|Health and Environment in Sustainable Development - Five Years after the Earth Summit (WHO, 1997, 258 pages)|
|Chapter 1: A new perspective on health|
It is clear that better health is achievable in all communities and countries currently burdened with excessive levels of disease and injury. However, better health is not an automatic outcome of economic growth. It requires guiding policies and an active contribution from government agencies, commercial enterprises and the community to secure the highest possible level of health with the resources available. Protection from environmental health hazards is a key element in such policies.
In particular, the health sector needs to show leadership by translating the preventive health message of Agenda 21 into practical action for its own institutions and professionals, as well as for those of other sectors. The WHO Health-for-All Policy provides a framework for such action. It is currently being updated and renewed (WHO, 1997b) to enable it to meet the challenges of the 21st Century more effectively, and to light "the way ahead" for health-and-environment actions towards sustainable development.
The Health-for-All Policy and Strategy were developed during the years 1977-1979 (WHO, 1979) and subsequently adopted by all WHO Member States. They are based on primary healthcare, community involvement in healthcare delivery and the application of appropriate technology for health. These key elements remain corner-stones of the renewed policy, but the link between health and development has been strengthened considerably (Box 1.6). Many of the issues raised in this book are also referred to in the draft renewed Health-for-All Policy, which will be presented to the World Health Assembly in 1998 for worldwide adoption (see Section 6.6). The policy highlights the "health-for-all value system" which includes: health security; health as a human right; equity, and gender-sensitivity. Additionally, it emphasizes the need to incorporate health in environment and sustainable development planning, and to create sustainable health systems (WHO, 1997b). Application of the policy will have important implications for how environment and social development is guided in the future. "Health for All" for the 21st Century requires concerted action on the driving forces behind bad health and good health. Chapter 2 provides a closer look at these driving forces.
The renewed Health-for-All policy, currently available in draft (WHO, 1997d), will be finalized at the World Health Assembly in 1998. The draft emphasizes that health is the "foundation on which all human endeavour rests" and that "health is central to development". This is in agreement with the Rio Declaration and Agenda 21 (UN, 1993).
Health and development are linked by four key elements:
· COMBATING POVERTY: the health problems of the poor result from inequitable and insufficient development, and at the same time, impede development.
· PROMOTING HEALTH IN ALL SETTINGS AND WITHIN ALL SECTORS: the settings where people live, work, seek healthcare, play, learn, eat and rest, all provide opportunities for promoting health. The policies of all sectors that have direct or indirect effects on health should therefore be aligned to promote and protect health.
· INCORPORATING HEALTH IN SUSTAINABLE DEVELOPMENT PLANS: health considerations should receive the highest priority in sustainable development plans. The health sector has a leading responsibility to ensure that the linkages between health and other sectors are clearly identified.
· GOVERNANCE TO ENSURE THAT HEALTH IS CENTRAL TO DEVELOPMENT: the state should create an enabling environment in which partnerships for health are encouraged or stimulated. The participation of nongovernmental organizations and community-based informal networks is fundamental to health development. At the international level, a strong alliance of all organizations and institutions working for better health is needed.