European level * The political response in Belgium * The National Environment and Health Action Plan (NEHAP), a crucial tool… * … plus specific recommendations * And what can you do? * Conclusions
In general, the European Union seeks to improve the environment and the quality of life through its Community programmes, which lay down guidelines for environment, health and research policy.
Specifically, the environmental priorities for the period 2002-2012 focus on water and air quality, propose a new way to manage chemicals and pesticides, and take account of the emerging issues of noise and the urban environment. (see also nehap_administration (HTML))
Since June 2003, the European Commission has also been devising a specific “European environment and health strategy (FR) (.PDF)”. By facilitating cooperation between the fields of environment and health, this strategy aims to prevent diseases caused by environmental factors.
Within this framework, the first measures relate to pathologies affecting children:
· respiratory diseases of children, asthma, allergies;
· neurological development disorders;
· childhood cancers;
· disorders of the endocrine system.
The political response in Belgium
In Belgium, the Regions are responsible for most areas of the environment. But the issues of environment and health policy are still handled at federal level through the :
· coordination and implementation of international environmental policy (see fact sheet CCPIE (HTML))
· integrated product policy (see fact sheet integrated products policy (HTML))
· policy on the marketing of chemicals and pesticides/biocides (see fact sheet Chemical substances (HTML))
The powers concerning health are devolved between the Federal Government and the Communities, with some exceptions. Generally speaking, the Communities are responsible for health promotion and the Federal Government for other aspects of health policy. (see also nehap_administration (HTML))
At any discussion of environment and health in Belgium, there are therefore automatically federal, regional and community representatives sitting around the table!
Given this institutional reality, Belgium must handle four major challenges in order to act effectively on environment and health.
1. Structuring measures into a coherent overall plan
The Joint Inter-ministerial Conference on Environment and Health (JICEH) was set up to enable ongoing consultation on the measures to be taken. This conference brings together the competent ministers from the three levels of power (federal, regional and community) and on 10 December 2003 it approved a cooperation agreement on the coordinated management of health and environmental policies.
2. Speaking with one voice at international level
Belgium must be able to speak with one voice in international and European fora. The cooperation agreement of 10 December 2003 therefore set up a national Cell on environment and health in which the competent administrations are represented; its mission is to prepare Belgian positions and drafts to be submitted to the JICEH.
3. Bringing the environmental and health players closer together
Even today, environmental and health specialists still tend to work separately from each other. Despite being complementary, these two sectors speak different languages and use approaches that are sometimes quite different from one another. There is therefore a need to foster ongoing cooperation and create a real synergy between them.
4. Establishing links with other sectors (transport, energy, economy, etc.) and taking account of sustainable development
The example of air pollution is illuminating. Effective environmental health measures can be taken only if the transport and energy policies are both involved and the costs and benefits of action or inaction are assessed on the economic, social and environmental levels.
The National Environment and Health Action Plan (NEHAP), a crucial tool…
Faced with these challenges, the NEHAP (WEB) constitutes more than just Belgium’s response to the commitment made in Helsinki in 1994. It takes stock of the scientific data currently available on environmental health issues. It inventories the measures taken at community, regional and federal levels (NEHAP - documents (doc I) (WEB)). It reports on the general situation of the links between the environment and health in this country (NEHAP - documents (doc II) (WEB)). And finally, it proposes priorities for action and a general framework applicable to all the players.
… plus specific recommendations
The NEHAP makes seven recommendations which serve as a basis for government action as a whole (NEHAP - documents (doc III)(WEB)):
1. Establish functional cooperation between the existing structures of the environment and health.
The adoption of the NEHAP, the signature of the cooperation agreement and the setting-up of cooperative structures at different levels of government are the first steps in that direction.
2. Develop and manage databases covering all aspects of environment and health.
The data are the basis of all government policy and depend, in these subject matters, on the three levels of government involved in the agreement.
3. Define priorities for research into the relationships between the environment and health.
It is essential that this research be coordinated at international and European level, in order to create the necessary synergies.
4. Develop a prevention policy for the relationships between the environment and health.
Prevention is one of the basic tools in the field of the relationships between the environment and health.
5. Communicate on the relationships between the environment and health.
In particular, it is necessary to find an effective way to bring the public’s concerns to the attention of the appropriate decision-making level.
6. Support the development of specific courses and training on the relationships between the environment and health.
Among other things, the challenge is to integrate the environmental dimension into the training of health professionals.
7. Raise awareness and educate people about the relationships between the environment and health.
The goal is ultimately to get citizens – especially young people - to change their everyday habits (for example, with regard to transport, domestic lifestyles, etc.).
By way of example, here are some measures that have already been introduced using this NEHAP logic:
· the joint funding of a study on environmental health indicators applicable to the whole of Belgium. More information: NEHAP (WEB)
· the introduction, in Flanders, of a large-scale campaign of measures aimed at evaluating the contamination of the population. More information: milieu en gezondheid (WEB) and milieugezondheidszorg (NL) (WEB)
· the setting-up by Wallonia of an environmental health platform responsible for studying specific problems. More information: Institut scientifique de service public (FR/NL) (WEB)
· the setting-up by the Brussels-Capital Region of the Regional Indoor Pollution Intervention Unit (CRIPI), focusing on forms of pollution in the home that can lead to health problems. More information: Bruxelles Environnement - IBGE (FR/NL) (WEB)
· the introduction by the French-speaking Community of medical supervision for residents around the Mellery landfill site. More information: Direction générale de la santé (FR) (WEB);
· the introduction of environmental aspects into the “health” measures of the Federal Authority’s Federal Plan for Sustainable Development (2004-2008). More information: Commission Interdépartementale du Développement Durable (WEB)
These sites offer only a glimpse of the potential measures. Naturally, other players and hence other, more specific sites should be consulted, for example with regard to food, transport, housing, etc.
· Increasingly, groups of patients, neighbourhood committees and other associations are setting themselves up as information relays or interfaces between government, scientific experts and the public. Trade-unions (FR) (WEB) are gathering information and passing it on to workers. Business federations are also making their voices heard.
Meanwhile, NGOs are joining international networks, so allowing them to make an active contribution to the discussions going on within the WHO and the European Union as well as in Belgium.
The Paris Appeal (WEB), launched in May 2004 at the initiative of scientists and doctors, has gone well beyond its initial framework. Nowadays, the whole of civil society is backing this Appeal in order to expose the chemical hazards threatening human health. Many Belgian associations and scientists have already signed the Appeal.
The trade-unions, business federations and NGOs have taken an active part in the consultation (FR) (WEB) on the NEHAP by submitting their own opinions or by sitting on the various advisory councils, including the Federal Sustainable Development Council.
For its part, the federal administration intends to continue to promote the involvement of civil society in environmental health issues. In December 2003, the NEHAP partners organised the first “Belgian Environmental Health Day” bringing together the main Belgian players involved in this issue. Other steps in this process of dialogue and exchange with civil society will soon be taken …
The links between the environment and health have become a topic of discussion in most decision-making circles, despite the degree of scientific uncertainty that remains about some aspects. A common line must be followed from international to local level!
Faced with a complex institutional context and high stakes, Belgium has not remained inactive. It has succeeded in developing a mechanism for coordinating all the levels of government, and specific measures are now taking shape. These are only the first steps that will be taken in order to offer the Belgian population a high level of well-being.