Developing environmental health action plans

An Environmental Health Action Plan (EHAP) will have a number of defining features: (a) defining the objectives to be attained; (b) providing a situation report giving the current status of environmental health within a defined area and giving the starting point of the plan; (c) provide a judgement of the significance of any disparity between the objectives and the situation report; (d) outline actions for closing the gap between the objectives and the situation report; (e) provide a time frame; (f) list a choice of priority actions if not all the gaps can be closed; and (g) provide a judgement on the availability of resources within the time frame.

It is difficult to separate the process of preparing an EHAP from its eventual content. Preparation of a plan will depend in part on what the plan is intended to achieve, the parties involved, and on other general considerations. In practice, in most plans the content of a plan and its presentation is dependent on the process of preparation.

The task of developing an EHAP can be summed up in three crucial questions: (a) What are the most significant environment-related health risks? (b) What resources and instruments exist to prevent and eliminate these risks? (c) What more can be done without recourse to new financial resources?

Participants in efforts to improve the environment and health should include: (a) central government authorities; (b) authorities at all levels in relevant sectors, including those concerned with agriculture, defence, education, employment, energy, finance, food, housing, industry, land use and transport; (c) nongovernmental organizations, including trade associations, trade unions, professional and technical bodies, advocacy groups, consumer associations and members of the public; (d) public and private businesses, both large and small; (e) the mass media and public relations and information services; (f) universities, research centres and scientific associations; and (g) international organizations.

The World Health Organization policy for "Health for all in the twenty-first century," adopted by the world community in May 1998, aims to realize the vision of health for all – a vision born in the World Health Assembly in 1977 and launched at the Alma-Ata Conference in 1978. It sets out, for the first two decades of the twenty-first century, global priorities and ten targets that will create the conditions for people worldwide to reach and maintain the highest attainable level of health throughout their lives. The policy calls for regional and national policies to be developed on the basis of the global policy.

Central government is generally the principal driving force for implementation of an EHAP. The other actors recognize that central government provides a framework, continuity and resources. Most importantly for implementation, they look to it to: (a) take action on environmental health policy and prepare any necessary legislation; (b) ensure all relevant ministries develop EHAP implementation programmes that are integrated into their own overall plans and coordinated with those of other ministries; (c) take account of priorities defined by the EHAP when preparing the national budget; (d) take the lead in mobilizing other actors; (e) set realistic timetables for the completion of actions and their component stages; (f) set in place fiscal and economic measures; (g) ensure that responsibility for actions is clearly allocated and devolved; (h) empower, exhort, guide or otherwise set the scene for other actors; (i) provide proper enforcement and control systems; (j) ensure effective monitoring, reporting and evaluation of results at national level; (k) take the initiative in securing internal or external funding for implementing the EHAP; and (l) take actions involving international collaboration.