Discussion on Integrating Sources
World Health Organization
Report Part Title: WHO’s role and leadership in global health
Report Title: WHO Global Strategy on Health, Environment and Climate Change Report Subtitle: The transformation needed to improve lives and wellbeing sustainably through healthy environments Report Author(s): World Health Organization Published by: World Health Organization (2020) Stable URL: https://www.jstor.org/stable/resrep32997.9
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WHO Global Strategy on Health, Environment and Climate Change
WHO’s role and leadership in global health
33.
Programme of Work, 2019–2023 (see Box 1). The basic health, environment and climate change activities fall under the strategic priority “Promoting healthier populations”, but the
strategic priority of “Achieving universal health coverage” should underlie mechanisms for implementing basic environmental health services, such as access to safe drinking-water and clean fuels.
Box 1. The health, environment and climate change strategy and WHO’s Thirteenth General Programme of Work, 2019–2023
In corporate strategy, three strategic priorities drive contribution to ensuring healthy lives and promoting well-being for all at all ages. The three strategic priorities, with a description of how health and environment contributes to each of them, are:
(i) Achieving universal health coverage. environmental health services, knowledge and capacities need to constitute an integral part of universal health coverage.
(ii) Addressing health emergencies. Improved resilience of the health sector and communities to climate change, reduced vulnerabilities, and enhanced preparedness, surveillance and response to health emergencies will prevent and reduce the health impacts of environmental emergencies.
(iii) Promoting healthier populations. Conditions for healthier populations include: healthier cities; sustainable provision of safe water, sanitation and hygiene practices; healthy transport solutions; clean energy policies; sustainable food; safe and sustainable products, housing and workplaces; and sustainable agriculture.
34.
to build a community to work for the shared future of humankind, empowering all people to improve their health, address health determinants and respond to health challenges.”15 To work towards that vision, the strategic objectives cover actions by, or with key input of, the health sector, in terms of primary prevention, cross-sectoral action on health determinants, leadership on health matters with reference to determinants of health, and health-related monitoring. To support these objectives, the Secretariat focuses on providing support to the health sector, and on multisectoral action on health determinants. Activities in this strategy
15 The Thirteenth General Programme of Work further states “WHO will advocate for health at the highest political level”, “WHO will speak up against practices from any sector including industry that, based on evidence, are harmful to health”, “The United
the health impacts of climate change and the environment, and of other factors that have a major impact on health”, and “With respect to air pollution (i.e. outdoor, household and workplace air pollution) and climate change mitigation, WHO will
national and local level to monitor air quality, develop strategies for transitioning to healthier technologies and fuels and for
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WHO Global Strategy on Health, Environment and Climate Change
16
therefore create the strengths and relative advantages to take the lead on the matters
and policy support; (b) evidence synthesis and advocacy; and (c) provision of direct country
United Nations system will be ensured through various mechanisms,17 and cooperation is already active on various activities.18
16 Providing leadership on matters critical to health and engaging in partnerships where joint action is needed; shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge; setting norms and standards, and promoting and monitoring their implementation; articulating ethical and evidence-based policy options; providing technical support, catalysing change, and building sustainable institutional capacity; and monitoring the health
17 agencies (see https://www.who.int/globalchange/coalition/en/, accessed 27 March 2019).
18
Programme (https://washdata.org/, accessed 27 March 2019).
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WHO Global Strategy on Health, Environment and Climate Change
Fig. 2. Outline of WHO’s role and leadership in health, environment and climate change
Impact
Outcomes
Governance mechanisms and capacity of the health sector are strengthened
for intersectoral action and the Health in All Policies
approach
Norms, standards and legal instruments are in place and enforced to protect
primary prevention
Policies are implemented and regularly adapted through monitoring, evidence-supported
solutions and coordinated research
Populations who are vulnerable or in vulnerable
situations are protected from environmental and
climate change risks in an equitable way, including
during emergencies
Outputs
Adequate governance mechanisms have been
supported and leadership has been provided on policies, strategies and
plans
information on solutions are developed and
disseminated, and change is monitored
Relevant actors are fully informed about risks and engaged in solutions, and can access relevant tools
and technical cooperation
Outputs and implementation are
communication and strategic partnerships
Key activities
Provide leadership on health, environment and climate change Shape the research agenda choices and provide platforms for key
stakeholders
Support governance mechanisms for integrated and cross-sectoral action
Identify, assess and respond to emerging environmental threats to
health
Build capacity of national institutions and other implementing partners
Build global alliances for advancing global agendas develop and update norms and
guidance on interventions
Provide assistance with implementation of norms and
solutions
in cooperation with partners Provide tools for estimating costs and Implement special initiatives for people
who are vulnerable or in vulnerable situations
Foster development and implementation of legal instruments
Monitor health risks, impacts and implementation of solutions, and communicate progress to adapt
strategies
Support expansion of universal health coverage through essential
environmental health services
Provide platforms for high-level global and regional forums
Scale up communication to raise awareness of health impacts, costs to
society, and solutions
Provide environmental and occupational health response in
emergencies
Develop strategic partnerships at the
Key platforms for implementation
Multilateral, regional and global policy
platforms
Partnerships for social
movements monitoring platforms
Health sector support
Settings such as cities,
workplaces, households
platforms
Intervention topics
Water, sanitation, waste and hygiene Vector control Chemical safety Occupational risks and work
environments
Climate and ecosystem change Air pollution Built environments Radiation Noise
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WHO Global Strategy on Health, Environment and Climate Change
Promoting healthier populations
35. Under this strategic priority, WHO will undertake the following activities.
Provide leadership
(a) Provide leadership in guiding healthy energy transitions, healthy transport and urban design solutions, a safe and healthy circular economy and other ongoing
advocacy. Foster high-level political support, in interactions with Member States and civil society.
(b) Coordinate regional policy processes by providing or expanding regional platforms for environment and health governance, bringing together key sectors and stakeholders.
(c) Stimulate good governance to develop healthy and sustainable cities.
engaged in the subsequent implementation of instruments, for example through
International Chemicals Management towards the 2020 goal and beyond which will contribute to achieving the sustainable development goals globally19 and the Paris Agreement on climate change.
Synthesize evidence and advocate for building global goods for health
information on policy impacts will be essential to supporting cross-sector action and
health, such as safe water and clean air, or safe products and technologies, such as consumer goods. The Secretariat will help to develop and sustainably extend innovative solutions in order to accelerate the reduction of environmental health risks.
decision-making. Information creates awareness about health risks and available solutions, and triggers demand for healthier environments.
(c) Monitor change in risks to health and implementation of solutions – in terms of
monitoring in order to realign priorities and implementation strategies in countries is needed. WHO will continue to expand its work in convening partners to develop data
19 WHO. Road map to enhance health sector engagement in the Strategic Approach to International Chemicals Management
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WHO Global Strategy on Health, Environment and Climate Change
platforms that integrate the diverse data needed to monitor progress. WHO is also reporting on several indicators on health and the environment (within Goals 3, 6, 7 and 11).
Enhance WHO’s direct impact in countries
through engaging in policy dialogue, providing guidance on healthy policies and governance mechanisms, and assisting in implementation of standards, and monitoring.
needs, and may vary in focus between upstream actions (policy-related and strategic) and downstream actions (such as technical cooperation). Activities will be closely
(the One-United Nations approach) and partners.
stewardship, leadership and coordination in health matters with cross-sectoral scope.
environment and climate change at national and regional levels. Support related
and of progress in implementing solutions. Also lead by example in order to limit impacts of the health sector on health, the environment and climate change, in other words green the health sector.
(c) Provide platforms for key stakeholders in shaping healthy choices related to the environment and climate change. Provide data, information and advocacy material (such as the Breathelife campaign20) to civil society in order to support their engagement in matters concerning healthy choices in relevant policies. Support mayors and other local key actors in shaping health-supportive environments by providing tools and information on healthy choices. Develop platforms facilitating the sharing of data, solutions and experiences between major stakeholders and countries.
(d) Develop special initiatives for populations in situations of vulnerability. Provide enhanced support to those who are vulnerable or in vulnerable situations (such as
in emergency situations, poor communities, populations of small island developing States and least developed countries, the Arctic, water-stressed and low-lying areas and
long-term future of the most vulnerable.
(e) Provide emergency response. Support countries in developing systems to be prepared for environmental disasters and emergencies and to provide normative and technical guidance. Strengthen global and regional networks of experts to provide support to
20 See paragraph 34 above.
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WHO Global Strategy on Health, Environment and Climate Change
countries in responding to environmental emergencies. Responding to environmental health emergencies and delivery of environmental health services represent additional important activities in countries.
Addressing environmental health emergencies
36. and health around the world, with climate change and forced migration being likely to further
health conditions and the least capacity to respond to environmental health emergencies. Preventing and managing such emergencies is essential to health security in order to keep people safe.
37. A systematic approach to environmental emergencies, such as a chemical or nuclear release, and to the environmental health aspects of all types of emergencies and disasters requires the Secretariat to work with all Member States to invest in assessment of vulnerability and risk, as well as planning for preparedness, response and recovery. The International Health Regulations (2005) provide a readily available vehicle to build national and regional capacities in core competencies pertinent to the detection of, preparedness for and response to
38. The objectives for environmental health management in emergencies are as follows:
(a) identify, assess and map environmental and occupational health risks and vulnerabilities in countries susceptible to crisis;
occupational health aspects of emergencies, for instance by enhancing the resilience of health systems and facilities;
(c) ensure that health care facilities: have access to basic environmental health services, such as those for safe water, adequate sanitation and hygiene and to clean, reliable
managing occupational health and safety;
management cycle of the disaster or emergency.
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WHO Global Strategy on Health, Environment and Climate Change
39. Suggested priority actions for environmental health management in emergencies are outlined in Table 1.
Table 1. Suggested priority actions for environmental health management in emergencies
Strategic response Action by Member States Action by the Secretariat
Developing the capacities of the health sector to manage environmental and occupational health services throughout the life cycle of emergencies
• Develop environmental health (such as resource mapping
establish or update environmental health plans for emergencies
• programmes and management systems pertinent to environmental health services in health care facilities, including the assessment, provision and restoration of services
• Integrate the protection of occupational health and safety into national health security plans
• Develop systems for the prediction and early warning of, and preparedness for, environmental disasters and manmade emergencies
• regional networks of
and occupational health specialists and sanitarians
and deployed in a timely manner to provide support to countries in need
• to protect occupational health and safety in public health emergencies
Providing adequate environmental health services in health care facilities during emergencies
• Strengthen the health sector capacity to develop
policies, programmes and management systems pertinent to environmental and occupational health services in health care facilities, refugee camps and other areas hosting internally displaced persons
• Provide normative and technical guidance
Developing national capacities for responding to chemical, radiological and nuclear events for implementation of the International Health Regulations (2005)
• Strengthen national capacities for responding to chemical, radiological and nuclear events.
in core capacities required by the International Health Regulations (2005)
• Provide normative and technical guidance
• Strengthen global and regional thematic networks of experts to provide support to countries in monitoring and responding to chemical and nuclear events
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WHO Global Strategy on Health, Environment and Climate Change
Achieving universal health coverage by providing environmental health services
40. towards universal health coverage. Universal health coverage includes ensuring that all people have access to and can use promotive and preventive health services appropriate to their
the main aim to improve health are an integral part of universal health coverage. Such services include, for example, provision of drinking water of safe quality, safely managed sanitation services, clean energy and technologies, and workforce protection, both within health care facilities and within communities.
41. for example, in a reduction in the number of individuals with diarrhoeal diseases, following improved water and sanitation services) and noncommunicable diseases (for example, cardiovascular and chronic respiratory diseases through clean energy and technologies in households).
Goals to be achieved
42. Within the global strategy, the goals to be achieved by the transformational approach are highlighted in Box 2.
Box 2. Goals to be achieved by the transformational approach
To sustainably improve lives and well-being through healthy environments
1. People. People live longer and healthier lives owing to the reduction of environmentally- related diseases. People are aware of the environmental exposures harming their lives and how to avoid them, and of the voice heard by policy-makers. This ultimately leads to better health and well-being.
2. Universal health coverage. primary prevention measures, such as essential environmental and occupational health services and health promotion, as an integral part of universal health coverage.
3. Air pollution. Countries and major cities have set health-based air-quality targets and have put in place policies to achieving the targets by involving relevant sectors. Polluting fuels technologies reduced.
4. Climate change. Health systems and communities around the world are resilient to climate variability and change, and drive down rates of climate-sensitive infectious disease. Carbon emissions are reduced to meet international commitments. Cleaner energy systems public transport systems promoting active movement are in place, disease vectors are appropriately controlled, more sustainable diets and more resilient food systems are promoted and implemented, and homes and workplaces should
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WHO Global Strategy on Health, Environment and Climate Change
5. Water, sanitation and hygiene. All countries have incorporated the pillars of the Water and Sanitation Safety Planning into their strategies and have adequate hygiene integrated into the water safety plans. All health-care facilities have access to safe water, sanitation and hygiene. Sanitation and waste-water barriers to combat antimicrobial resistance are in place.
6. Chemical safety. Impacts on health from exposure to chemicals are reduced, as the health impacts from exposure to chemicals and their mixtures are better known, the use of chemicals is well regulated, national institutions have the capacity to meet chemical threats, including incidents and emergencies, and are involved in chemicals management activities.
7. Radiation safety. Health impacts from ultraviolet radiation are decreasing through better awareness of risks and through better personal protection. Unnecessary exposures from medical imaging techniques radon
Nuclear incidents are adequately responded to and managed.
8. Health care settings. All health care facilities and services are environmentally sustainable: using safely managed water and sanitation services and clean energy; sustainably managing their waste and procuring goods in a sustainable manner; are resilient to extreme weather events; and capable of protecting the health, safety and security of the health workforce.
9. Workplaces. All workplaces have systems in place for the management of occupational health and safety and for promotion of health at work. All workers have access to essential interventions for the prevention and control of occupational and work-related diseases and injuries.
10. Global and regional settings. International agreements and policies are in place as appropriate that global and regional drivers of health, such as climate and ecosystem change.
11. Emergencies. All countries have the capacity to manage environmental health services throughout emergencies. Countries have the capacity to respond to chemical,
radiological and nuclear events and to protect the occupational health and safety of emergency responders.
12. Governance. National and local governments (for example, of cities) have mechanisms in place that facilitate cross-sectoral cooperation and integrate health in all relevant policies and ensure that they
43. The WHO website provides access to supporting documents and details of activities in the 21
21 See Public health, environmental and social determinants of health (http://www.who.int/phe/publications/global- strategy/en/, accessed 27 March 2019).
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