Health & environment: tools for effective decision-making

The WHO-UNEP Health and Environment Linkages Initiative (HELI): Review of initial findings

© World Health Organization and United Nations Environment Programme, 2004


From longstanding to emerging hazards, environmental factors are a root cause of a significant burden of death, disease and disability - globally and particularly in developing countries. They range from poor water quality and access, vector-borne disease and air pollution to toxic chemical exposures, climate change and degraded urban environments. The resulting impacts are estimated to cause over 25% of death and disease globally, reaching nearly 35% in regions such as sub-Saharan Africa (1). Much of this burden rests upon the shoulders of the poor and vulnerable.

Many of these deaths are avoidable and much of this disease is preventable. However, effective action requires renewed moral commitment to sustainable development and determined political action through international and national partnerships. Together we must translate our global knowledge-base on environment and health linkages into practical policy tools and action at the country level, incorporating environment and health considerations into social, economic and political decisions.

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Simple and cost-effective solutions can best be implemented when potential impacts are considered early in the policy process -- rather than after environmental damage has occurred, health problems have emerged and human lives cut short or damaged. This requires an inclusive approach to the problems. For too long, the vicious cycle of unsustainable development, ecosystem degradation, poverty and ill health has been addressed sectorally, from a crisis management and curative perspective, rather than multisectorally and through preventive strategies.

In response to the urgent need for a more coherent and proactive policy agenda, the World Health Organization (WHO) and the United Nations Environment Programme (UNEP) joined forces at the 2002 World Summit on Sustainable Development (WSSD) to launch the Health and Environment Linkages Initiative (HELI). Sponsored by the Government of Canada and supported by the United States Environment Protection Agency, the overriding mission is the facilitation of better access at country level to existing knowledge, tools and methods for making good policy decisions on environment and health.

UNEP and WHO provide partner countries with direct support to address critical development/policy issues of their choice from a linked environment and health perspective; develop a holistic package of recommendations; and take action for implementation. This intersectoral approach can optimize the use of economic tools to quantify the health and environmental impacts of alternative choices and, where relevant, translate these impacts into the monetary terms upon which decision-makers often base their judgements. Using the tools of economic valuation to address health and environmental problems creates other synergies. It contributes to a greater appreciation of the goods and services provided by natural ecosystems. It can help decision-makers to identify mutually beneficial strategies that simultaneously promote human well-being and environmental protection and development, as well as poverty reduction.

In Jordan, Thailand and Uganda, HELI's initial country partners, decision-makers from health, environment and other government sectors are working together to assess water, agricultural and livestock management policies from an integrated health and environmental perspective. At the global level, HELI is developing tools and resources relevant to country-level policy-makers. This includes guidance on the conduct of assessments and on economic analysis of linked impacts. A web portal is being developed to provide an initial point of access for information about priority environmental hazards, related health issues and best practice policy approaches -- with reference to the wider range of WHO and UNEP resources available.

No initiative is a panacea or a "one-fix" solution. However, by linking scientific knowledge to its application in a demand-driven approach and by working directly with country-level policy-makers from a wide range of sectors, UNEP and WHO can catalyse the design of more complementary environment, social and economic policies. Our country partners share our conviction that it is time to adopt a more proactive approach to environment and health decision-making, addressing the root causes of much disease rather than the symptoms alone. Together, we want to demonstrate that such an approach makes good public policy sense, that in the broader and long-term perspective: what is good for the environment can be good for health and good for development.

With less than a year of implementation behind us, an inclusive process is now well under way and gaining momentum. We are very pleased to share this report on the initial findings and results of HELI's activities and pilot projects, reflecting both the achievements and the challenging work still ahead.

A product of the partnership spirit of Johannesburg, HELI is an example of effective cooperation and action at international, regional and country levels. It combines the talents of WHO and UNEP in a targeted approach to policy-makers. We invite others to join us, strengthening health and environment linkages in policy-making, as part of our common response to the implementation imperative posed by the World Summit on Sustainable Development and the United Nations Millennium Development Goals.