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Sustaining Health and Environment in the Americas
A statement presented by the Canadian Association of Physicians for the Environment on behalf of Health and Environment organizations from civil society to the meeting of the Health and Environment Ministers of the Americas
Ottawa, March 4th, 2002

We welcome this meeting, and hope it will be the forerunner of more efforts to link issues of health and environment in the Americas - and to link the various countries of the Americas together. We welcome the opportunity to provide input to this meeting and recommend that such input from civil society become a regular, formal and active part of the process of developing an agenda for health and the environment in the Americas.

Basic Principles

1. We approach this issue in light of the following:
   • the first principle of the Rio Declaration on Sustainable Development, which states:
     • "Human beings are at the centre of concern for sustainable development. They are entitled to a healthy and productive life in harmony with nature."
   • the Pan American Charter on Health and Environment in Sustainable Human Development, adopted in 1995, which noted that we face "conditions and trends that threaten to expand human misery and inequity. Urgent and continuing action to promote health and protect the environment through sustainable development is our responsibility."
   • the right of the people of the Americas, enshrined in the Constitutions of many but not yet all our nations, to a healthy environment.
2. A fundamental issue that cuts across all issues of health and environment in sustainable human development is that of social equity, including gender equity, and environmental justice. Almost invariably, those most affected by environmental health problems are people living in poverty. Too often they pay much of the price for development, but get little of the benefit. It is their needs that are most demanding of our attention. We urge you in the strongest possible terms to give priority to those countries and those groups whose health is most affected by environmental problems by virtue of poverty and other disadvantage. Of particular concern are indigenous peoples, who also suffer disproportionately from environmental degradation because they live closer to the land. The health and environment agenda must be integrated
3. A second cross-cutting issue is that of children's environmental health. Children are not simply small adults. Rather, for a variety of reasons well documented elsewhere they are as a group more likely to be exposed to toxic chemicals (including pesticides) and other forms of environmental hazard even before conception, as well as throughout pregnancy and infancy, and to be more susceptible to that exposure. Any effort to protect human health must focus on protecting children's health, especially in communities with a high proportion of children, such as many indigenous communities, for in protecting our must vulnerable population we protect ourselves and future generations.

Environmental determinants of health

1. The health of the ecosystems of which we are a part is the most fundamental determinant of the health of our people. Without the essential life support functions they perform, our health would be severely damaged, our very survival threatened. Protecting ecosystem health is a prerequisite for protecting human health.
2. No issue is more central to human health in the Americas than the provision of clean water and the safe disposal of sanitary wastes. We strongly support all efforts to ensure the provision of an adequate supply of clean water, which should be viewed as a basic human right, and not as a private commercial activity only available to those with sufficient resources to purchase them. The economic benefits of the improved health and productivity of people with clean water will more than repay the public investment in these essential services.
3. Clean air is another basic human right. Yet in every country urban air quality poses a threat to human health, and in far too many countries that threat is growing. The inefficient and wasteful use of energy - and in particular fossil fuels - in heating, electricity generation, transportation, industrial processes and other uses has enormous health impacts. Moreover, these same fuels are the principal contributors to global warming. It is thus essential to the health of the people of the Americas and their environment that a comprehensive energy conservation and clean energy program be developed. An assessment of the health impact of energy use in the Americas would be a useful place to begin an integrated health impact assessment.
4. The issue of food safety needs to be added to the list of priority issues. Bacterial and chemical contamination arising from some aspects of modern agricultural and food processing practices pose a threat to health. The widespread and inappropriate use of antibiotics in agriculture encourages the emergence of antibiotic-resistant organisms, while the widespread use of hormones and pesticides is also of concern. Nor should it be forgotten that food is by far the largest source of the intake of many persistent organic pollutants, an issue that is of particular concern to the Inuit and other indigenous peoples whose food chains are contaminated.

Taking action on health and the environment

1. The nations of the Americas that you represent must act as if "human beings are at the centre of concern for sustainable development". This means, as the Pan American Charter on Health and Environment in Sustainable Human Development notes, that
   "Protecting and promoting the health of all persons in an environment that supports their wellbeing should serve as the prime decision-making criterion in planning and managing socio-economic development."
   Nations should make decisions based on the long-term health and wellbeing of the population, of future generations, and of the ecosystems that sustain them, not simply on short-term economic considerations.
2. The health of the environment and the people who live within it is determined not only by actions within the health and environment sectors, but by policies in sectors such as energy, housing and urban development, agriculture, transportation, natural resource management, industrial development, and other sectors. Thus a comprehensive approach is called for, nationally and internationally, that goes beyond the health and environment sectors to involve other sectors whose activities can either harm or improve health. This means establishing national and international structures that can develop and then implement integrated policies for sustainable human development, and undertaking environmental and health impact assessments of development policies and activities.
3. There are already a significant number of important treaties, agreements, conventions, declarations and other instruments relating to health and the environment. If they were simply fully adopted and implemented, the health of the people of the Americas and their environment would be substantially protected.
   Accordingly, we urge you to work together to see the following key instruments are signed, adopted, and, where appropriate, ratified by all governments in the Americas within the next two years.
   • the Kyoto Accord on Climate Change
   • the Stockholm Convention on Persistent Organic Pollutants
   • the Miami Declaration on Children's Environmental Health
   • the Montreal Declaration on the Global Program of Action for the Protection of Marine Environment From Land-Based Activities
   • the Clean Air Initiative and the regional plan of air quality and health of PAHO
   • the Montreal Protocol on Substances that Deplete the Ozone Layer
   • the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal.
   • the Rotterdam Convention on Prior Informed Consent for Certain Hazardous Chemicals in International Trade
   • the Convention on Biological Diversity
   Beyond that, we urge you to set up a mechanism to report on a regular basis to future meetings of the Ministers of Health and Environment on progress in adopting and implementing each of these vitally important international agreements in each country of the Americas.
4. The complex ecosystems of which we are a part resist complete understanding, while some uncertainties are nearly impossible to resolve completely. Waiting for absolute proof and complete understanding will predictably lead to further degradation of ecosystems and their functions that are essential for life support. Therefore in all decision-making that affects human and ecosystem health, it is essential to incorporate the precautionary principle in a process of transparent decision-making in order to protect human and ecosystem health in the face of uncertainty.

5. We live in a world that is increasingly economically integrated, and where international trade agreements are superseding national authority. This is of enormous concern because it allows - and has allowed - corporations to challenge and indeed to overthrow environmental health protection measures instituted by sovereign nations. This is unacceptable. No trade agreements, including the proposed Free Trade Agreement of the Americas, should include terms which constrain the authority of governments to adopt measures which they consider necessary for environmental, occupational and community health protection, or permit such measures to be challenged by corporations or other parties to the agreement. This is not a side issue, but is central to the pursuit of sustainable human development.

6. Related to this issue is the need to ensure that there is a uniform set of environmental and occupational health standards across the Americas to protect human and ecosystem health. Harmonization is needed to prevent business from moving to pollution havens, or using the threat of such a move to force a lowering of standards. But it must be harmonization upwards, to the most protective standard anywhere in the Americas. Our citizens should be assured an equal measure of protection throughout the Americas. Obviously, such a process takes time, but a useful first step would be to acknowledge the principle at this meeting.
7. The nations of the Americas are becoming increasingly urban. Cities across the Americas have shown remarkable leadership in addressing environmental and human health problems in the context of sustainable human development. Action at the local level is essential, it is practical, it involves people where they live, and it must be supported. The networks of "healthy cities and communities" and "sustainable cities and communities" that already exist in many countries should be strengthened, more closely integrated with each other and with national governments and civil society.
8. People have enormous capacities that they can use to improve their situation, if given the opportunity. The people who are most affected by environmental injustice must be engaged in developing solutions to the problems that plague them.
9. An important step in building capacity to address environmental threats to human health is to re-build the infrastructure and re-invest in the human and technical resources that have been whittled away over the past decade or two in countries throughout the Americas. This means strengthening the public sector - particularly by creating Ministries of Environment where they do not yet exist and strengthening them where they do - and investing in research, monitoring and surveillance, and in enforcement.
10. The burden of environmental degradation and resultant health impact falls most heavily upon the people of the less wealthy nations of the Americas. Accordingly, we call on the two North American members of the G7 - Canada and the United States - as well as other nations in the Americas that have the capacity to do so, to make a significant contribution of the economic, technical and other forms of assistance that are needed to create healthy environments for all the peoples of the Americas.
11. An important part of a nation's capacity exists within civil society, and this too must be strengthened - civil society organizations play a vital role in protecting and improving human and ecosystem health. Health and environment NGOs must be strengthened and supported, nationally and internationally, in their role as public watchdogs, as monitors, as raisers of public awareness, as public educators, as community mobilizers, as researchers and as advocates.
12. We welcome the proposal to establish a follow-up mechanism including regular meetings of the Health and Environment Ministers, the creation of a Ministerial Steering Committee, the establishment of a Senior Officials Committee and of an Inter-agency Secretariat. However, it is important to recognize that the strengthening of international linkages should not be restricted to governments alone. Our own presence here today speaks to the importance of international linkages among the environmental and health groups within civil society. We strongly urge you to support the further development of international linkages between health and environment NGOs.
13. We welcome the opportunity provided at this meeting for civil society organizations to participate and to provide input. We are vital partners who want to work with you in protecting and enhancing both ecosystem and human health, on the path to sustainable human development. We strongly urge you to maintain this engagement by involving civil society in future meetings and in the international structures that you establish to continue your joint work in the future.
    

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