Third Ministerial Conference on Environment and Health
London, June 16-18, 1999

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Introduction

The Third Ministerial Conference on Environment and Health built on foundations laid at previous regional ministerial conferences held in Frankfurt (1989) and Helsinki (1994), which had themes of "Policy formulation" and "planning", respectively. The theme of this Conference was "Action in partnership".

A total of 1146 people participated in the Conference, including 73 ministers from 54 countries, representatives of 7 United Nations bodies and 11 international organizations, a delegation of representatives of nongovernmental organizations (NGOs), and 186 observers from the parallel conference for NGOs, the Healthy Planet Forum.

The Conference elected as co-presidents the Rt. Hon. Tessa Jowell (Minister of State for Public Health, United Kingdom), the Rt. Hon. Michael Meacher (Minister for the Environment, United Kingdom), and the Lord Whitty of Camberwell (Parliamentary Under-Secretary of State for Environment, Transport and the Regions, United Kingdom). The chairperson of each session and Professor Liam Donaldson (Chief Medial Officer, United Kingdom) were elected co-vice-presidents. Dr Alan Pintér (Hungary) was elected rapporteur.

Water and health

The Conference noted the serious burden of water-related diseases and the pressing problems in water management, water supply and sanitation that existed in the European Region. Participants described the particular problems of NIS; the importance of education, training and the involvement of communities and enterprises; and the policy frameworks offered by the ECE 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes and by EU policy instruments. The importance of the Protocol on Water and Health was emphasized, as was its significance as WHO’s first legislative act jointly with ECE.

Many countries expressed strong support for the Protocol, voiced expectations that it would be effective and proposed practical measures to assist implementation (for example, production of guidance, capacity-building measures, and sharing of information). The roles played by EEHC, the Meeting of the Parties to the Convention and the Government of Hungary were commended. The Conference welcomed initiatives to develop pilot projects on implementing the Protocol and noted that in many countries implementation would require extensive financial support. The Conference invited the secretariats of WHO and ECE to finalize a Memorandum of Understanding between their organizations, in the light of decisions about programmes and budgets for the period after 1999. The Conference took note of plans to hold the first Meeting of the Parties to the Protocol in October 2000 and for a seminar on sustainable water management and health to be held in the Russian Federation in May 2000.

The Conference adopted the Protocol on Water and Health by consensus. The Protocol was signed by the following countries: Albania, Armenia, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Italy, Latvia, Lithuania, Luxembourg, Malta, Monaco, Netherlands, Norway, Poland, Portugal, Romania, Russian Federation, Slovakia, Slovenia, Spain, Sweden, Switzerland, Ukraine and United Kingdom. A number of other countries expressed their readiness to sign the Protocol soon.

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DECLARATION OF THE THIRD MINISTERIAL CONFERENCE ON ENVIRONMENT AND HEALTH

Preamble

1. We, ministers and representatives of European Member States of WHO responsible for health and the environment gathered in London from 16 to 18 June 1999. Our meeting built on foundations laid at the previous Environment and Health conferences in Frankfurt (1989) and Helsinki (1994) and marked a new commitment to action in partnership for improving the environment and health in the twenty-first century.

Europe’s environment and health at the turn of the twenty-first century

2. We welcome the WHO report An overview of environment and health in Europe in the 1990s. It demonstrates that the ten years since our first conference have seen various achievements, which give grounds for optimism about improvements in Europe’s environment and health in the twenty-first century. However, it also shows that the Region still faces many urgent environment and health challenges.
3. Many problems remain unsolved and new challenges have emerged.
• In the Region as a whole, serious problems remain and some are increasing. We draw particular attention to the increasing inequity between and within countries and the need for international cooperation on transboundary problems, such as air pollution; to the continuing lack of reliable access to sufficient safe water and sanitation for many communities, as a basic prerequisite for health; and to transport, where solutions have yet to be found to the adverse environment and health impacts of increasing traffic, especially due to road transport.
• Within countries, the lack of economic growth and stability are urgent problems for some countries, denying a sustainable basis for protecting the environment and health. Special assistance is needed for countries in transition and some Member States which face more severe and often worsening environment and health problems. We express our horror at the continuation of armed conflicts in some countries of the Region, and the resulting loss of life and destruction of natural environments, health care establishments and recreational zones; there is a need for international assessment of the damage being done to the environment and health, and for immediate remedial action.
• Some trends are of great concern, such as climate change and ozone depletion; unsustainable patterns of consumption and production; and the tendency to conceive of development and economic growth as unrelated issues, unaware of the fact that economic development is fundamentally linked to improvements in people’s health.
4. However, there are many reasons for being confident that improvements can be made.
• In the Region as a whole, democracy has continued to be strengthened, and cooperation between countries has increased notably. In addition to the Environment and Health process, many other processes such as Environment for Europe, programmes of the European Commission (EC) and the process of enlargement of the European Union (EU) have also particularly contributed to this; coordination with them can yield added value for the environment and health. WHO’s Health for All policy framework for the European Region for the twenty-first century (Health21) provides an additional, positive framework for making further progress, and its European Centre for Environment and Health (ECEH) can serve as a platform of scientific and operational support for effective action.
• Within countries, most have exploited the foundations laid by international cooperation, by developing health strategies that embody the principles of Health for All, National Environmental Health Action Plans (NEHAPs), National Environmental Action Programmes (NEAPs) and Agenda 21 strategies.
• There are many positive trends, such as increases in life expectancy at birth in many countries; advances in technology and in its use for the benefit of human health; improved education; progress in research and understanding; greater involvement of civil society in environment and health matters; and the continuing willingness of governments to take strong measures to protect health and the environment.
5. In the past ten years we have learnt that by working in intersectoral partnerships and increasing coordination of relevant initiatives, we can have a greater effect in reducing the negative impacts of human activity on the environment and health. We are determined to strengthen and expand our coordination and partnership, as we work towards improved environment and health within sustainable development.

Commitment to action

6. We wish to record here, in the paragraphs below, the actions that we have agreed at our third Conference.

Water and health

7. We adopt the Protocol on Water and Health to the 1992 Convention on the Protection and Use of Transboundary Watercourses and International Lakes, (MP.WAT/AC.1/1999/1 – EHCO 020102 P, Conference document EUR/ICP/EHCO 020205/8 05299 – 24 March 1999), with the aim of preventing, controlling and reducing the incidence of water-related disease through collaboration on water management and protection of health and the environment. We thank the Government of Hungary for leading the process of developing this Protocol and call upon all Member States of the United Nations Economic Commission for Europe (UN/ECE) and those in the European Region of WHO to ratify both the Protocol and, if they have not already done so, the parent Convention. We also thank the Secretary-General of the United Nations for acting as the Protocol’s Depositary.
8. Within the framework of the Protocol we will take all appropriate measures for the purpose of achieving:
1. adequate supplies of wholesome drinking-water which is free from any micro-organisms, parasites and substances which, owing to their numbers or concentration, constitute a potential danger to human health. This shall include the protection of water resources which are used as sources of drinking water, treatment of water and the establishment, improvement and maintenance of collective systems;
2. adequate sanitation of a standard which sufficiently protects human health and the environment. This shall be done especially through the establishment, improvement and maintenance of collective systems;
3. effective protection of water resources used as sources of drinking water, and their related water ecosystems, from pollution from other causes, including agriculture, industry and other discharges and emissions of hazardous substances. This shall aim at the effective reduction and elimination of discharges and emissions of substances judged to be hazardous to human health and water ecosystems;
4. adequate safeguards for human health against water-related disease arising from the use of water for recreational purposes or for the production of fish from aquaculture, from the water in which shellfish are produced or from which they are harvested, from the use of waste water for irrigation or from the use of sewage sludge in agriculture or aquaculture;
5. effective systems for monitoring situations likely to result in outbreaks or incidents of water-related disease and for responding to such outbreaks and incidents and the risk of them.
9. We will apply the Protocol’s provisions to the maximum extent possible pending its entry into force. We ask UN/ECE and WHO to assist in that, especially by:
1. organizing meetings of the Signatories, open to all States who are entitled to sign the Protocol, to the European Commission and to all relevant international intergovernmental and nongovernmental organizations;
2. providing the necessary infrastructure within the framework of existing budgets.
10. We call for close cooperation in this work between UN/ECE, WHO, the United Nations Environment Programme (UNEP), the United Nations Development Programme (UNDP) and EC, as well as other relevant international organizations. We specifically call upon UN/ECE and UNDP to make a useful contribution to national strategies for sustainable development by helping to build up national capacity in the area of water and water management. We offer to share our experience with other regions of the world and commend the Protocol to other regional commissions of the United Nations and regional offices of WHO.

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