exposure to health hazards;

iv. Promote the introduction of environmentally sound technologies within the industry and energy sectors;

j. Monitoring and assessment: Establish, as appropriate, adequate environmental monitoring capacities for the surveillance of environmental quality and the health status of populations;

k. Injury monitoring and reduction:

i. Support, as appropriate, the development of systems to monitor the incidence and cause of injury to allow well-targeted intervention/prevention strategies;

ii. Develop, in accordance with national plans, strategies in all sectors (industry, traffic and others) consistent with the WHO safe cities and safe communities programmes, to reduce the frequency and severity of injury;

iii. Emphasize preventive strategies to reduce occupationally derived diseases and diseases caused by environmental and occupational toxins to enhance worker safety;

l. Research promotion and methodology development:

i. Support the development of new methods for the quantitative assessment of health benefits and cost associated with different pollution control strategies;

ii. Develop and carry out interdisciplinary research on the combined health effects of exposure to multiple environmental hazards, including epidemiological investigations of long-term exposures to low levels of pollutants and the use of biological markers capable of estimating human exposures, adverse effects and susceptibility to environmental agents.

(6.41 Chapter 6 Protecting and Promoting Human Health Agenda 21)

6.42.

The Conference secretariat has estimated the average total annual cost (1993-2000) of implementing the activities of this programme to be about $3 billion, including about $115 million from the international community on grant or concessional terms. These are indicative and order-of magnitude estimates only and has not been reviewed by Governments. Actual costs and financial terms, including any that are non-concessional, will depend upon, inter alia, the specific strategies and programmes Governments decide upon for implementation. (b) Scientific and technological means (6.4.2 Chapter 6 Protecting and Promoting Human Health Agenda 21)

6.43. setting of priorities and strategies in relation to health and development.

Although technology to prevent or abate pollution is readily available for a large number of problems, for programme and policy development countries should undertake research within an intersectoral framework. Such efforts should include collaboration with the business sector. Cost/effect analysis and environmental impact assessment methods should be developed through cooperative international programmes and applied to the setting of priorities and strategies in relation to health and development.

d. To identify and compile, as appropriate, the necessary statistical information on health effects to support cost/benefit analysis, including environmental health impact assessment for pollution control, prevention and abatement measures.(d)

Capacity-building

6.46. Basic capacity requirements must include knowledge about environmental health problems

Each country should develop the knowledge and practical skills to foresee and identify environmental health hazards, and the capacity to reduce the risks.

 Each country should develop the knowledge and practical skills to foresee and identify environmental health hazards, and the capacity to reduce the risks. Basic capacity requirements must include knowledge about environmental health problems and awareness on the part of leaders, citizens and specialists; operational mechanisms for intersectoral and intergovernmental cooperation in development planning and management and in combating pollution; arrangements for involving private and community interests in dealing with social issues; delegation of authority and distribution of resources to intermediate and local levels of government to provide front-line capabilities to meet environmental health needs. Notes 1/ A/45/625, annex. 2/ Report of the WHO Commission on Health and Environment (Geneva, forthcoming)

Basis for action 7.6. Access to safe and healthy shelter is essential to a person's physical, psychological, social and economic well-being

The right to adequate housing as a basic human right is enshrined in the Universal Declaration of Human Rights

 Access to safe and healthy shelter is essential to a person's physical, psychological, social and economic well-being and should be a fundamental part of national and international action. The right to adequate housing as a basic human right is enshrined in the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights. Despite this, it is estimated that at the present time, at least 1 billion people do not have access to safe and healthy shelter and that if appropriate action is not taken, this number will increase dramatically by the end of the century and beyond.

7.16 d. thereby promoting employment generation that is environmentally sound and protective of human health

Developing local strategies for improving the quality of life and the environment, integrating decisions on land use and land management, investing in the public and private sectors and mobilizing human and material resources, thereby promoting employment generation that is environmentally sound and protective of human health. (b) Strengthening urban data systems

7.20. the Healthy Cities Programme of WHO, should be intensified

All cities, particularly those characterized by severe sustainable development problems, should, in accordance with national laws, rules and regulations, develop and strengthen programmes aimed at addressing such problems and guiding their development along a sustainable path. Some international initiatives in support of such efforts, as in the Sustainable Cities Programme of Habitat and the Healthy Cities Programme of WHO, should be intensified. Additional initiatives involving the World Bank, the regional development banks and bilateral agencies, as well as other interested stakeholders, particularly international and national representatives of local authorities, should be strengthened and coordinated. Individual cities should, as appropriate:

7.30

g. Accelerate efforts to promote access to land by the urban and rural poor, including credit schemes for the purchase of land and for building/acquiring or improving safe and healthy shelter and infrastructure services;

 

7.35. , the inadequacy and lack of environmental infrastructure is responsible for widespread ill-health and a large number of preventable deaths each year.

The sustainability of urban development is defined by many parameters relating to the availability of water supplies, air quality and the provision of environmental infrastructure for sanitation and waste management. As a result of the density of users, urbanization, if properly managed, offers unique opportunities for the supply of sustainable environmental infrastructure through adequate pricing policies, educational programmes and equitable access mechanisms that are economically and environmentally sound. In most developing countries, however, the inadequacy and lack of environmental infrastructure is responsible for widespread ill-health and a large number of preventable deaths each year. In those countries conditions are set to worsen due to growing needs that exceed the capacity of Governments to respond adequately.

7.39. implement environmentally sound technology to ensure that the environment, human health and quality of life are protected.

All countries should assess the environmental suitability of infrastructure in human settlements, develop national goals for sustainable management of waste, and implement environmentally sound technology to ensure that the environment, human health and quality of life are protected. Settlement infrastructure and environmental programmes designed to promote an integrated human settlements approach to the planning, development, maintenance and management of environmental infrastructure (water supply, sanitation, drainage, solid-waste management) should be strengthened with the assistance of bilateral and multilateral agencies. Coordination among these agencies and with collaboration from international and national representatives of local authorities, the private sector and community groups should also be strengthened. The activities of all agencies engaged in providing environmental infrastructure should, where possible, reflect an ecosystem or metropolitan area approach to settlements and should include monitoring, applied research, capacity-building, transfer of appropriate technology and technical cooperation among the range of programme activities.

7.48. Transport accounts for about 30 per cent of commercial energy consumption and for about 60 per cent of total global consumption of liquid petroleum. In developing countries, rapid motorization and insufficient investments in urban-transport planning, traffic management and infrastructure, are creating increasing problems in terms of accidents and injury, health, noise, congestion and loss of productivity similar to those occurring in many developed countries. All of these problems have a severe impact on urban populations, particularly the low-income and no-income groups. Objectives 7.49. The objectives are to extend the provision of more energy-efficient technology and alternative/renewable energy for human settlements and to reduce negative impacts of energy production and use on human health and on the environment.

G. Promoting sustainable construction industry activities Basis for action 7.67. The activities of the construction sector are vital to the achievement of the national socioeconomic development goals of providing shelter, infrastructure and employment. However, they can be a major source of environmental damage through depletion of the natural resource base, degradation of fragile eco-zones, chemical pollution and the use of building materials harmful to human health.

 

Objectives 7.68. The objectives are, first, to adopt policies and technologies and to exchange information on them in order to enable the construction sector to meet human settlement development goals, while avoiding harmful side-effects on human health and on the biosphere, and, second, to enhance the employment generation capacity of the construction sector. Governments should work in close collaboration with the private sector in achieving these objectives.

 

7.70. All countries should: a. Promote the free exchange of information on the entire range of environmental and health aspects of construction

All countries should: a. Promote the free exchange of information on the entire range of environmental and health aspects of construction, including the development and dissemination of databases on the adverse environmental effects of building materials through the collaborative efforts of the private and public sectors; b. Promote the development and dissemination of databases on the adverse environmental and health effects of building materials and introduce legislation and financial incentives to promote recycling of energy -intensive materials in the construction industry and conservation of waste energy in building-materials production methods; c. Promote the use of economic instruments, such as product charges, to discourage the use of construction materials and products that create pollution during their life cycle; d. Promote information exchange and appropriate technology transfer among all countries, with particular attention to developing countries, for resource management in construction, particularly for non-renewable resources; e. Promote research in construction industries and related activities, and establish and strengthen institutions in this sector.

 

Agenda 21 – Chapter 9 Protection of the Atmosphere

Better understanding and prediction of the various properties of the atmosphere and of the affected ecosystems, as well as health impacts and their interactions with socio-economic factors, are needed.

 

Basis for action 9.6. Concern about climate change and climate variability, air pollution and ozone depletion has created new demands for scientific, economic and social information to reduce the remaining uncertainties in these fields. Better understanding and prediction of the various properties of the atmosphere and of the affected ecosystems, as well as health impacts and their interactions with socio-economic factors, are needed.

(Chapter 9.6 Protection of the Atmosphere Agenda 21)

Activities

9.8. Governments at the appropriate level, with the cooperation of the relevant United Nations bodies and, as appropriate, intergovernmental and non-governmental organizations, and the private sector, should: a. Promote research related to the natural processes affecting and being affected by the atmosphere, as well as the critical linkages between sustainable development and atmospheric changes, including impacts on human health, ecosystems, economic sectors and society; (Chapter 9.8 Protection of the Atmosphere Agenda 21)

 

1.   Energy development, efficiency and consumption Basis for action

9.9. All energy sources will need to be used in ways that respect the atmosphere, human health and the environment as a whole

Energy is essential to economic and social development and improved quality of life. Much of the world's energy, however, is currently produced and consumed in ways that could not be sustained if technology were to remain constant and if overall quantities were to increase substantially. The need to control atmospheric emissions of greenhouse and other gases and substances will increasingly need to be based on efficiency in energy production, transmission, distribution and consumption, and on growing reliance on environmentally sound energy systems, particularly new and renewable sources of energy. 1/ All energy sources will need to be used in ways that respect the atmosphere, human health and the environment as a whole. (Chapter 9.9 Protection of the Atmosphere Agenda 21)

 

9.24 Participate actively in the continuous assessment of scientific information and the health and environmental effects

Participate actively in the continuous assessment of scientific information and the health and environmental effects, as well as of the technological/economic implications of stratospheric ozone depletion; and consider further actions that prove warranted and feasible on the basis of these assessments; d. Based on the results of research on the effects of the additional ultraviolet radiation reaching the Earth's surface, (Chapter 9.24 Protection of the Atmosphere Agenda 21)

D. Transboundary atmospheric pollution Basis for action

9.25. Transboundary air pollution has adverse health impacts on humans and other detrimental environmental impacts,

Transboundary air pollution has adverse health impacts on humans and other detrimental environmental impacts, such as tree and forest loss and the acidification of water bodies. The geographical distribution of atmospheric pollution monitoring networks is uneven, with the developing countries severely underrepresented. The lack of reliable emissions data outside Europe and North America is a major constraint to measuring transboundary air pollution. There is also insufficient information on the environmental and health effects of air pollution in other regions.

(Chapter 9.25 Protection of the Atmosphere Agenda 21)

 

 

Activities

9.28.

Governments at the appropriate level, with the cooperation of the relevant United Nations bodies and, as appropriate, intergovernmental and non-governmental organizations, the private sector and financial institutions, should:

9.28.a. greater emphasis should be put on addressing the extent, causes, health and socio-economic impacts of ultraviolet radiation, acidification of the environment and photo-oxidant damage to forests and other vegetation;

Establish and/or strengthen regional agreements for transboundary air pollution control and cooperate, particularly with developing countries, in the areas of systematic observation and assessment, modelling and the development and exchange of emission control technologies for mobile and stationary sources of air pollution. In this context, greater emphasis should be put on addressing the extent, causes, health and socio-economic impacts of ultraviolet radiation, acidification of the environment and photo-oxidant damage to forests and other vegetation; (Chapter 9.28.a Protection of the Atmosphere Agenda 21)

 

Agenda 21 – Chapter 11 Combating Deforestation

The greening of appropriate areas is a task of global importance and impact. The international and regional community should provide technical cooperation and other means for this programme area. Specific activities of an international nature, in support of national efforts, should include the following:

a. Increasing cooperative actions to reduce pollutants and trans-boundary impacts affecting the health of trees and forests and conservation of representative ecosystems;(11.15. Chapter 11 Combating Deforestation Agenda 21)

 

 

Agenda 21 – Chapter 12 Managing Fragile Ecosystems: Combating Desertification and Drought

Means of implementation

(a) Financing and cost evaluation

12.11. The Conference secretariat has estimated the average total annual cost (1993-2000) of implementing the activities of this programme to be about $350 million, including about $175 million from the international community on grant or concessional terms. These are indicative and order-of-magnitude estimates only and have not been reviewed by Governments. Actual costs and financial terms, including any that are non-concessional, will depend upon, inter alia, the specific strategies and programmes Governments decide upon for implementation.

(b) Scientific and technological means

12.12. Governments at the appropriate level, with the support of the relevant international and regional organizations working on the issue of desertification and drought, should:

a. Undertake and update existing inventories of natural resources, such as energy, water, soil, minerals, plant and animal access to food, as well as other resources, such as housing, employment, health, education and demographic distribution in time and space;

 

Agenda 21 – Chapter 13 Managing Fragile Ecosystems: Sustainable Mountain Development

13.14. Poverty, unemployment, poor health and bad sanitation are widespread.  

Soil erosion can have a devastating impact on the vast numbers of rural people who depend on rainfed agriculture in the mountain and hillside areas. Poverty, unemployment, poor health and bad sanitation are widespread. Promoting integrated watershed development programmes through effective participation of local people is a key to preventing further ecological imbalance. An integrated approach is needed for conserving, upgrading and using the natural resource base of land, water, plant, animal and human resources. In addition, promoting alternative livelihood opportunities, particularly through development of employment schemes that increase the productive base, will have a significant role in improving the standard of living among the large rural population living in mountain ecosystems.

Chapter 13 Managing Fragile Ecosystems: Sustainable Mountain Development

 

13.14

 

13.22. Governments at the appropriate level, with the support of the relevant international and regional organizations, should: a. Promote a multidisciplinary and cross-sectoral approach in training and the dissemination of knowledge to local people on a wide range of issues, such as household production systems, conservation and utilization of arable and non-arable land, treatment of drainage lines and recharging of groundwater, livestock management, fisheries, agroforestry and horticulture;

b. Develop human resources by providing access to education, health, energy and infrastructure;

 c. Promote local awareness and preparedness for disaster prevention and mitigation, combined with the latest available technology for early warning and forecasting.

Agenda 21 –

Chapter 14 Chemical control of agricultural pests has dominated the scene, but its overuse has adverse effects on farm budgets, human health and the environment Promoting Sustainable Agriculture and Rural Development

14.73. Chemical control of agricultural pests has dominated the scene, but its overuse has adverse effects on farm budgets, human health and the environment

World food demand projections indicate an increase of 50 per cent by the year 2000 which will more than double again by 2050. Conservative estimates put pre-harvest and post-harvest losses caused by pests between 25 and 50 per cent. Pests affecting animal health also cause heavy losses and in many areas prevent livestock development. Chemical control of agricultural pests has dominated the scene, but its overuse has adverse effects on farm budgets, human health and the environment, as well as on international trade. New pest problems continue to develop. Integrated pest management, which combines biological control, host plant resistance and appropriate farming practices and minimizes the use of pesticides, is the best option for the future, as it guarantees yields, reduces costs, is environmentally friendly and contributes to the sustainability of agriculture. Integrated pest management should go hand in hand with appropriate pesticide management to allow for pesticide regulation and control, including trade, and for the safe handling and disposal of pesticides, particularly those that are toxic and persistent. (14.73 Promoting Sustainable Agriculture and Rural Development Agenda 21 UNCED)

Objectives

14.74. The objectives of this programme area are:

information on the use of pesticides in each country and the side-effects on human health and environment,

c. Undertake national surveys to establish baseline information on the use of pesticides in each country and the side-effects on human health and environment, and also undertake appropriate education.

(14.74 Promoting Sustainable Agriculture and Rural Development Agenda 21 UNCED)

14.77. Appropriate United Nations agencies and regional organizations should:

a. Establish a system for collecting, analysing and disseminating data on the quantity and quality of pesticide used every year and their impact on human health and the environment; (14.74 a Promoting Sustainable Agriculture and Rural Development Agenda 21 UNCED

Activities

(a)  Management-related activities

14.85 d. Develop and encourage processes for the recycling of organic and inorganic waste into the soil structure, without harming the environment, plant growth and human health.

(14. 85 d Promoting Sustainable Agriculture and Rural Development Agenda 21 UNCED

 

Agenda 21 – Chapter 15 CONSERVATION OF BIOLOGICAL DIVERSITY

Conservation of biological diversity Basis for action

 

B. Improving human health Basis for action

16.11. The improvement of human health is one of the most important objectives of development.

The improvement of human health is one of the most important objectives of development. The deterioration of environmental quality, notably air, water and soil pollution owing to toxic chemicals, hazardous wastes, radiation and other sources, is a matter of growing concern. This degradation of the environment resulting from inadequate or inappropriate development has a direct negative effect on human health. Malnutrition, poverty, poor human settlements, lack of good-quality potable water and inadequate sanitation facilities add to the problems of communicable and non-communicable diseases. As a consequence, the health and well-being of people are exposed to increasing pressures.

Objectives 16.12. The main objective of this programme area is to contribute, through the environmentally sound application of biotechnology to an overall health programme, to: 5/ a. Reinforce or inaugurate (as a matter of urgency) programmes to help combat major communicable diseases; b. Promote good general health among people of all ages; c. Develop and improve programmes to assist in specific treatment of and protection from major non-communicable diseases; d. Develop and strengthen appropriate safety procedures based on programme area D, taking account of ethical considerations; e. Create enhanced capabilities for carrying out basic and applied research and for managing interdisciplinary research.

 

Objectives 18.36. The complex interconnectedness of freshwater systems demands that freshwater management be holistic (taking a catchment management approach) and based on a balanced consideration of the needs of people and the environment. The Mar del Plata Action Plan has already recognized the intrinsic linkage between water resource development projects and their significant physical, chemical, biological, health and socio-economic repercussions. The overall environmental health objective was set as follows: "to evaluate the consequences which the various users of water have on the environment, to support measures aimed at controlling water-related diseases, and to protect ecosystems". 1

18.38. b. Public health protection, a task requiring not only the provision of safe drinking-water but also the control of disease vectors in the aquatic environment;

18.39

f. To establish, according to capacities and needs, biological, health, physical and chemical quality criteria for all water bodies (surface and groundwater), with a view to an ongoing improvement of water quality;

18.47. Safe water-supplies and environmental sanitation are vital for protecting the environment, improving health and alleviating poverty. Safe water is also crucial to many traditional and cultural activities. An estimated 80 per cent of all diseases and over one third of deaths in developing countries are caused by the consumption of contaminated water, and on average as much as one tenth of each person's productive time is sacrificed to water-related diseases. Concerted efforts during the 1980s brought water and sanitation services to hundreds of millions of the world's poorest people. The most outstanding of these efforts was the launching in 1981 of the International Drinking Water Supply and Sanitation Decade, which resulted from the Mar del Plata Action Plan adopted by the United Nations Water Conference in 1977. The commonly agreed premise was that "all peoples, whatever their stage of development and their social and economic conditions, have the right to have access to drinking water in quantities and of a quality equal to their basic needs". 2/ The target of the Decade was to provide safe drinking-water and sanitation to underserved urban and rural areas by 1990, but even the unprecedented progress achieved during the Decade was not enough. One in three people in the developing world still lacks these two most basic requirements for health and dignity. It is also recognized that human excreta and sewage are important causes of the deterioration of water quality in developing countries, and the introduction of available technologies, including appropriate technologies, and the construction of sewage treatment facilities could bring significant improvement.

Objectives 18.48. The New Delhi Statement (adopted at the Global Consultation on Safe Water and Sanitation for the 1990s, which was held in New Delhi from 10 to 14 September 1990) formalized the need to provide, on a sustainable basis, access to safe water in sufficient quantities and proper sanitation for all, emphasizing the "some for all rather than more for some" approach. Four guiding principles provide for the programme objectives:

Objectives 18.48. The New Delhi Statement (adopted at the Global Consultation on Safe Water and Sanitation for the 1990s, which was held in New Delhi from 10 to 14 September 1990) formalized the need to provide, on a sustainable basis, access to safe water in sufficient quantities and proper sanitation for all, emphasizing the "some for all rather than more for some" approach. Four guiding principles provide for the programme objectives: a. Protection of the environment and safeguarding of health through the integrated management of water resources and liquid and solid wastes;

\ Activities 18.50. All States, according to their capacity and available resources, and through bilateral or multilateral cooperation, including the United Nations and other relevant organizations as appropriate, could implement the following activities:

a. Environment and health: a. Establishment of protected areas for sources of drinking-water supply;

 b. Sanitary disposal of excreta and sewage, using appropriate systems to treat waste waters in urban and rural areas;

18.55. Overall national capacity-building at all administrative levels, involving institutional development, coordination, human resources, community participation, health and hygiene education and literacy, has to be developed according to its fundamental connection both with any efforts to improve health and socio-economic development through water-supply and sanitation and with their impact on the human environment. Capacity-building should therefore be one of the underlying keys in implementation strategies. Institutional capacity-building should be considered to have an importance equal to that of the sector supplies and equipment component so that funds can be directed to both. This can be undertaken at the planning or programme/project formulation stage, accompanied by a clear definition of objectives and targets. In this regard, technical cooperation among developing countries owing to their available wealth of information and experience and the need to avoid "reinventing the wheel", is crucial. Such a course has proved cost-effective in many country projects already.

 

Basis for action 18.56. Early in the next century, more than half of the world's population will be living in urban areas. By the year 2025, that proportion will have risen to 60 per cent, comprising some 5 billion people. Rapid urban population growth and industrialization are putting severe strains on the water resources and environmental protection capabilities of many cities. Special attention needs to be given to the growing effects of urbanization on water demands and usage and to the critical role played by local and municipal authorities in managing the supply, use and overall treatment of water, particularly in developing countries for which special support is needed. Scarcity of freshwater resources and the escalating costs of developing new resources have a considerable impact on national industrial, agricultural and human settlement development and economic growth. Better management of urban water resources, including the elimination of unsustainable consumption patterns, can make a substantial contribution to the alleviation of poverty and improvement of the health and quality of life of the urban and rural poor. A high proportion of large urban agglomerations are located around estuaries and in coastal zones. Such an arrangement leads to pollution from municipal and industrial discharges combined with overexploitation of available water resources and threatens the marine environment and the supply of freshwater resources.

 

18.73. It should be ensured that rural communities of all countries, according to their capacities and available resources and taking advantage of international cooperation as appropriate, will have access to safe water in sufficient quantities and adequate sanitation to meet their health needs and maintain the essential qualities of their local environments.

Activities 18.76. All States, according to their capacity and available resources, and through bilateral or multilateral cooperation, including the United Nations and other relevant organizations as appropriate, could implement the following activities: a. Water-supply and sanitation for the unserved rural poor: i. Establish national policies and budget priorities with regard to increasing service coverage; ii. Promote appropriate technologies; iii. Introduce suitable cost-recovery mechanisms, taking into account efficiency and equity through demand management mechanisms; iv. Promote community ownership and rights to water-supply and sanitation facilities; v. Establish monitoring and evaluation systems; vi. Strengthen the rural water-supply and sanitation sector with emphasis on institutional development, efficient management and an appropriate framework for financing of services;

19.9. There is international concern that part of the international movement of toxic and dangerous products is being carried out in contravention of existing national legislation and international instruments, to the detriment of the environment and public health of all countries, particularly developing countries.

19.10. In resolution 44/226 of 22 December 1989, the General Assembly requested each regional commission, within existing resources, to contribute to the prevention of the illegal traffic in toxic and dangerous products and wastes by monitoring and making regional assessments of that illegal traffic and its environmental and health implications. The Assembly also requested the regional commissions to interact among themselves and to cooperate with the United Nations Environment Programme, with a view to maintaining efficient and coordinated monitoring and assessment of the illegal traffic in toxic and dangerous products and wastes.

A. Expanding and accelerating international assessment of chemical risks

19.11. Assessing the risks to human health and the environment hazards that a chemical may cause is a prerequisite to planning for its safe and beneficial use.

Assessing the risks to human health and the environment hazards that a chemical may cause is a prerequisite to planning for its safe and beneficial use. Among the approximately 100,000 chemical substances in commerce and the thousands of substances of natural origin with which human beings come into contact, many appear as pollutants and contaminants in food, commercial products and the various environmental media. Fortunately, exposure to most chemicals (some 1,500 cover over 95 per cent of total world production) is rather limited, as most are used in very small amounts. However, a serious problem is that even for a great number of chemicals characterized by high-volume production, crucial data for risk assessment are often lacking. Within the framework of the OECD chemicals programme such data are now being generated for a number of chemicals.

 

19.13. The objectives of this programme area are: a. To strengthen international risk assessment. Several hundred priority chemicals or groups of chemicals, including major pollutants and contaminants of global significance, should be assessed by the year 2000, using current selection and assessment criteria; b. To produce guidelines for acceptable exposure for a greater number of toxic chemicals, based on peer review and scientific consensus distinguishing between health- or environment-based exposure limits and those relating to socio-economic factors.

 

19.16. Industry should provide data for substances produced that are needed specifically for the assessment of potential risks to human health and the environment. Such data should be made available to relevant national competent authorities and international bodies and other interested parties involved in hazard and risk assessment, and to the greatest possible extent to the public also, taking into account legitimate claims of confidentiality.

19.20. Major research efforts should be launched in order to improve methods for assessment of chemicals as work towards a common framework for risk assessment and to improve procedures for using toxicological and epidemiological data to predict the effects of chemicals on human health and the environment, so as to enable decision makers to adopt adequate policies and measures to reduce risks posed by chemicals.

19.21. Activities include: a. Strengthening research on safe/safer alternatives to toxic chemicals that pose an unreasonable and otherwise unmanageable risk to the environment or human health and to those that

19.24. Adequate labelling of chemicals and the dissemination of safety data sheets such as ICSCs (International Chemical Safety Cards) and similarly written materials, based on assessed hazards to health and environment, are the simplest and most efficient way of indicating how to handle and use chemicals safely.

 

19.36. In order to address this issue, provisions for Prior Informed Consent (PIC) procedures were introduced in 1989 in the London Guidelines (UNEP) and in the International Code of Conduct on the Distribution and Use of Pesticides (FAO). In addition a joint FAO/UNEP programme has been launched for the operation of the PIC procedures for chemicals, including the selection of chemicals to be included in the PIC procedure and preparation of PIC decision guidance documents. The ILO chemicals convention calls for communication between exporting and importing countries when hazardous chemicals have been prohibited for reasons of safety and health at work. Within the General Agreement on Tariffs and Trade (GATT) framework, negotiations have been pursued with a view to creating a binding instrument on products banned or severely restricted in the domestic market. Further, the GATT Council has agreed, as stated in its decision contained in C/M/251, to extend the mandate of the working group for a period of three months, to begin from the date of the group's next meeting, and has authorized the Chairman to hold consultations on timing with respect to convening this meeting.

 

Activities (a) Management-related activities 19.39. Governments and relevant international organizations with the cooperation of industry should: a. Strengthen national institutions responsible for information exchange on toxic chemicals and promote the creation of national centres where these centres do not exist; b. Strengthen international institutions and networks, such as IRPTC, responsible for information exchange on toxic chemicals; c. Establish technical cooperation with, and provide information to, other countries, especially those with shortages of technical expertise, including training in the interpretation of relevant technical data, such as Environmental Health Criteria Documents, Health and Safety Guides and International Chemical Safety Cards (published by IPCS); monographs on the Evaluation of Carcinogenic Risks of Chemicals to Humans (published by the International Agency for Research on Cancer (IARC)); and decision guidance documents (provided through the FAO/UNEP j Activities (a) Management-related activities 19.39. Governments and relevant international organizations with the cooperation of industry should: a. Strengthen national institutions responsible for information exchange on toxic chemicals and promote the creation of national centres where these centres do not exist; b. Strengthen international institutions and networks, such as IRPTC, responsible for information exchange on toxic chemicals; c. Establish technical cooperation with, and provide information to, other countries, especially those with shortages of technical expertise, including training in the interpretation of relevant technical data, such as Environmental Health Criteria Documents, Health and Safety Guides and International Chemical Safety Cards (published by IPCS); monographs on the Evaluation of Carcinogenic Risks of Chemicals to Humans (published by the International Agency for Research on Cancer (IARC)); and decision guidance documents (provided through the FAO/UNEP j

F. Prevention of illegal international traffic in toxic and dangerous products 19.66. There is currently no global international agreement on traffic in toxic and dangerous products (toxic and dangerous products are those that are banned, severely restricted, withdrawn or not approved for use or sale by Governments in order to protect public health and the environment). However, there is international concern that illegal international traffic in these products is detrimental to public health and the environment, particularly in developing countries, as acknowledged by the General Assembly in resolutions 42/183 and 44/226. Illegal traffic refers to traffic that is carried out in contravention of a country's laws or relevant international legal instruments. The concern also relates to transboundary movements of those products that are not carried out in accordance with applicable internationally adopted guidelines and principles. Activities under this programme area are intended to improve detection and prevention of the traffic concerned.

Objectives 19.68. The objectives of the programme are: a. To reinforce national capacities to detect and halt any illegal attempt to introduce toxic and dangerous products into the territory of any State, in contravention of national legislation and relevant international legal instruments; b. To assist all countries, particularly developing countries, in obtaining all appropriate information concerning illegal traffic in toxic and dangerous products. Activities (a) Management-related activities 19.69. Governments, according to their capacities and available resources and with the cooperation of the United Nations and other relevant organizations, as appropriate, should: a. Adopt, where necessary, and implement legislation to prevent the illegal import and export of toxic and dangerous products;

20.4. There is international concern that part of the international movement of hazardous wastes is being carried out in contravention of existing national legislation and international instruments to the detriment of the environment and public health of all countries, particularly developing countries.

Agenda 21 – Chapter 20 ENVIRONMENTALLY SOUND MANAGEMENT OF HAZARDOUS WASTES, INCLUDING PREVENTION OF ILLEGAL INTERNATIONALTRANSFER

/ Agenda 21 – Chapter 34 TRANSFER OF ENVIRONMENTALLY SOUND TECHNOLOGY, COOPERATION AND CAPACITY-BUILDING

34.25. Visits should be sponsored and, on a voluntary basis, the return of qualified experts from developing countries in the field of environmentally sound technologies who are currently working in developed country institutions should be facilitated. (f) Technology assessment in support of the management of environmentally sound technology 34.26. The international community, in particular United Nations agencies, international organizations, and other appropriate and private organizations should help exchange experiences and develop capacity for technology needs assessment, in particular in developing countries, to enable them to make choices based on environmentally sound technologies. They should: a. Build up technology assessment capacity for the management of environmentally sound technology, including environmental impact and risk assessment, with due regard to appropriate safeguards on the transfer of technologies subject to prohibition on environmental or health grounds;

 

Agenda 21 – Chapter 7 PROMOTING SUSTAINABLE HUMAN SETTLEMENT DEVELOPMENT

A. PROVIDING ADEQUATE SHELTER FOR ALL

SCIENCE FOR SUSTAINABLE DEVELOPMENT

35.7d. Develop, apply and institute the necessary tools for sustainable development, with regard to: i. Quality-of-life indicators covering, for example, health, education, social welfare, state of the environment, and the economy;

35.7 e. Collect, analyse and integrate data on the linkages between the state of ecosystems and the health of human communities in order to improve knowledge of the cost and benefit of different development policies and strategies in relation to health and the environment, particularly in developing countries;

Basis for action 35.15. Meeting scientific research needs in the environment/development field is only the first step in the support that the sciences can provide for the sustainable development process. The knowledge acquired may then be used to provide scientific assessments (audits) of the current status and for a range of possible future conditions. This implies that the biosphere must be maintained in a healthy state and that losses in biodiversity must be slowed down. Although many of the long-term environmental changes that are likely to affect people and the biosphere are global in scale, key changes can often be made at the national and local levels. At the same time, human activities at the local and regional levels often contribute to global threats - e.g., stratospheric ozone depletion. Thus scientific assessments and projections are required at the global, regional and local levels. Many countries and organizations already prepare reports on the environment and development which review current conditions and indicate future trends. Regional and global assessments could make full use of such reports but should be broader in scope and include the results of detailed studies of future conditions for a range of assumptions about possible future human responses, using the best available models. Such assessments should be designed to map out manageable development pathways within the environmental and socio-economic carrying capacity of each region. Full use should be made of traditional knowledge of the local environment.

Activities 35.17. The following activities should be undertaken: a. Coordinate existing data- and statistics-gathering systems relevant to developmental and environmental issues so as to support preparation of long-term scientific assessments - for example, data on resource depletion, import/export flows, energy use, health impacts and demographic trends; apply the data obtained through the activities identified in programme area B to environment/development assessments at the global, regional and local levels; and promote the wide distribution of the assessments in a form that is responsive to public needs and can be widely understood;

Agenda 21 – Chapter 36 PROMOTING EDUCATION, PUBLIC AWARENESS AND TRAINING

36.22

e. Relevant authorities should ensure that every school is assisted in designing environmental activity work plans, with the participation of students and staff. Schools should involve schoolchildren in local and regional studies on environmental health, including safe drinking water, sanitation and food and ecosystems and in relevant activities, linking these studies with services and research in national parks, wildlife reserves, ecological heritage sites etc.;

Agenda 21 – Chapter 40 INFORMATION FOR DECISION-MAKING

40.8. Countries and, upon request, international organizations should carry out inventories of environmental, resource and developmental data, based on national/global priorities for the management of sustainable development. They should determine the gaps and organize activities to fill those gaps. Within the organs and organizations of the United Nations system and relevant international organizations, data-collection activities, including those of Earthwatch and World Weather Watch, need to be strengthened, especially in the areas of urban air, freshwater, land resources (including forests and rangelands), desertification, other habitats, soil degradation, biodiversity, the high seas and the upper atmosphere. Countries and international organizations should make use of new techniques of data collection, including satellite-based remote sensing. In addition to the strengthening of existing development-related data collection, special attention needs to be paid to such areas as demographic factors, urbanization, poverty, health and rights of access to resources, as well as special groups, including women, indigenous peoples, youth, children and the disabled, and their relationships with environment issues.

 

 

 

Well-beingthe ecosystem on which we depend for our well being

In 1992, at Rio, the United Nations affirmed that “Humanity stands at a defining moment in history. We are confronted with perpetuation of disparities between nations, and a worsening of poverty, hunger, ill health and illiteracy and the continuing deterioration of the ecosystem on which we depend for our well-being (Agenda 21, UNCED, 1992).

6.33 Eliminate unsustainable patterns of production and consumption, particularly in industrialized countries; this pattern has contributed to poverty, to the inequitable distribution of resources within countries and between countries, has increased the vulnerability to natural disasters and has threaten the well-being of future generations.

 

economic and social development.  The global objective is to achieve a 10 to 40 per cent improvement in health indicators in the year 2000.  The same rate of improvement should be achieved for environmental, housing and health service indicators.  These include the development of quantitative objectives for infant mortality, maternal mortality, percentage of low birth weight newborns and specific indicators (e.g. tuberculosis as an indicator of crowded housing, diarrhoeal diseases as indicators of inadequate water and sanitation, rates of industrial and transportation accidents that indicate possible opportunities for prevention of injury, and social problems such as drug abuse, violence and crime that indicate

 underlying social disorders).6.33.Agenda 21 UNCED

 

****1992 RIO DECLARATION

 

  Recognizing the integral and interdependent nature of the Earth, our
home,
 
    Proclaims that:
 
                             Principle 1
 
    Human beings are at the centre of concerns for sustainable development. 
They are entitled to a healthy and productive life in harmony with nature.

 

                            Principle 14

 

    States should effectively cooperate to discourage or prevent the

relocation and transfer to other States of any activities and substances that

cause severe environmental degradation or are found to be harmful to human

health.

 

 

                            Principle 15

 

    In order to protect the environment, the precautionary approach shall be

widely applied by States according to their capabilities.  Where there are

threats of serious or irreversible damage, lack of full scientific certainty

shall not be used as a reason for postponing cost-effective measures to prevent

environmental degradation.

 

 

****1994 INTERNATIONAL CONFERENCE ON POPULATION AND DEVELOPMENT,

1.2.Ecological problems, such as global climate change, largely driven by unsustainable patterns of production and consumption, are adding to the threats to the well-being of future generations.(Preamble, 1.2 International Conference on Population and Development, 1994)

Around the world many of the basic resources on which future generations will depend for their survival and well-being are being depleted and environmental degradation is intensifying, driven by unsustainable patterns of production and consumption, unprecedented growth in population, widespread and persistent poverty, and social and economic inequality (Preamble, 1.2. International Conference on Population and Development, 1994)

 

****1996 HABITAT II

making human settlements safer, healthier and more liveable, equitable, sustainable and productive.

1.   We, the Heads of State or Government and the official delegations of countries assembled at the United Nations Conference on Human Settlements (Habitat II) in Istanbul, Turkey from 3 to 14 June 1996, take this opportunity to endorse the universal goals of ensuring adequate shelter for all and making human settlements safer, healthier and more liveable, equitable, sustainable and productive. Our deliberations on the two major themes of the Conference - adequate shelter for all and sustainable human settlements development in an urbanizing world - have been inspired by the Charter of the United Nations and are aimed at reaffirming existing and forging new partnerships for action at the international, national and local levels to improve our living environment. We commit ourselves to the objectives, principles and recommendations contained in the Habitat Agenda and pledge our mutual support for its implementation.

5. The challenges of human settlements are global, but countries and regions also face specific problems which need specific solutions. We recognize the A/CONF.165/14 page 8 need to intensify our efforts and cooperation to improve living conditions in the cities, towns and villages throughout the world, particularly in developing countries, where the situation is especially grave, and in countries with economies in transition. In this connection, we acknowledge that globalization of the world economy presents opportunities and challenges for the development process, as well as risks and uncertainties, and that achievement of the goals of the Habitat Agenda would be facilitated by, inter alia, positive actions on the issues of financing of development, external debt, international trade and transfer of technology. Our cities must be places where human beings lead fulfilling lives in dignity, good health, safety, happiness and hope.

 

****2002 WSSD

WSSD38 Achieve the Millennium Declaration target to halve in the year 2015, the  proportion of the world’s people who suffer from hunger and realize the right to a standard of  living adequate for the health and well-being

 

(a) Achieve the Millennium Declaration target to halve in the year 2015, the  proportion of the world’s people who suffer from hunger and realize the right to a standard of  living adequate for the health and well-being of themselves and their families, including food,  including by, promoting food security and fighting hunger in combination with measures which  address poverty, consistent with the outcome of the World Food Summit and, for State Parties,  with their obligations under Article 11 of the Covenant on Economic, Social and Cultural  Rights.

 

WSSD42. Biodiversity, which plays a critical role in overall sustainable development and poverty  eradication, is essential to our planet, human well-being and to the livelihood and cultural  integrity of people. However, biodiversity is presently being lost at unprecedented rates due to  human activities; this trend can only be reversed if the local people benefit from the  conservation and sustainable use of biological diversity, in particular in countries of origin of PAGE 29.genetic resources, in accordance with Article 15 of the CBD. The Convention on Biological  Diversity (CBD) is the key instrument for the conservation and sustainable use of biological  diversity and the fair and equitable sharing of benefits arising from use of genetic resources.  [Achieving a significant reduction in the current rate of biodiversity loss [by 2010]  includes actions at all levels to]/[With a view to having instruments in place to stop the  current alarming biodiversity loss [by 2010], actions are required at all levels to]:

 

 

Article 23.         Human activities are having an increasing impact on the integrity of ecosystems that provide essential resources and services for human well-being and economic activities.

1.2    Increased ecological threats to future generations

Ecological problems, such as global climate change, largely driven by unsustainable patterns of production and consumption, are adding to the threats to the well-being of future generations. (Preamble, 1.2 c WSSD)

 

 

TO PROMOTE HEALTH AND WELL BEING, THE FOLLOWING UNSUSTAINABLE ACTIVITIES SHOULD  END.

. End the trumping of health, environment, civil and political and human rights for the sake of "militarized security, 

 

. End misplaced spending priorities: on militarism, on adulterated unsafe food, on production of products and substances harmful to the environment and human health, and redirecting budgetary expenses to eradicate poverty.

      to promote and fully guarantee respect for human rights including labour rights, women’s rights civil and political rights, indigenous rights, social and cultural rights – right to food, right to housing, right to safe drinking water and sewage treatment, sanitation, right to education and right to universally accessible not for profit health care system;

..Prevent the relocation and transfer to other States of any activities and substances that cause severe environmental degradation or are found to be harmful to human health. (Principle 14 Rio Declaration, 1992)

 

 End the defiance by industrialized states, of principle 7 of the 1992 Rio Declaration which was adopted by all states at the UN Conference on Environment and Development (UNCED). This principle states that:

``States shall cooperate in a spirit of global partnership to conserve, protect and restore the health and integrity of the Earth's ecosystem. In view of the different contributions to global environmental degradation, States have common but differentiated responsibilities. (Principle 7, Rio Declaration)

 

 End environmentally induced diseases, address the social determinant of health problems- such as poverty, and provide universal access to a publicly-funded not-for-profit health non-two tier health care system.

 

 End the use of the notion of ‘prior consent" to persuade the poor, disadvantaged and vulnerable countries or communities within developed countries to accept the dumping of products and substances that are potentially harmful to the environment and human health. End the ruse of using extraterritorialism. -what right do we have to impose our higher standards on a developing country with lower standards. the dumping of mine tailing in lakes and other waterways. 

 

. Prevent Pharmaceutical collusion between university and Pharmaceutical corporations. And end the policy of permitting Universities to sell products of research to corporations

 

.End practice of the Pharmaceutical industry in creating new health problems to create market potential for new drugs

 

.Prohibit the patenting of genes under the WTO TRIPS provision

 

.End the misguided dependency on drugs when doctors fail to offer the possibility that change in life style could effectively address the health problem

 

68. End all proposals which will result, through the practice of harmonization of standards and regulations, in arriving at the lowest common denominator for health and environmental standards.

71. End the privatization, including Public Private Partnerships, of public services such as water, sewage and health care, and end the opposition to the affirmation that the access to water is a human right.

 

76. Phase out sunset industries-ones that are harmful to human health and the environment and institute a fair and just transition for workers and communities affected by the phase out, and end the lucrative profits made on money trading...

 

85.End the violation of human rights including labour rights, civil and political rights, social and cultural rights- right to food, right to housing, right to water right to sewage treatment, right to a universally accessible, not-for-profit health care system, right to education and social justice.

 

 

 

 

Last Updated on Wednesday, 16 September 2015 08:31
 

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