World
Health Organisation (WHO) Third Ministerial Conference on Environment and Health
for Europe – Action in Partnership, London 1999
ISSUES:
Health and Environment
GOALS:
PARTICIPATING
STAKEHOLDERS: NGOs; academics;
health professionals
TIME
FRAME: 16-19 June 1999
MSP
CONTACT DETAILS; PUBLICATIONS; URL: www.unedforum.org/health/index.htm
Type
& Level of MSP
Level:
Regional - A
Planning and Informing process at European level
Procedural
Aspects:
Designing
the MSP
The
process was designed by WHO in consultation with UNED Forum who put together a
multi-stakeholder advisory committee There
was some consultation with stakeholders on process design facilitated by UNED.
The European Environment & Health Committee (EEHC) helped plan this (a
relatively small group of professionals/representatives of different sectors
with 1-2 NGOs although NGO involvement increased markedly during the process.
A
complex process involving 11 working groups set up by WHO, run by WHO, with
substantial NGO input and with a parallel NGO forum, supported by WHO and other
UN agencies. The scope was health and environment in its broadest sense; with
objective of furthering debate on a range of issues and helping to develop
various protocols/agreements e.g. Freshwater, and Transport and Health and a
Ministerial Declaration on Environment and Health Priorities for Europe in 21st
century.
Identifying
the issues to be addressed in an MSP
Largely
set by WHO European Regional Office as the involvement of stakeholders began
only after the start of the process.
Identifying
relevant stakeholders
NGOs
and other stakeholders were invited into the process. UNED facilitated the
broadening out the stakeholders beyond that although WHO also had their own
links with stakeholders too – governments and health professionals being the
most obvious groups. Local authorities also came into the process.
Interestingly, WHO didn’t use their own multi-stakeholder process – the
Healthy Cities initiative** – to any great extent. Reasons include the fact
that Healthy Cities has its own agenda, it is world-wide initiative, the
European part was not very heavily involved and possibly due to some
professional internal matters within WHO.
Identifying
MSP participants
People
have different perceptions as to how much outreach was done. WHO did some in
terms of identifying participants but perception was that it was a bit ‘hit
and miss’. Most health professionals knew it was happening, bodies such as
Chartered Institute of Environmental Health Officers (CIEH) and the
International Federation of Environmental Health (IFEH) who were already
involved through the EEHC did a lot to help involve a wider audience. Most of
the other outreach was facilitated by UNED and the multi-stakeholder advisory
group set up by UNED.
Setting
the goals of an MSP
A
main goal was to hold the event, secondly to come up with the relevant
protocols, charters etc. Remit also included setting up the Working Groups.
Goals developed as the process went along. As there has been 2 previous
Ministerial Conferences, the dialogue-building process does go back along way.
The London process started immediately after the ratification of previous
meeting. It was pushed by EEHC, pushed by various governments, and by
international health and environment professionals.
About
50 countries participated, with about 40 in the preparatory events. So it was
something of a consensus building process. As with many of these international
declarations, things wouldn’t happen if there wasn’t a fairly substantial
Government consensus. Without this people like the Vatican city could block the
bits they didn’t like. But with this 3rd event previous WHO
conferences of this type (after 1989 and 1994), hopefully the process has gone
from a mere exchange of views through to the development of agreements, and
through to implementation – although this last stage remains to be seen.
There
was quite a lot of serious checking back with constituencies at the Governmental
level. It is unclear (not documented) just how far other representatives checked
back. There is the suggestion that people who go to these international
processes tend to become sucked into those processes and that almost becomes
their peer group, rather than the people that sent them there in the first
place. For example, the CIEH are still involved in the issues but it is
questionable, due to time constraints etc, how far they actually checked back
with individual environmental health officers. Another example, did the IFEH
consult back with bodies such as the UK CIEH, etc.?
Setting
the agenda
As
above – goes with goal setting
Setting
the time-table
Once
a conference date is set then a timetable is set
Preparatory
process
A
preparatory process with a range of specialist working groups taking place and
NGOs consulted through various events. Soesterberg conference was the main one
but by the time NGOs get interested most of the agenda is set, so it is mostly a
working out / lobbying role regarding ‘What we will do about this or that?’
as opposed to a ‘What do we want to talk about?’ position. But the increased
NGO involvement and capacity building has already led to NGO involvement in the
Budapest 2004 preparations (small groups format).
Communication
process
There
was increasingly substantial use made of electronic networks. EEHC was the main
co-ordinating body and various other meetings both for preparatory process and
conference, and the working groups.
UNED
set up a list server for stakeholders to be able to be kept informed and a
quarterly newsletter and a web site.
Power
gaps: Probably not much, partly because WHO (an agency funded by governments)
was desperately trying to get its staff to attend meetings. They were extremely
short of resources and reliant on national governments. Therefore it could be
said that national governments probably had more power. NGOs also had a lot of
power in terms of turning out to lobby at the right time and often after having
done their homework much better than governments. A lot depended on how strongly
the Governments felt about something; if it was much more open, then NGOs had
quite a lot of power. Industry did not take the Conference that seriously and so
was not lobbying in the same way as NGOs.
Don’t
think there was much reflection about the kind of process, it was more a ‘Lets
Get On and Do It’ approach.
Decision-making
process: procedures of agreement
Agreement
had to be sought in standard International Process terms with governments able
to effectively force a lowest common denominator, with bracketed text, etc.
Implementation
process
Agreements
go back to the Working Groups for implementation. Those that had funding are
largely medical professionals run by a WHO Senior professional.
Closing
the MSP
The
London process concluded with the London Conference but it has also impacted on
the Working Groups and NGO process in the run-up to Budapest 2004.
On
all the main issues - freshwater, climate change, transport – far more is
happening but not necessarily as a result of the Ministerial Conference. On some
of the other issues on the agenda – children’s health, economics &
health, local processes for environment and health – more might be expected to
be happening than it actually is as a result of the London event.
Structural
Aspects:
Structures
/ institutions of the MSP
International
secretariat at WHO, the EEHC, a NGO co-ordinating group which was close to being
multi-sector. There is a question as to how far professional networks (IFEH) are
included as NGOs. Business wasn’t involved in NGO dialogues. They had more
direct input through WHO (a two sided process).
Facilitation
See
above
Documentation
All
documentation was freely available via the WHO and UNED web sites.
Relating
to not-participating stakeholders
Non-participating
stakeholders had an opportunity to attend the meetings at the conference on the
NGO process, and an opportunity to feed in through their own agencies or to WHO
directly.
Relating
to the general public
Relatively
little – a specialist process.
Linkage
into official decision-making process
Linked
to an official decision-making process. Re transparency – at least people knew
a conference was happening.
The
Ministerial Declaration noted that it wished to “encourage greater
transparency in the work of the EEHC” and extended its membership by adding 6
representatives of major groups, including NGOs, local government, business,
trade unions, and environment and health professionals nominated by their
appropriate organisations. The Declaration also noted the value of NGO input
into the process, called for partnership to help with the implementation and in
the “regular and transparent reviews of progress”.
Funding
WHO
provided some, Governments provided a lot of the key funding. The British
Government funded the UK conference. But people like CIEH, Glaxo Welcome, EU, UK
and Dutch Governments had to help fund NGO and other stakeholder involvement
because there wasn’t enough money available. The whole process was
under-funded.
**
WHO’s
Healthy Cities is a classic 2 way partnership between WHO and local authorities.
Some of the individual Healthy Cities have been very effective in bringing other
parties besides health professionals into the debate, for example, business and
voluntary sector groups.
[ information gathered as of
19 February 2001 ]
