WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU REGIONAL DU PACIFIQUE OCCIDENTAL
REGIONAL COMMITTEE Forty-fourth session Manila 13-17 September 1993 Provisional agenda item 16
WPRlRC44/13
11 June 1993 ORIGINAL: ENGLISH
REGIONAL STRATEGY ON HEALTH AND ENVIRONMENT, INCLUDING FOLLOW-UP OF THE UNITED NATIONS CONFERENCE ON ENVIRONMENT AND DEVELOPMENT (UNCED)
WHO has evaluated its past approaches to environmental health problem solving and developed a more effective strategy, outlined in this document. Initiated by a Regional Consultative Group on Health and Environment in November 1991, this process of review has resulted in a Regional Strategy on Health and Environment intended to guide regional activities over the next six years. Particular emphasis is placed on priority activities that are significant, timely and practicable. In addition, a new focus for traditional activities is suggested. Specific plans of action will be prepared. These will be dynamic documents reflecting priority concerns, responsive to changing circumstances, but always moving to improve health in measurable ways. The commitment of Member States is vital, as these plans must be advocated and conducted at national and local levels. In reviewing this document, the Regional Committee is requested to consider the priority areas identified for special attention in the Region as a whole, as well as for individual countries or groups of countries, and to specify additional areas as necessary. Following the session of the Regional Committee, Member States are. requested to develop and specify proposals for funding consideration by external support agencies, especially the UNDP and its associated Capacity 21 initiative.
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1.
INTRODUCTION
In the past, WHO has organized environmental health activities into five programme areas: community water supply and sanitation, rural and urban development and housing, control of environmental health hazards, food safety and chemical safety. WHO has provided technical support for implementation including advisory services, human resources development through fellowships and group training activities, and small amounts of supplies and equipment to support the development of institutions and infrastructures. cope with increasingly severe environmental health problems. The growing challenges of resolving complex issues relating to health, the environment and development, and the increasing demand for limited organizational resources, have necessitated a fresh look at programme strategy. At the global leveL this review process was guided by the work of the WHO Commission on Health and Environment (1990-1992); at the regional level, it was initiated by a Consultative Group on Health and Environment, convened in Manila, Philippines, in November 1991. approaches. In addition, the 1992 United Nations Conference on Environment and Development (UNCED), held in Brazil, further confirmed the critical need to depart from traditional This has been done with varying degrees of effectiveness, but on balance the programmes have made a significant contribution to
2. THE STRATEGY
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The Regional Strategy on Health and Environment is intended to guide WHO activities over the next six years. It recognizes that many of the activities under the five traditional programme areas will continue, though many will need to be supplemented with more effective and practicable mechanisms for implementation and coordination with others. WHO has limited resources and these must be focused on priority activities in situations which maximize effectiveness and impact. The strategy is made up of two separate but interrelated components: (1) (2) a new focus for traditional activities, and the selection of priority activities on the basis of significance, timeliness, and
practicability.
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This is not a radically different approach. It recognizes the need to learn from the past and focus on those activities which, when combined with the work of other programmes, solve environmental health problems in sustainable ways rather than by simply responding to immediate needs.
2.1
The regional goals The environmental health programme goals formulated by the WHO Commission on Health
and Environment. and reflected in the 1993 global strategy document!, also cover the broad range of interactive health and environment needs in the Western Pacific Region: to achieve a sustainable basis for health for all; to provide an environment that promotes health; and to make all individuals and organizations aware of their responsibility for health and its environmental basis.
2.2
The regional objectives Similarly. the broad organization-wide objectives set out in the global strategy document are
equally applicable at the regional level: To support countries in providing the environmental elements required to meet basic health
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needs; to promote increased awareness and understanding of [the] interaction between health, the environment, and development among leaders and the public so as to strengthen community action for health and sustainable development; to collaborate with national and local authorities in the creation of supportive environments for health; to promote the central role of health in decision-making and [in] programmes on matters of environment and development, and to foster cooperation between the health sector and related sectors in these processes;
I WHO Global Strategy for Health and Environment. document A46/1l (23 March 1993) for the Forty-si.th World Health Assembly, Geneva, May !993. This strategy was endorsed by the Health Assembly in resolution WHA46.20.
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to strengthen capabilities for emergency preparedness and response to cover the public health aspects of disasters and violent conflicts; to strengthen national capacities for humar. resources development in work related to health, the envirorunent, and development; to improve technical capabilities for the monitoring and assessment of envirorunental risks to health; to improve technical capabilities for the management of envirorunental risks to health, i.e., their prevention, abatement, and control; to strengthen local, national and international envirorunental health information systems, for the exchange and proper use of information; to promote research on a progressively stronger scientific and technical basis for the wide range of interventions needed to achieve the health goals of sustainable development; to foster envirorunentally safe and sound methods and technology for the effective control, prevention and treatment of disease and disability; and to promote and support other institutional and sectoral capacities for
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improving progressively policies, plans, legislation and actions on health, the envirorunent and development.
3.
NEW FOCUS FOR TRADITIONAL ACTIVITIES
To a great extent, WHO's General Programme of Work and the associated budgetary process will continue to shape activities along traditional lines. In order to be more effective, however, these activities will need a new focus. This new focus will comprise: (\) (2) responding to the most urgent needs and declining less urgent requests; proposing simple measures that positively affect the solution of complex envirorunental
health problems; (3) solving; networking more effectively among organizations involved in envirorunental health problem
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(4)
advocating the timely involvement of government officials in critical decision-making in
other sectors; and (5)
promoting and educating in regard to health to bring about behavioural change. Successfully dealing with the most urgent needs will, in most cases, require collaboration
among several external support agencies; extended coordination with national and local officials; and close cooperation with community leaders. Networking more effectively among organizations includes the idea of working with logical geographical subgroups of countries such as south-east Asia, north-east Asia and the Pacific island countries. This implies interregional sharing of
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resources such as the use of Western Pacific Environmental Health Centre (EHC) staff in WHO's South-East Asia Region.
4. PRIORITY ACTIVITIES
To judge from current knowledge of national interests and needs, the likely availability and allocation of resources, and significant external factors such as the impact of the United Nations Conference on Environment and Development, the following will be priority activity areas:
4.1
Assessment of the impact of development on health Although it is desirable to evaluate the impact of development on health in practical terms,
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this has rarely been achieved, because the relationship between cause and effect is complex and long-term in nature. However, progress is being made in this difficult area of quantifying health, environment and development relationships to support decision-making for the future. regard, the following are priority activities: (1)
In this
the development and implementation of environmental health impact assessment guidelines
in collaboration with the Asian Development Bank and others; and (2) the promotion of environmental epidemiology training and applied studies to influence
decision-making (The creation of the new post of Environmental Epidemiologist at EHC in 1994; ongoing work with the University of the Philippines related to the health impacts of transportation-related air pollutants; and interaction with the Centre for Environmental Epidemiology in Singapore are important in this regard).
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4.2
Development of environmental health action plans External support agencies play an important role in ensuring that significant socioeconomic
growth is linked to responsible environmental management. For example, in 1992, the "Viet Nam National Plan for Environment and Sustainable Development: 1991-2000 Framework for Action" was developed with UNDP funding. Earlier, the Government of Viet Nam, in collaboration with WHO and UNDP, had successfully increased the environmental health problem-solving capabilities of the Vietnamese Institute of Tropical Technology and Environmental Protection, located in Ho Chi Minh City. These complementary activities offer the opportunity to deal effectively with environmental problems as part of the development process. With the support of external funding agencies, this could be most effectively realized through the development of an environmental action plan. A similar approach would be appropriate for other countries of the Region. WHO priority activities in this regard are as follows: (I) liaising with bilateral and multilateral support agencies and others regarding support for the
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development of environmental action plans in those areas with high development potential (e.g., the Subic Bay Metropolitan Authority site in the Philippines); (2) using the expertise of WHO/EHC staff to collaborate with the Vietnamese Institute of
Tropical Technology and Environmental Protection and appropriate government officials in the development of an environmental management plan for Ho Chi Minh City and other areas in the southern part of Viet Nam; (3) using the expertise of WHO/EHC and the intercountry programme staff based in Hanoi
(1994) to enhance institutional capabilities in the northern part of Viet Nam; and (4) using the expertise of WHO/EHC staff, the intercountry programme staff based in Hanoi
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(1994) and national institutional capabilities in the countries concerned as a basis for increased involvement in the Global Environmental Monitoring Systems (GEMS) water project in the Mekong River, and other initiatives affecting the Indo-China peninsula.
4.3
Information management to improve environmental health decision-making Data collection and information analysis should play a more direct role in decision-making
in developing countries. Among other things, this necessitates the increase of national capacities for information management. In this regard, priority activities are as follows:
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(1)
collaboration with UNICEF and national governments in the improvement of management th~
practices through the promotion and implementation of newly developed environmental health database programmes which can be adjusted to fit (2) needs of decision-makers;
development of environmental health indicators in relation to the environmental health
impact assessment guidelines formulated in cooperation with the Asian Development Bank together with a new emphasis on environmental epidemiology; (3) development and promotion of practical street food safety guidelines, and the provision of
required basic water and sanitation services to street food vendors; and
(4)
training of people in the monitoring of chemical or pesticide residues in food, including the
development of laboratory capabilities.
4.4
Drinking-water quality guidelines The revised WHO Guidelines for drinking-water quality, issued in early 1993, have
redirected attention to related environmental health problems as countries assess their status with respect to these guidelines. The priority activities in this situation are: (1) promotion of the revised WHO drinking-water quality guidelines and the importance of safe
drinking-water to health; (2) the protection of fragile drinking-water supplies (i.e., supplies that are vulnerable to
......
contamination and overuse) in South Pacific island countries, with emphasis on developing appropriate national standards and promoting good sanitation practices; (3) technology transfer to solve chemical contamination problems related to drinking-water
supplies in highly industrialized countries where conventional treatment is no longer adequate (e.g., China, the Republic of Korea, Malaysia, and the Philippines); and (4) promotion of a comprehensive approach to water resources planning and management in
broad geographical terms, with particular emphasis on urban drinking-water supplies and related development planning.
4.5
Safety and control of toxic chemicals and hazardous wastes Environmental health problems associated with toxic chemicals and hazardous wastes are of
significant concern throughout the Region. The WHO/UNDP project on the safety and control of
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toxic
chemicals
and
hazardous
wastes
(completed
in
early
1993)
was
successful
in
increasing awareness, highlighting priority issues and problems, and raising expectations of possible solutions. In addition, each participating country ceveloped follow-up project proposals for funding consideration by external support agencies. WHO must continue its involvement in this process through the following priority activities: (1) project; (2) development and promotion of practical guidelines for hazardous waste disposal (including collaboration with China, Malaysia, the Philippines, the Republic of Korea and Singapore in
the further development, promotion and implementation of follow-up proposals to the WHOIUNDP
appropriate technology transfer) in South Pacific island countries; (3) development and promotion of practical guidelines for the handling and disposal of
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hazardous hospital wastes; and (4) collaboration with selected governments and industries regarding specific priority
environmental health problems in the workplace. 4.6 Motor "ehide emissions control In the congested urban areas of Asia, motor vehicle-related pollution is one of the most serious environmental health problems. focusing on fuel quality and Government regulatory agencies and private sector control technology. and reviewing mass producers of vehicles and emissions-control devices are addressing the sources of the problems by emissions
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transportation alternatives. In this regard, the following are priority activities: (1) Asia); (2) collaboration with the Government of the Philippines, the Asian Development Bank, the promotion and support of the development and implementation of diesel particulate control
technology, particularly in the Republic of Korea (recognizing the potential for its use throughout
World Bank and others in the development of an air pollution control master plan, with particular emphasis on motor vehicle emissions control in Metro Manila; and (3) regionwide support for initiatives to reduce the lead content of gasoline, including, in the
Philippines, a study of the impact of motor vehicle emissions on the health of vulnerable populations.
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4.7
Coal use Coal will continue to be a principal source of energy in support of industrial development,
as well as commercial and domestic heating, in major parts of Asia.
Air and water pollution
resulting from the extraction, processing and combustion of coal has a widespread adverse impact on health. For example, in certain areas of China, the high fluoride content of coal results in serious indoor air pollution problems that contribute significantly to clinical fluorosis. activities with respect to this situation are: (I)
The priority
the promotion of technology transfer to remove pollutants (e.g., fluoride, sulphur, sulphur
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dioxide, nitrogen oxides, etc.), from coal, wastewater associated with coal preparation, and coal combustion emissions; (2) in China, the promotion of technology transfer to resolve that aspect of the
fluorosis problem associated with contaminated groundwater from coal preparation activities (e.g .. by promotion and application of appropriate fluoride removal methods for use by individual households or communities); and (3) collaboration with UNDP/World Bank water sector projects, and with other organizations
supporting coal-use projects in the energy and industrial development sectors.
4.8
Urban health development Each of the priority activities listed above has an important urban environmental health
component. Many of WHO's other programmes have significant environmental health dimensions (e.g., communicable disease control, occupational health, nutrition, etc.). Because of the complex factors affecting health in an urban environment, individual programme efforts often fall short of their goals for improving health and well-being. Although it is no easy task, it is essential that more effective cross-programme projects be developed in health and environment, making a synergistic response to a complex set of problems. However, such projects cannot be developed in isolation or imposed on communities from the outside; they must be developed in cooperation with community leaders and decision-makers. Also, it is essential that these cross-programme projects be manageable, be fully supported by the leadership of the programmes and organizations involved, and receive the solid commitment of participating staff. In the area of urban health development, the following priority activities have been defined, although it is recognized that much work remains to be done to define others:
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(I)
convening of a meeting of officials from selected cities in the Region by WHO in Manila in
August 1993, to delineate specific cross-programme projects which will have local leadership support; and (2) collaboration with national and local officials and nongovernmental organizations in the
Philippines in developing and implementing a chronic emergency response programme for communities affected by mud flow and ash falls from the Mt Pinatubo and Mt Mayon volcanoes.
5. FUTURE ACTIVITIES
Guidance for future
The principal work for the future will be the formulation of specific plans of action for the new focus and for each of the priority activities. These will be dynamic documents, responsive to changing circumstances, but always improving health in measurable ways. and environment (see Annex); activities will also come from the resolutions of the World Health Assembly which relate to health and from collaborative frameworks such as the United Nations Development Programme's Capacity 21 initiative, which aims at translating the commitments of the 1992 UNCED (i.e., Agenda 21) into national action. The successful implementation of this regional strategy requires improved collaboration among national and external support agencies involved in activities related to health, the environment and development. These plans must be advocated and conducted at national and local levels, and they must reflect priority concerns. Even more important, this strategy calls for a renewed sense of partnership between the Member States and WHO. Effective solutions to complex environmental health problems cannot be developed or implemented in isolation, nor can they be imposed from the outside. The key to clear decision-making in the complex of issues related to health, the environment and development, and a vital role for WHO in the future, is to focus on specific needs at the source of the problems and to push for fundamental change in the way that planning and development activities that affect health are carried out.
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ANNEX
FORTY-SIXTH WORLD HEALTH ASSEMBLY Agenda Item 18.2
WHA46.7 10 May 1993
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INTERNATIONAL CONFERENCE ON NUTRITION: FOLLOW-UP ACTION The Forty-sixth World Health Assembly. Having considered the report of the Director-General on the International Conference on Nutrition and the consequent proposed WHO strategy for supporting nutrition action at aU levels; Commending Member States. organizations of the United Nations system and other intergovernmental and nongovernmental organizations concerned for their participation in the preparatory process and in the International Conference itself. and for their pledge to foUow it up; Commending the Director-General for his effective collaboration with other organizations of the United Nations system. especially FAO. in organizing the International Conference and for according high priority to nutrition by allocating additional resources. in particular for those countries most in need. 1. ENDORSES in their entirety the World Declaration and Plan of Action for Nutrition adopted by the Conference;'
2.
URGES Member States: (1) by the year 2000, to strive to eliminate famine and famine-related deaths, starvation and nutritional deficiency diseases in communities affected by natural and man-made disasters, and in particular iodine and vitamin A deficiencies; (2) by the year 2000. to reduce suhstantially the prevalence of starvation and widespread chronic hunger; undernutrition, especially among children. women and aid people; iron deficiency anaemia; foodhorne diseases; and social and other impediments to optimal breast-feeding; and to remedy inadequate sanitation and poor hygiene; (3) to contain and reduce the rising prevalence of diet-related diseases and conditions related to them;
(4) to develop, or strengthen as appropriate. plans of action setting out national nutritional goals and how they are to be achieved in keeping with the ohjectives, major policy guidelines and nine actionoriented strategies that were elaborated in the Plan of Action adopted by the International Conference on Nutrition. which also endorsed the nutritional goals of the Fourth United Nations Development Decade and of the World Summit for Children;
, International Conference on Nutrition. World Declaration and Plan of Action for Nutrition. Rome, December 1992, Food and Agriculture Organization of the United Nations and World Health Organization.
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Annex (5) to ensure the implementation of plans of action which: (a) incorporate nutrition objectives into national development policies and programmes;
(b) strengthen measures in various sectors to improve nutrition through governmental mechanisms at all levels, especially district development plans, and in collaboration with nongovernmental organizations and the private sector; (c) include community-based measures, particularly through primary health care activities, for nutritional improvement that are crucial if full and sustainable benefits are to be obtained for all people; (d) (e) are sustainable in the long term and contribute to protection of the environment; enlist the cooperation of all groups concerned;
3. CALLS UPON organizations of the United Nations system, other intergovernmental and nongovernmental organizations and the international community as a whole:
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(1) to renew their commitment to the achievement of the objectives and strategies set out in the World Declaration and Plan of Action for Nutrition including, to the extent that their mandates and resources allow, technieal cooperation and financial support to recipient countries; (2) to reinforce and foster concerted action at all levels for the establishment and implementation of national plans of action in nutrition with a view to attaining health and nutritional well-being for all;
4.
REQUESTS the Director-General: (1) to support Member States in establishing and implementing national plans of action for nutritional improvement that emphasize self-reliance and community-based action, especially as regards their healthrelated aspects; (2) to reinforce WHO's capacity for food and nutrition action in all relevant programmes. so that increased emphasis can be given as a priority to maternal, infant and young child nutrition, including breast-feeding; micronutrient malnutrition; nutrition emergencies (particularly training in preparedness and management); monitoring of nutritional status; control of diet-related chronic diseases; food safety control and the prevention of foodborne diseases; and research and training in subjects related to food and nutrition, including health implications of the misuse of chemicals and hormones in agriculture; (3) to give priority to least developed, low income, and drought-affected countries, and to provide support to Member States in establishing national programmes, especially those concerned with nutritional well-being of vulnerable populations, including women and children, refugees and displaced persons; (4) to stimulate regional exchange of ideas and plans;
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(5) to report on progre.'IS in implementation by Member States of the World Declaration and Plan of Action for Nutrition to the Health Assembly in 1995 as stated in the Plan of Action.
Eleventh plenary meeting, 10 May 1993 A46/VR/l1
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Annex
FORTY-SIXTH WORLD HEALTH ASSEMBLY
WHA46.17 12 May 1993
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Agenda item 18.2
HEALTH DEVELOPMENT IN A CHANGING WORLD A CALL FOR COLLECTIVE ACTION The Forty-sixth World Health Assembly, Recalling resolutions WHA30.43, WHA34.36, WHA39.7, WHA42.2, WHA45.4 and WHA45.5, concerning the Strategy for Health for All by the Year 2000 and progress in its implementation; Reaffirming resolutions WHA42.37 and WHA43.9 concerning the importance of technical cooperation among developing countries (TCDC) as a fundamental element of health development, and the implementation of the medium-term programme (1990-1995) of TCDC for health for all; Deeply concerned with the deteriorating health and social conditions of the people in some of the least developed countries;
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Being aware th,.t further progress in health must be sustained by effective multisectoral action, particularly on social issues related to population, education, women and development, children and young people; Recognizing that this is a time of profound change and rapid transition. of great challenge as well as of opportunities, especially for the achievement of health for all; 1. NOTES with satisfaction the "Jakarta message: a call for collective action and the democratization of international relations" emanating from the Tenth Conference of Heads of State or Government of Non· aligned Countries, held in Jakarta from 1 to 6 September 1992, which reaffirmed the right to a standard of living adequate for health and well-being - a fundamental human right· and endorsed technical cooperation among developing countries as a key approach for enhancing healtli development;
2. WELCOMES the commitment of the Heads of State or Government of the Non-aligned Countries to the full and effective implementation of: the Declaration and Plan of Action of the World Summit for Children (1990); the Summit Declaration on the Advancement of Rural Women (1992); Agenda 21 adopted by the United Nations Conference for Environment and Development (1992); and to the forthcoming International Conference on Population and Development (1994); the World Conference on Women: Action for Equality, Development and Peace (1995); and the World Summit for Social Development (1995); 3. URGES' all Member States to undertake the necessary measures to participate effectively in these important events;
WPRlRC44/13 page 14 Annex 4. CALLS UPON all Member States to continue to elaborate and implement health policies aimed at reducing inequalities in health, improving access to health care, and promoting healthy life-styles, better nutrition and a healthy environment;
5.
URGES developing countries: (1) to intensify further and accelerate their actions for implementation of primary health care, with emphasis on underserved and underprivileged population groups; (2) to mobilize and encourage the support of all partners in health development, including nongovernmental organizations and institutions in the private sector, in the implementation of their national strategies for health for all; (3) to strengthen existing mechanisms and explore new ones, establishing focal points at appropriate levels, in order to mobilize effectively their human and financial resources for the development and implementation of TCDC activities, particularly in the fields of training, supply and control of pharmaceuticals, and traditional medicine;
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6.
CALLS UPON the developed countries: (1) to facilitate the transfer of technology and resources to developing countries for health development programmes that correspond to the assessed needs and priorities of the developing countries and further support the application of the principles of TCDC;
(2) to provide WHO with the necessary financial resources to implement programmes which support effectively the efforts of developing countries in accelerating the implementation of health for all through primary health care; 7.
REQUESTS the Director-General: (1) to strengthen international technical cooperation by reinforcing and reorienting WHO programmes to mobilize effectively political, technical and financial support for the achievement of health goals, especiaUy for the least developed countries;
(2) to strengthen the TCDC aspects of all WHO programmes with potential emphasis on building national capacity for the sustained implementation of primary health care, as well as the application and transfer of appropriate methods, techniques and procedures that are sociaUy relevant to the needs and priorities of developing countries; (3) to support the continued implementation of the medium-term programme on TCDC for health for all for the period 1990-1995, through the provision and mobilization of the necessary financial resources for catalytic support to enhance the capacity of subregional, regional and global collaborating institutions for health development and TCDC;
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(4) to participate effectively in the follow-up of the recommendations in the Declaration and Plan of Action of the World Summit for Children (1990) and the Summit Declaration on the Advancement of Rural Women (1992); and contribute to the successful outcome of the International Conference on Population and Development (1994), the World Conference on Women: Action for Equality, Development and Peace (1995), and the World Summit for Social Development (1995). Twelfth plenary meeting, 12 May 1993 A46/VR/12
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FORTY-SIXTH WORLD HEALTH ASSEMBLY Agenda item 19
WHA48.20 12 May 1993
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WHO GLOBAL STRATEGY FOR HEALTH AND ENVIRONMENT The Forty-sixth World Health Assembly, Having considered the reports of the Director-General on the draft WHO global strategy for health and environment,' prepared in response to resolution WHA45.31 on Health and Environment, and on the United Nations Conference on Environment and Development;' Recalling resolutions WHA42.26 on WHO's contrihution to the international efforts towards sustainable development, WHA45.32 on the International Programme on Chemical Safety, and EB91.R6 on the WHO global strategy for health and environment; Mindful of resolution CD35.R17 of the Directing Council of the Pan American Health Organization and the Pan American Health Organization regional plan for investment in the environment and health; Considering the United Nations Conference on Environment and Development and its results, in particular the Rio Declaration on Environment and Development and Agenda 21; Noting the European Charter on Environment and Health; Responding to resolution 47/191 of the United Nations General Assemhly on institutional arrangements to foUow up the United Nations Conference on Environment and Development, in particular the section on coordination within the United Nations system which requests aU United Nations specialized agencies and related organizations of the United Nations system to strengthen and adjust their activities. programmes and medium-term plans, as appropriate, in accordance with Agenda 21. and invites the governing bodies of aU the competent organizations to ensure that the tasks assigned to them are carried out effectively; I. THANKS the Director-General for the very timely and thorough response to the directives of the United Nations Conference on Environment and Development;
2.
ENDORSES the WHO g10hal strategy for health and environment;
3. CALLS UPON Member States, in response to the United Nations Conference on Environment and Development: (I) to give high priority, in line with paragraph J8.8 of Agenda 21. to matters relating to health and the environment in the development of plans on sustainahle development at the country level and to utilize the WHO global strategy as the framework for the environmental health aspects of these plans;
, Document A46/11. , Document A46/INF.DOC./3.
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Annex (2) to coUaborate closely with WHO in order to strengthen their own capacities in matters related to health and the environment for the attainment of environmentaUy sound and sustainable development;
(3)
to aUocate adequate resources to implement the WHO global strategy at the country level;
(4) to establish appropriate coordinating mechanisms. if they have not yet done so, to ensure coUaboration among the authorities in all sectors having responsibilities for health and the environment, including nongovernmental organizations;
4. APPEALS to multilateral and bilateral funding organizations to support the WHO global strategy and to give high priority to programmes and projects on health and tbe environment in financing sustainable development; 5. REQUESTS regional committees to use the global strategy in developing corresponding regional strategies and action plans; 6.
REQUESTS the Director-General: (1) to support Member States in ensuring that measures for health and the environment are fully incorporated into plans and activities for sustainable development;
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(2) to promote actively the global strategy as the basis for measures for health and the environment in Member States; (3) to promote and carry out as part of the strategy, prospective studies on potential environmental hazards to human health; (4) to exploit fuUy available resources by establishing new approaches and mechanisms required to implement the global strategy, in particular approaches involving several programmes and the strengthening of the role of WHO representatives' offices in countries; (5) to determine the resources required to implement plans of action based on the global strategy throughout WHO, to mobilize the required extrabudgetary resources for implementation at country level and to ensure that priority is given to related requirements in future programme budgets; (6) to expand coUaborative activities with other organizations responsible for matters relating to health and the environment and to establish aUiances with financial and other organizations to ensure that health goals are incorporated into their programmes on environment and development; (7) to support the convening, in line with paragraph 19.76 of Agenda 21, and in collaboration with the International Labour Organisation and the United Nations Environment Programme, an intergovernmental meeting to consider further the recommendations 'of the meeting of governmentdesignated experts held in London in December 1991, on increased coordination among United Nations bodies, and on proposals for an intergovernmental mechanism on chemical risk assessment and management;
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(8) to participate actively in the United Nations Development Programme's Capacity 21, a countrylevel capacity-building programme in support of Agenda 21;
(9) to contribute actively to the work of the Commission on Sustainable Development, established by the United Nations Economic and Social Council, and the Interagency Committee on Sustainable Development, and to forward to the Commission reports on WHO's contribution to the implementation of Agenda 21; (10) to keep the Health Assembly informed through the Executive Board of progress in implementing this resolution .. Twelfth plenary meeting, 12 May 1993 A46/VR/12
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