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World Health Organisation (WHO) Third Ministerial Conference on Environment and Health for Europe – Action in Partnership, London 1999


ISSUES: Health and Environment




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).



See above



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”.



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 ]


Contact Minu Hemmati and Felix Dodds for further information.