Developing financial strategies for national environmental health action plans

A financial strategy will almost certainly be a key factor in implementing a National Environmental Health Action Plan (NEHAP). Countries who decide to develop NEHAPs will need to consider how to raise the funds to undertake their proposals and there may well be an interaction between proposals and financing.

Achievement of the aims of NEHAPs demands that environmental health risks as well as costs and benefits of remedial and prevention actions be more clearly recognized in making choices at both the individual and societal level.

An effort should be made to broadly quantify the expected rate of return on environmental health investments, in order to justify the decisions to be taken (whether by national or international funders). For all projects, the costs of implementation are offset by the material and non-material burdens removed or abated and the material and non-material benefits delivered. Such analyses of NEHAP projects are useful to donors in determining what projects they might finance.

The resources available for implementation of the NEHAP may be boosted by: (a) obtaining external aid or loans; (b) economic measures such as taxes; or (c) franchising and privatisation schemes. Where aid or a loan is possible the NEHAP process may be a useful tool in identifying appropriate schemes. It may be worthwhile framing proposed actions in terms which meet the investment criteria of donors or lenders and inviting contributions at the earliest possible opportunity. In regard to franchising and privatisations, the private sector has often proved more innovative than the public sector and has different sources of finance.

A NEHAP will tend to concentrate on Government and other public sector actions. However, large private sector schemes may have a significant bearing on environmental health. In most cases, planning, control and monitoring systems will be adequate to take account of the private sector but, at a time when a national plan is being evolved, specific considerations of large private sector schemes are merited. Such schemes may have beneficial economic effects also.

Because a NEHAP constitutes a holistic approach to planning actions to improve environmental health, it is unreasonable to expect it to be funded by a lump sum or by one source. Sources and ways of funding may differ depending on individual actions, the added value and who benefits. Because many states experience shortage of financial resources, implementation should reduce financial burdens on society and release funds for its further development. Accordingly, NEHAP implementation merits careful planning of the financial aspects of its activities.

The holistic philosophy of a NEHAP should apply equally to funding actions stemming from it: (a) to maintain the inter-relations of its components; (b) to minimize uncoordinated and piecemeal funding; (c) to use priority-setting instruments based on health gains and cost-effectiveness; and (d) to apply a systematic approach to identifying available funds and assessing their benefits and disadvantages.

Some measures or actions will be specific to an area and performed most appropriately by a local body. The funding of such local work by central or local funds, or some combination of them, is crucial to successful implementation. Because limited financial resources are the principal impediment to implementation, clear criteria are essential for setting funding priorities at local level and to ensure management commitment and continuing political support. The latter requires local politicians, interest groups and the public in the relevant area to be convinced of the merits of the NEHAP. Seed money from central government can indicate the seriousness of the central government's commitment. Alternatively, successful implementation of a pilot project may attract funds from a variety of sources for wider implementation. Projects should be on an achievable scale and involve local people in all aspects, so that they can contribute to the resulting improvements.

In some states the government may need to promote NGOs or may find it helpful to partially fund NGOs and community groups. Promotion measures could include the provision of financial incentives for private donors. Care needs to be taken, however, to avoid compromising the independence of NGOs.

Access to a realistic level of resources has to be ensured. Local project implementers, particularly individuals and organizations with no regular access to public sector finance, can be very creative in obtaining and using resources and mobilizing community support. Except where NGO, community or private sector partners have access to sufficient finance and resources, most local EH projects benefit from an injection of public sector resources. Mechanisms for securing genuine access to public resources by these local project implementers ought to be available or established.