Summary report, 4–5 March 2002

The first Meeting of the Health and Environment Ministers of the Americas was held from 4-5 March 2002 in Ottawa, Ontario, Canada. The meeting was organized by the Canadian Departments of Health and Environment, in cooperation with the Pan American Health Organization (PAHO) and the United Nations Environment Programme (UNEP). Twenty-nine Ministers of Health and/or Environment from the Americas gathered for the meeting, which was also attended by over 150 other representatives of governments, intergovernmental and non-governmental organizations, and United Nations agencies. Canadas Minister of Environment, David Anderson, and Minister of Health, Anne McLellan, facilitated the meeting and moderated the discussions.

The meeting aimed to build bridges between the health and environment sectors to address common issues, strengthen countries capacities to manage health and environment issues effectively, establish follow-up mechanisms, and contribute to the upcoming World Summit on Sustainable Development (WSSD) in Johannesburg. To achieve these aims, participants met in Plenary sessions focusing on the following issues: building bridges between the health and environment sectors and setting future directions; establishing issues of common concern and shared goals; and building and sharing capacities to address environmental threats to human health.

The meeting concluded with the adoption of a Ministerial Communiqu on health and environment that will feed into the WSSD and Summit of the Americas processes. The Communiqu established an agenda and an ongoing process for future work on environment and health issues.

A BRIEF HISTORY OF INTERSECTORAL INITIATIVES ON HEALTH AND ENVIRONMENT

The linkages between human health and environment have been recognized for many years. Contaminated water, toxic chemicals, and poor air quality are commonly cited examples of widespread problems that affect the health of both humans and ecosystems.

During the past three decades, an increasing awareness of the importance of environmental management has resulted in the establishment of independent environment ministries to deal with issues previously addressed by health departments. As a result, the linkages between institutions working in the health and environment fields have often diminished at the local, national, regional and international levels.

The need to strengthen these linkages was recognized at the international level at the 1992 UN Conference on Environment and Development (UNCED) the Rio Summit which agreed on the Agenda 21 global action plan to achieve sustainable development. The Rio process affirmed that human beings are at the center of sustainable development, as well as peoples right to live a healthy and productive life.

A regional response to this issue was formulated at the Pan American Conference on Health and Environment in Sustainable Human Development, which took place in 1995 in Washington, DC. This conference produced the Pan American Charter on Health and Environment in Sustainable Human Development and a Regional Plan of Action, both of which were ratified the following year at the Santa Cruz Summit on Sustainable Development.

Many countries of the Americas subsequently took action to begin implementing policies and measures outlined in the Regional Plan and the Charter. However, in recent years, some experts and observers have expressed concern that the political momentum has not been adequately maintained.

In March 2001, the First Meeting of the Environment Ministers of the Americas was held in preparation for the Third Summit of the Americas in April 2001. Participants recommended that a joint regional meeting between Ministers of Environment and Health be convened to "take stock of progress achieved, identify priority areas for renewed emphasis and cooperative initiatives, and explore ways of moving the environmental agenda forward in the Americas and globally, with a view to contribute to the 2002 World Summit on Sustainable Development."

REPORT OF THE MEETING

The first Meeting of the Health and Environment Ministers of the Americas opened on Monday morning, 4 March 2002. Anne McLellan, Canadas Minister of Health, welcomed ministers and other participants to the meeting, which she said represented a unique opportunity to reinvigorate implementation of the Pan American Charter on Health and Environment in Sustainable Human Development. She informed participants that the meeting would seek to: take stock of what has been accomplished under the Charter and discuss an approach to closer collaboration; examine issues of common concern in the Americas from which common goals could be developed; and consider the role of knowledge in providing the basis for policies and actions to address environmental threats to human health. Noting that a key outcome would be a Ministerial Communiqu, she said ministers should use the meeting to build on the foundations that already exist.

David Anderson, Minister of the Environment for Canada, said the meeting marked an important milestone connecting the Rio Earth Summit, the Summit of the Americas and the upcoming World Summit on Sustainable Development. He said ministers had an opportunity to demonstrate their commitment to sustainable development in the Americas. Urging participants to build stronger bridges between health and environment, he underscored the benefits of cooperation, citing the example of progress made in phasing out lead in gasoline following a collective commitment at the First Summit of the Americas in 1994. He concluded by highlighting the value of involving civil society and other stakeholders.

Trevor Hancock, Chair of the Board of the Canadian Association of Physicians for the Environment, made a statement on behalf of civil society organizations concerned with health and environment issues. He emphasized that humans must be at the center of sustainable development and the importance of giving priority to groups that are most affected by environmental injustice, including indigenous peoples and those living in poverty. He recommended:

• implementing the Pan American Charter on Health and Environment in Sustainable Human Development;
• fully adopting and implementing existing treaties and other instruments relating to health and environment, such as the Kyoto Protocol;
• ensuring that trade agreements do not restrict environmental, occupational and community health protection measures;
• strengthening national and international networks of healthy and sustainable cities and communities; and,
• building capacity to undertake research, monitoring, enforcement, education and community mobilization, with the US and Canada making a significant contribution.

After hearing these opening speeches, Ministers began their substantive consideration of key issues to be taken up at this meeting. They convened in three Plenary sessions comprised of keynote presentations followed by discussion periods.

SESSION ONE: BUILDING BRIDGES BETWEEN HEALTH AND ENVIRONMENT SECTORS AND SETTING FUTURE DIRECTIONS

The first substantive session convened on Monday morning and early afternoon. Its purpose was to take stock of what had been accomplished to date on implementing the Pan American Charter on Health and Environment in Sustainable Human Development, identify barriers to progress and reach agreement on follow-up mechanisms for ongoing collaboration. The session included a keynote presentation on the issue followed by a discussion period.

PRESENTATION: George Alleyne, Director of the Pan American Health Organization (PAHO), highlighted the need for cooperation to address the linkages between human health and the environment. Taking stock of progress since ratification of the Pan American Charter in 1996, he suggested that, although most countries had taken initial steps to implement the Charter, momentum has waned in recent years. He recommended that this Conference renew its political commitment and establish supplementary goals, and proposed that a regional mechanism could be established to promote hemispheric intersectoral cooperation regarding environmental threats to human health. The mechanism could include the following components:

• meetings of health and environment ministers at regular intervals to ensure an ongoing commitment and oversight at the ministerial level;
• the establishment of a ministerial steering committee and a senior officials committee to advance work endorsed by ministers; and
• the creation of an interagency secretariat by PAHO and UNEP to support the work of ministers and the committees.

DISCUSSION: Minister Anderson opened the discussion, inviting comments on substantive issues and the proposed follow-up mechanism. Many speakers underscored the timeliness of this meeting and endorsed its goal of reinvigorating the health-environment process. Speakers also described and assessed national circumstances and policies aimed at linking the health and environment sectors more effectively, and presented recommendations on the way forward.

National Circumstances and Policies: On national circumstances and policies, St. Vincent and the Grenadines and St. Kitts and Nevis commented on the heavy workload resulting from merging both functions within one ministry, and asked for financial assistance for the Caribbean Environmental Health Institute (CEHI) to continue its work on capacity building. Chile proposed earmarking funds and creating institutions to promote environmental health. He observed that Southern states use information primarily generated in the North that is not always absolutely relevant or applicable, and called for funding to develop their own information base.

Venezuela elaborated on the linkages between air and water quality, development, occupational health, soil erosion, food production and malnutrition. She drew attention to the negative impacts of genetically modified organisms (GMOs) on biodiversity, and the effects of external debt on investments in health policy and water purification. Bolivia cited examples to illustrate the socioeconomic impact of climate change and stressed the need to address environmental issues in an integrated manner.

Brazil outlined national policies aimed at achieving sustainable development and supported information exchange to learn from other countries experiences. Haiti stressed its lack of potable water and sanitation, which has resulted in higher levels of child mortality. He recommended special assistance for countries experiencing extreme levels of poverty.

Dominica reported on its elaboration of an integrated development plan to ensure that environmental management was part of all planning processes, as enshrined in the Grenada Declaration of the Organization of Eastern Caribbean States (OECS). Ecuador said its ministries of health and the environment had, with international support, developed a charter to deal with public waste, dangerous chemical substances and resulting health and environment implications.

Jamaica outlined specific areas of concern, including: water supply, waterways management, urbanization and land use, household solid waste and industrial waste management, hazardous and toxic materials, natural disasters, exposure to vector-borne diseases, and the environmental impacts of the transportation sector. Colombia said environmental quality was deteriorating in spite of global initiatives and proposed concrete efforts, such as developing an integrated water plan for the Americas and special ethics regarding the environment.

The Way Forward: On future strategies, several countries, including El Salvador and the US, questioned whether it was necessary to create new institutions, and suggested building on the work of existing organizations such as UNEP and PAHO. Bolivia called for a regional plan of action without setting up new bureaucratic institutions. The US highlighted the potential role of the Institute for Connectivity in the Americas, which is dedicated to the use of information technologies for information exchange. Brazil highlighted the role of existing institutions such as the Organization of American States (OAS) and the Inter-American Development Bank.

On the proposed regional mechanism, Mexico said the focus should be on priority issues and areas where a mechanism could add value. He recommended that it focus on: information exchange, including identifying best practices; management of international/transboundary risks such as climate change; integration of free trade with human health, labor and environmental considerations; the role of multilateral financing agencies in promoting progress on health and environmental issues; and capacity building.

Barbados stressed the importance of mobilizing resources, the potential for further South-South cooperation, and the need to mobilize broad-based intersectoral cooperation at the national level. St. Kitts and Nevis reminded delegates of the vulnerability of small Caribbean states to natural disasters and the need for early warning systems. Jamaica highlighted the importance of capacity building, new resources, debt forgiveness, public education, information gathering, and the issue of HIV/AIDS. He said outcomes from this meeting should feed into the WSSD process.

Commenting on the Ministerial Communiqu, Panama said it should reflect principles of equity, social justice and improved quality of life for all citizens.

Other Organizations: In addition to comments from government ministers, representatives of other organizations were invited to speak. UNEP welcomed delegates request to work together with existing institutions, pointing to cooperation between UNEP, PAHO, international financial institutions and other important stakeholders. He pledged to focus on the "vicious cycle" of environmental degradation as a consequence of poverty, resulting in food insecurity, social instability and economic crisis. He asked Ministers of Health and Environment to cooperate on transboundary issues such as water and air pollution and dangerous chemicals, and called for early warning mechanisms for natural disasters. He urged countries to focus on prevention and on implementation of best practices by taking a holistic approach and making information publicly available. He reminded participants that the meetings outcomes would be of interest to other regions, which share many common concerns.

The Caribbean Environmental Health Institute related the Caribbean experience of cooperation between ministers of health in addressing environmental health and sustainable development.

SESSION TWO: ISSUES OF COMMON CONCERN AND SHARED GOALS

The second session was held Monday afternoon and focused on possible priority areas for which common goals for the Americas could be developed. The session consisted of a presentation introducing the issue followed by a discussion period.

PRESENTATION: Ricardo Sanchez Sosa, Regional Director of UNEP for Latin America and the Caribbean (ROLAC), presented an overview of five priority areas of common concern: clean water and sanitation; clean air; chemical safety; health implications of climate vulnerability; and health impacts of natural disasters. He underscored the need for ecosystem approaches and integrated risk management. Stressing the severity and frequency of natural disasters and the fact that disaster relief is seven times more expensive than prevention, he called for joint management to address this problem.

DISCUSSION: In the ensuing discussion, Argentina summarized preparatory discussions on this agenda item held the previous day. She noted agreement on the five proposed areas of common concern and highlighted suggestions by several countries, including Chile and Haiti, to add food security to the list. Other points of agreement included the need to: make tangible progress in policy action; finance policies from national sources; hold another meeting of health and environment ministers before the next Summit of the Americas; and continue these meetings without establishing new governance structures or duplicating efforts.

Several speakers outlined their countries activities and areas of concern. Uruguay cited positive health indicators resulting from good environmental quality, and outlined its national strategy based on legal and regulatory instruments, capacity building, training and improving access to information. Describing information as "global public property," he emphasized the need for international exchange of technical and scientific information. Trinidad and Tobago endorsed the five key priorities suggested and urged support for developing national capacity.

A number of speakers highlighted the importance of water issues. Peru and El Salvador endorsed a broad-based, holistic approach to water issues. Brazil said water should be considered a right rather than a commodity and suggested using ethics-based indicators. The US proposed focusing actions on children, given their greater vulnerability to environmental and health impacts. Chile expressed concerns about relying excessively on state regulation and proposed exploring alternative methods and incentives.

Ecuador suggested prioritizing integrated water and air pollution management, especially across borders. Costa Rica and El Salvador supported engaging industries and drawing resources for policy implementation from the private sector. Grenada said the international agencies that might lead the process should be clearly identified, and called for coordination and cooperation by other stakeholders to avoid duplication of efforts. St. Lucia proposed adopting concrete quantified targets as a means of stimulating progress.

In summarizing the discussion, Minister McLellan noted agreement on the need for: integrated approaches to health and environmental policies; regional coordination of policies; capacity building and information exchange; meeting on a regular basis; and using existing mechanisms and processes without setting up new bureaucracies.

SESSION THREE: BUILDING AND SHARING OUR CAPACITIES TO ADDRESS ENVIRONMENTAL THREATS TO HUMAN HEALTH

The third session took place on Tuesday morning and examined the role of knowledge in providing the basis for policy responses and actions to address environmental threats to human health. The session consisted of a presentation outlining the issue followed by a discussion period.

PRESENTATION: Maureen ONeil, President of the International Development Research Centre (IDRC), emphasized the importance of turning research and knowledge into a basis for policies and action. Supporting an "eco-health approach," she cited examples of research undertaken at a local level on mercury contamination in Brazil and DDT in Mexico that had translated into effective action and was being replicated elsewhere. She observed that the gaps between research, policy and action need to be bridged and said researchers must make their work more timely, relevant and accessible, while policy makers need to demand and finance appropriate research, and then translate the policies that emerge into concrete action. She drew attention to the International Forum on Ecosystem Approaches to Human Health, which will take place from 18-23 May 2003 in Montreal as a follow-up to the WSSD.

DISCUSSION: Minister Anderson invited comments on the development and sharing of knowledge on environmental threats to human health, and on translating this knowledge into policies and action. He highlighted possible questions that could be considered during this session, including: whether an integrated assessment of human health and environment linkages should be conducted for the Americas to build capacity in the region and support decision making; how the knowledge gathered could be translated into effective information exchange and best practices; and which tools and mechanisms would enable the use of knowledge and science available in the region.

Colombia stressed the importance of traditional knowledge, highlighting the long-term inter-generational experience of indigenous peoples, which is rooted in their understanding of their environment. The US stated that information is critical in targeting resources effectively and ensuring that actions assist the most vulnerable. She supported the development of hemispheric indicators in key areas, and proposed a focus on childrens needs, highlighting the value of health-environment indicators for children.

Commenting on the proposed integrated assessment, El Salvador, supported by Venezuela, emphasized the need to build on existing experiences at the national level and to incorporate scientific, academic and traditional knowledge. Mexico emphasized the need for an integrated assessment of health and environment as the basis of decision-making and action, noting that skilled human resources would be needed to implement policies resulting from their research.

Barbados called for the collection of scientific data and its economic analysis to demonstrate the real value of environmental protection in ensuring peoples quality of life. St. Vincent and the Grenadines drew attention to the economic losses in developing countries resulting from the emigration of skilled workers and highlighted the adverse effects of climate change on small island developing states (SIDS).

Costa Rica stressed that policies must be based on solid data and called for better measurement of policy impacts through indicators on issues such as child mortality. Bolivia supported integrated assessments establishing threshold levels for environmental health risks. Brazil stressed the need for interdisciplinary research that would provide usable information, methodologies for risk management and indicators of environmental health. He suggested that PAHO create a publication detailing national efforts to link health and environment.

Canada underscored the importance of partnerships and cited its achievements in the exchange of information, technology and expertise. She stressed the need for streamlined, low-cost and timely access to high-quality, relevant and usable information, and supported the proposed regional assessment coupled with development of indicators. Venezuela stressed the importance of information exchange and development of indicators for measuring policy effectiveness. With Jamaica, she called for steps to improve knowledge on the consequences of GMOs. Colombia proposed the establishment of a working group to develop a list of common indicators. Stressing the problem of GMOs, he urged countries to ratify the Cartagena Protocol on Biosafety.

Uruguay emphasized the need to agree on basic common indicators and called for increased financing from multilateral institutions. He stated that there is an ethical obligation to reduce poverty and seek to improve environmental and human health. Ecuador proposed developing indicators measuring exposure to environmental threats, wellness and quality of life.

Summarizing the discussions, Maureen ONeil noted comments on the importance of indigenous knowledge and traditional medicines and drew attention to IDRCs support for research and work on this issue in various countries. She also noted ministers references to public participation and civil society involvement in discussions and decision making on environment-health issues. Other topics raised by speakers included capacity building, food safety, cooperation among countries and organizations, and the need to translate knowledge and policies into action that positively impacts on peoples lives.

Other Organizations: In addition to comments from government ministers, representatives of other organizations were also invited to speak. UNEP-ROLAC emphasized the importance of developing indicators and baselines that will enable more efficient targeting and use of available resources. He outlined UNEPs various activities in this area, including its contributions toward the Global Environment Outlook assessment.

PAHO acknowledged IDRCs important role in research. He suggested that consensus on regional goals and priorities should be reached so that the most appropriate indicators can be identified and developed. OAS recognized the role of this meeting within the Summit Process, with its mandate from the most recent Summit of the Americas in Quebec City, which affirmed previous statements recognizing environmental health as a priority. He confirmed that there would be follow-up through the Summit Task Force, which is facilitated by the OAS, and which will be briefed on this meeting.

KEYNOTE LUNCHTIME PRESENTATIONS

In addition to the Plenary sessions, participants also heard lunchtime addresses. On Monday, these presentations focused on Mexicos efforts to eliminate DDT, a pesticide used primarily for malaria control. On Tuesday, participants were briefed on the health and environment agenda in Central America.

A SUCCESS STORY ON DDT: On Monday, participants viewed a short film on Mexicos success in eliminating DDT use in just three years using alternative methods of malaria control and involving local communities. Mexicos approach has now been adopted by eight Central American countries. Janine Ferretti, Executive Director of the Commission for Environmental Cooperation (CEC), placed the DDT case study within the framework of the Stockholm Convention on Persistent Organic Pollutants (POPs). She noted that DDT and chlorine are no longer produced in North America as a result of a 1996 joint action plan adopted by Canada, the US, and Mexico, and supported by international organizations. She noted that the partnership on this issue established between CEC, PAHO, UNEP and the Global Environment Facility (GEF) provides a model for inter-agency collaboration.

Mexicos Secretary of Health, Julio Jos Frenk, shared his experiences on the DDT case study, emphasizing: the importance of local policy action; the need for regional approaches; the value of non-regulatory policies; and the benefits of integrating health and environmental policies.

HEALTH AND ENVIRONMENT AGENDA IN CENTRAL AMERICA: On Tuesday, delegates were briefed on the health and environment agenda in Central America. Jorge Salazar, Minister of Environment and Natural Resources for Nicaragua, reported on environmental and health challenges in the region and the search for stable policy mechanisms to protect the basic right to health. He said the agenda is based on principles of protection of health and the environment, prevention of potential environmental and health deterioration, socioeconomic justice, and citizen participation.

Alexis Pinzon, Vice-Minister of Health of Panama, described the Central American Action Plan for Health and Environment, which relies on national and regional instruments and focuses on the provision of safe drinking water and sanitation, waste management, food security, and natural disaster management.

ADOPTION OF THE MINISTERIAL COMMUNIQU

On Tuesday, 5 March, Ministers considered a draft Ministerial Communiqu that had been negotiated by government representatives during separate talks held in parallel with the meetings Plenary sessions. The Co-Chairs of the negotiating group, Christine Guay, Director of General International Relations for Environment Canada, and Dann Michols, Assistant Deputy Minister, Health Canada, introduced the latest draft of the Communiqu, highlighting parts of the text where agreement had not been reached.

Ministers then proceeded to consider these parts of the text. In a paragraph on the follow-up process, ministers discussed whether reference to existing international institutions should include the OAS and IDB. Barbados expressed concerns that referring to international financial institutions in the context of policy development would allow them to impose their policies on developing countries, and inserted wording designed to restrict them to supporting member countries strategies and programmes.

In a paragraph listing priority areas requiring concerted action across the region, ministers added the need for basic sanitation, the impact of HIV/AIDS on workers productivity, the effect of climate change, especially on SIDS, and food security and safety.

Regarding a paragraph listing initial goals relating to the priority areas, delegates rejected an informal request by an NGO to replace "we agree to consider working towards" with "we agree to work towards."

In a paragraph on the role of scientific knowledge as a foundation for policy, delegates accepted Colombias proposal to include "relevant traditional knowledge." Regarding a subparagraph on indicators, they accepted a proposal by the US to harmonize indicators "as appropriate."

Regarding a paragraph encouraging WSSD leaders to set priorities, the meeting accepted a US proposal to delete a reference to improving national and international governance, as well as Colombias suggestion to remove a list of specific principles.

Following this discussion, Minister Anderson declared that all outstanding matters relating to the text had been resolved, and delegates adopted the Ministerial Communiqu.

SUMMARY OF THE MINISTERIAL COMMUNIQU

The Ministerial Communiqu begins with some general statements, followed by four sections on: Setting Future Directions for Health and Environment in the Americas; Issues of Common Concern and Shared Goals; Building and Sharing our Capacities to Respond to Threats to Human Health and the Environment; and Messages for the World Summit on Sustainable Development. The Communiqu concludes with a brief section containing Final Messages.

The following is a summary of the Communiqu. The complete text is available at: http://www.ec.gc.ca/international

GENERAL STATEMENTS: The Ministers of Health and Environment recognize countries different levels and patterns of development, their cultural diversity, and the diversity of ecosystems within the Americas. They affirm their awareness of the relationship between the environment and socio-economic factors such as poverty, poor housing, unsustainable production and consumption patterns, inequity in distribution of wealth and the debt burden, and their impact on health. The ministers highlight the "very negative impact" of terrorism on human life, human health and the environment, and reject terrorism in all its forms. While noting progress on health and environment issues, they point out that various challenges, including inadequate infrastructure and urban and rural planning, contribute to the persistence of diseases such as diarrhea and respiratory ailments. Emphasizing that environmental degradation particularly affects the health of the most vulnerable and least protected groups, and that it may have an increased impact on future generations, the ministers express their grave concerns and recognize the need to focus efforts on common objectives, domestically and regionally, in order to establish equal opportunities to achieve sustainable development throughout the region.

SETTING FUTURE DIRECTIONS FOR HEALTH AND ENVIRONMENT IN THE AMERICAS: On setting future directions for health and environment in the Americas, the ministers reaffirm commitments made at the Pan American Conference on Health, Environment and Sustainable Human Development in 1995, take into account the urgent need to strengthen action plans, and state that countries should seek to further mobilize resources for implementation and follow-up. They acknowledge that action begins in their home countries, and commit to work in cooperation with relevant stakeholders, adding that each country has primary responsibility for decision-making and for investing in health and the quality of the environment, while recognizing the interdependence of ecosystems across the region.

The ministers recognize the need to further strengthen partnerships between ministries responsible for health and environment. Regarding cooperation among the international institutions, they urge the OAS, PAHO, UNEP, IDB and other relevant organizations to continue to take steps to integrate issues related to health and environment in their work programmes, and to strengthen inter-agency cooperation so it becomes part of their modus operandi.

The ministers also agree to consider a follow-up process to help each country advance work at the national and regional levels. They agree to meet regularly prior to the Summits of the Americas in order to set directions and assess progress, and to establish a task force to make proposals on the process, stipulating that it should not duplicate work of existing organizations.

ISSUES OF COMMON CONCERN AND SHARED GOALS: The Ministers state that common concerns can be more effectively addressed when countries define and act on shared goals. In this regard, they identify the following priority areas requiring concerted action across the region: integrated management of water resources, including water contamination and sanitation; air quality; health implications of natural and human-made disasters, especially in SIDS; sound management of chemicals; the potential impacts of climate variability and change; workers health, including the detrimental impact on productivity of HIV/AIDS; food security and safety; and the ethics of sustainable development from a health and environment perspective.

Identifying some initial goals on these priority areas, Ministers agree to consider working towards:

• advancing the Water Supply and Sanitation Collaborative Council Vision21 Goals for 2015 and 2025 on universal coverage and hygiene, adopting the Millennium Summits water-related goals, and developing and using practical technologies;
• preventing and abating water pollution through integrated water resource management and through efforts to fulfill the 2001 Montreal Declaration on the Global Programme of Action for the Protection of the Marine Environment from Land-based Activities;
• undertaking an economic and technical assessment of sewage and water treatment systems;
• using best practices for improved management of solid wastes;
• phasing-out lead in gasoline and developing national strategies to phase-out lead from other sources;
• developing national action plans to reduce air emissions from transportation sources;
• developing strategies to improve indoor air quality;
• bringing into force the Stockholm Convention on Persistent Organic Pollutants;
• developing pollutant release and transfer registries as a tool to manage exposure to chemical releases;
• developing plans for emergency and disaster prevention, preparedness and response;
• undertaking scientific research to improve understanding of the health and environment effects of climate variability; and,
• enhancing efforts between UNEP, UNDP, PAHO and ECLAC to develop a regional proposal on the ethics of sustainable development, for consideration at the WSSD.

BUILDING AND SHARING OUR CAPACITIES TO RESPOND TO THREATS TO HUMAN HEALTH AND THE ENVIRONMENT: The ministers recognize that scientific knowledge provides the foundation for effective action. They affirm their commitment to expand and improve their understanding of the health-environment linkages and to improve the availability, understanding and use of information, including traditional and local knowledge. In this regard, the ministers agree on a number of capacity-building actions, including:

• enhancing surveillance and monitoring of the health of people and ecosystems;
• supporting development, through capacity building, of integrated health and environment assessments for the region;
• further exchanging and disseminating knowledge through all possible mechanisms, including conferences and other fora;
• reviewing the capacities of current pan-national institutions to determine their ability to assist nations and to review countries capacities to access and use knowledge;
• recommending means to improve the sharing of information for action and the exchange of best practices, with a focus on information and communication technologies; and
• facilitating and supporting public education and awareness programmes.

MESSAGES FOR THE WORLD SUMMIT ON SUSTAINABLE DEVELOPMENT: The ministers renew their support for the results of UNCED, the Rio Declaration and Agenda 21, particularly Chapter Six on Protecting and Promoting Human Health Conditions. They underscore the need to establish a dialogue leading to the "creation of an ethic" for sustainable development, and the importance of investments in health as a key component for ensuring sustainable development. They also recognize the integrated management of water resources as a critical issue.

The ministers urge leaders at the WSSD to explicitly recognize the need to make integration of action and approaches to human health and environment a focus for development by building stronger bridges between health, environment, and other ministries. They also urge the WSSD to make the protection of vulnerable populations - especially children - a high priority, and ask it to request technical and financial cooperation institutions to support programmes and policies aimed at vulnerable populations. In addition, the ministers encourage the WSSD to make capacity building, sharing information and best practices a priority.

FINAL MESSAGES: In the Communiqus final section, the ministers make a commitment to ensuring that civil society and other stakeholders are appropriately engaged in the development and implementation of national strategies. Recognizing the importance of mobilizing and managing investments to promote sustainable development, they encourage leaders at the upcoming UN Financing for Development conference to agree on a sustainable path for financing that is consistent with Agenda 21s health and environment goals. The ministers conclude by observing that this Communiqu establishes a hemispheric agenda reflecting their common concerns, and stating that they are prepared to take actions based on this agenda that will improve peoples quality of life on the path to sustainable development for the entire region.

CLOSING REMARKS

In his closing statement, Minister Anderson underscored the importance of this meeting, noting that these issues were considered at UNEPs ministerial meeting in Cartagena and will be taken up in the European Forum on Health and Environment and by the African Ministers for Health and the Environment. He assured his colleagues that he would report the results to the upcoming Third Session of the Preparatory Committee for the WSSD in New York, and would make sure that they are reflected in the reports considered by the WSSD itself.

Referring to this meeting as a "ground-breaking" event, Minister McLellan said it had offered a valuable opportunity for health and environment ministers to meet and develop a collective understanding of the interconnectedness of their portfolios. She thanked ministers for their cooperation and officials for their support, which she said had made this meeting a success, and declared the final session closed at 3:00 pm.

THINGS TO LOOK FOR BEFORE THE WSSD

INTERNATIONAL CONFERENCE ON FINANCING FOR DEVELOPMENT: The UN International Conference on Financing for Development will be held from 18-22 March 2002 in Monterrey, Mexico. It will bring together high-level representatives from governments, the UN and other leading international trade, finance and development-related organizations. For more information contact: Harris Gleckman, Coordinating Secretariat; tel: +1-212-963-4690; e-mail: gleckman@un.org or Federica Pietracci; tel: +1-212-963-8497; e-mail: pietracci@un.org; Internet: http://www.un.org/esa/ffd

35TH SESSION OF THE COMMISSION ON POPULATION AND DEVELOPMENT: This meeting will be held from 1-4 April 2002 at UN Headquarters in New York. It will address reproductive rights and reproductive health, with special reference to HIV/AIDS. The 36th Session in 2003 will focus on population, education and development. For more information contact: Population Division; tel: +1-212-963-3179; fax: +1-212-963-2147; Internet: http://www.un.org/esa/population/cpd/comm2002.htm

G-8 ENVIRONMENT MINISTERS MEETING: The G-8 Ministers of the Environment are scheduled to meet from 12-14 April 2002 in Banff, Canada. Ministers will seek to support the G-8 Summit to address the challenge of poverty alleviation, particularly in Africa. For more information contact: Environment Canada; tel: +1-819-956-5212; fax: +1-819-956-5964; e-mail: enviroinfo@ec.gc.ca; Internet: http://www.Canada2002earthsummit.gc.ca

SIXTH CONFERENCE OF THE PARTIES TO THE CONVENTION ON BIODIVERSITY: CBD COP-6 will take place in The Hague, the Netherlands, from 7-19 April 2002. At this meeting, the COP is expected to review implementation of its programme of work and consider various issues, including: forest biological diversity; invasive alien species; and access and benefit-sharing as related to genetic resources. Parties are also expected to adopt a budget for the next biennium. For more information contact: CBD Secretariat; tel: +1-514-288-2220; e-mail: secretariat@biodiv.org; Internet: http://www.biodiv.org/meetings/cop-06.asp

THIRD MEETING OF THE INTERGOVERNMENTAL COMMITTEE FOR THE CARTAGENA PROTOCOL ON BIOSAFETY TO THE CBD: ICCP-3 will take place from 22-26 April 2002 in The Hague, the Netherlands. For more information contact: CBD Secretariat, Montreal, Canada; tel: +1-514-288-2220; e-mail: secretariat@biodiv.org; Internet: http://www.biodiv.org/meetings/cop-06.asp

ELEVENTH INTERNATIONAL CONFERENCE ON HEALTH AND THE ENVIRONMENT GLOBAL PARTNERS FOR GLOBAL SOLUTIONS: This Conference will take place from 25-26 April 2002 at UN Headquarters in New York. The meeting will focus on the theme of Childhood Antecedents to Adult Illness, and is being organized by World Information Transfer Inc., a non-profit organization, in collaboration with the Government of Ukraine. For more information contact: World Information Transfer, fax: +1-212-686-2172; e-mail: wit1986@aol.com; Internet: http://www.worldinfo.org

16TH SESSION OF THE SUBSIDIARY BODIES TO THE UN FRAMEWORK CONVENTION ON CLIMATE CHANGE (UNFCCC): SB-16 will take place in Bonn, Germany, from 3-14 June 2002. For more information contact: UNFCCC Secretariat; tel: +49-228-815-1000; fax: +49-228-815-1999; e-mail: secretariat@unfccc.de; Internet: http://www.unfccc.de

CONFERENCE ON HEALTHY ECOSYSTEMS, HEALTHY PEOPLE - LINKAGES BETWEEN BIODIVERSITY, ECOSYSTEM HEALTH AND HUMAN HEALTH: This Conference will take place from 6-11 June 2002 in Washington, DC. Participants will focus on the complex linkages and interdependencies between biodiversity, ecosystem health and human health. For more information contact: International Society for Ecosystem Health, University of Western Ontario; tel: +1-519-661-2111 ext. 86223; fax: +1-519-661-3737; e-mail: hehp@ecosystemhealth.com; Internet: http://www.ecosystemhealth.com/hehp/

POPS INC-6: The sixth session of the Intergovernmental Negotiating Committee for an International Legally Binding Instrument for Implementing International Action on Certain Persistent Organic Pollutants (POPS INC-6) will be held from 17-22 June 2002 in Geneva, Switzerland. For more information contact: POPs Secretariat, tel: +41-22-917-8193; fax: +41-22-797-3460; e-mail: pops@unep.ch

WORLD SUMMIT ON SUSTAINABLE DEVELOPMENT: The World Summit on Sustainable Development will take place in Johannesburg, South Africa, from 26 August - 4 September 2002. It is being preceded by numerous preparatory meetings, including the Third Session of the Preparatory Committee, which will convene in New York from 25 March - 5 April, and the Fourth Session, scheduled for 27 May 7 June in Indonesia. For more information contact: Andrey Vasilyev, DESA; tel: +1-212-963-5949; e-mail: vasilyev@un.org. Major groups contact: Zehra Aydin-Sipos; tel: +1-212-963-8811; e-mail: aydin@un.org; Internet: http://www.johannesburgsummit.org/