REPORT
WORKING GROUP ON INTEGRATION OF ENVIRONMENTAL HEALTH INTO PLANNING FOR URBAN DEVELOPMENT
Convened by the
WHO Western Pacific Regional Centre for the Promotion of Environmental Planning
and Applied Studies (PEP AS)-
Kuala Lumpur, Malaysia, 25 February- 1 March 1991
Not for sale
Printed and ~istributed by the WHO Western Pacific Regional Centre for the Promotion of Environmenta-l Planning
and Applied Studies (PEP AS) P.O. Box 12550
50782 Kuala Lumpur Malaysia August 1991
•
NOTE
The views expressed in this report are those of the temporary advisers in the Working Group and do not necessarily reflect the policies of the World Health Organization.
This report has been prepared by the WHO Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEP AS) for governments of Member States in the Region and for the temporary advisers in the Working Group on Integration of Environmental Health into Planning for Urban Development held in Kuala Lumpur, Malaysia, from 25 February to 1 March 1991.
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SUMMARY ... 1
1. INTRODUCTION... 3
1.1 Objectives... 3
1.2 Work:i~g ~roup members... 3
1.3 Orgaruzat1on... 3
1.4 Opening ceremony... 5
2. PROCEEDINGS... 5
2.1 Country reports... 5
2.2 Summary of papers and discussions... 6
3. CONCLUSIONS AND RECOMMENDATIONS... 15
ANNEXES: ANNEX 1 - LIST OF MEMBERS, REPRESENTATIVE, OBSERVER AND SECRETARIAT... 19
ANNEX 2- AGENDA ... 23
ANNEX 3 - LIST OF DOCUMENTS DISTRIBUTED DURING THE WORKING GROUP MEETING... 27
ANNEX 4- INAUGURAL ADDRESSES ... 29
ANNEX 5- SUMMARIES OF THE COUNTRY REPORTS ... 31
Key words· ·
Urban development planning- environmental health
Objectives of the Working Group m~eting:
The objectives of the Working Group on Integration of Environmental Health into Planning for Urban Development were:
(a) to review the experience gained in programmes, projects, studies, and other activities involving the integration of various planning efforts to improve environmental health in urban areas at both the national and municipal levels;
(b) to identify the environmental health problems associated with urban development activities;
(c) to delineate technical and institutional options for integrating planning activities for urban environmental health improvement;
(d) to formulate regional strategies for the improvement of urban environmental health management through integrated planning; and (e) to recommend specific activities to be carried out by WHO for the promotion of healthy urban environments in cities and towns of the Region.
Summary of proceedings, conclusions and recommendations
The Working Group meeting was attended by seventeen members from Australia, China, Japan, Malaysia, New Zealand, the Philippines, the Republic of Korea, Singapore and VietNam, a representative of the United Nations Centre for Regional Development (UNCRD) and an observer from Australia.
The members of the Working Group presented their country reports
highli~bting urban environmental health problems and the link to policy,
plannmg and management mechanisms. The WHO secretariat reviewed WHO activities in environmental health and urban health development and discussed the technical and institutional options for integration of environmental health into urban planning and development processes. These sessions were followed by the presentation of three case-studies.
Group discussions were held in three groups to address the institutional arrangements required to strengthen intersectoral cooperation; the supportive mechanisms necessary to enhance advocacy and participation; and the
monitoring, training and research components essential to effective programme implementation. The group discussions produced the following
recommendations:
(1) WHO should strengthen its advocacy at the highest level of
Government of the need to ensure that planning for urban development and management produces a healthy and sustainable urban environment.
(2) In carrying out its advocacy role, WHO should contact the authorities responsible for formulating arid implementing urban development policies and for urban management to promote healthy urban environments.
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(3) WHO should collaborate with other external support agencies to encourage multinational companies to take account of healthy urban environments in their development, planning and marketing strategies.
( 4) WHO should form a multidisciplinary technical advisory group (comprising planners, environmental scientists and public health experts) to help formulate, develop and monitor the implementation of healthy urban environment programmes.
(5) WHO should collaborate with Member States in the Region and international-organizations to provide training courses to up~rade technical and professional skills required to resolve conflicts in achievmg a healthy urban environment, to facilitate the exchange of expertise, and to support related research programmes.
(6) To promote healthy urban environments, WHO should establish a regional network of cities and towns.
(7) WHO should provide guidelines and promote information sharin~ to strengthen intersectoral collaboration and citizen participation in plannmg for both private and public development.
(8) WHO should support the development of information systems at the country level, including computer based systems, to manage, monitor, and evaluate the progress towards a healthy urban environment.
(9) WHO should disseminate information on the relationship between environmental and health issues; the link of environmental health
programmes with urban development planning; and developments in healthy urban environment acqvities, including information on "good practice" examples in the Region.
(10~ WHO should introduce a r~gional project to promote clean, healthy, environmentally sound and sustamable cities and towns throughout the Region.
1. INTRODUCTION
The meeting of the WHO Working Group on Integration of Environmental Health into Planning for Urban Development was held at the WHO Western Pacific Regional Centre for the Promotion of Environmental Planning and Applied Studies (PEP AS) on the campus of the University of Agriculture, Malaysia (Universiti Pertanian Malaysia), Serdang, Selangor, Malaysia, from 25 February to · 1 March 1991. ·
1.1 Objectives
The objectives of the Working Group were as follows:
(a) to review the experience gained in programmes, projects, studies and other activities involving the integration of various planning efforts to improve environmental health in urban areas at both the national and the municipal levels;
(b) to identify the environmental health problems associated with urban development activities;
(c) to delineate technical and institutional options for integrating planning activities.for urban environmental health improvement;
(d) to formulate regional strategies for the improvement of urban environmental health management througn integrated planning; and (e) to recommend specific activities to be carried out by WHO for the promotion of healthy urban environments in cities and towns in the Region.
1.2 Working group members
The Working Group was attended by seventeen members from nine countries in the Wester.n.Pacific Region, a repre entative from the United Nations· Centre for Regional Development (UNCRD) and an observer from Australia. A list of the members, representative, observer and secretariat members is given in Annex 1.
1.3 Organization
The following officers were elected from the members:
Chairman Vice Chairman Rapporteur
MrS. Pillay (Malaysia) Ms B. Balagot (Philippines) Mr J. Fletcher (New Zealand)
The provisional agenda was discussed, modified and adopted. The agenda and the List of working papers and background literature provided to the members are given in Annexes 2 and 3 respectively. The Chairman invited the WHO secretariat and the members of the Working Group to present programmes and activities carried out by WHO and their Member States, respectively, to improve health and the environment in urban areas in the Region. These presentations were followed
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by discussions on some case-studies and technical and institutional options for integrating planning activities for urban environmental health improvement. Each of these presentations was followed by questions and discussions, which identified the key issues and problems associated with the improvement of environmental -health in cities and towns of the Region.
Following these presentations, the members were divided into three groups to discuss the following topics:
Group 1
Institutional arrangements to strengthen multi-sectoral cooperation Moderator: Mr M. Richardson (New Zealand)
Members: Mr J. Butler (Australia) Dr T. Furuichi (Japan)
Mr S. Pillay (Malaysia)
Dr P.S. Kang (Repubhc of Korea)
Dr L. Minh (Socialist Republic of VietNam) MrS. Tamplin (WHO secretariat)
Dr A. Fernandez (Representative, UNCRD) Group 2
Supportive mechanisms to enhance advocacy and participation Moderator:
Members:
Group 3
Mr H. Raysmith (Australia)
Dr Z. Lu (People's Republic of China) Mr J. Fletcher (New Zealand)
Mr A. Hormillosa (Philippines) Mr J.Y. Ko (Republic of Korea) Dr H. Ogawa (WHO secretariat) Mr T. Townson (Observer, Australia)
Monitoring and evaluation of programmes, and research and training Moderator: Mr K.P. Wong (Singapore)
Members: Mr G.L. He (People's Republic of China) Dr T. Yamada (Ja£an)
Ms B. Balagot (Philippines) Dr P~S. Kang (Republic of Korea)
Dr T.H.T. Nguyen (Socialist Republic of Viet Nam) Dr K.S. Lee (WHO secretariat)
Dr R. Simpson (WHO consultant)
~e views expressed by the discussion groups vl~re summarized by their respective moderators at a plenary session. These are reflected in the Proceedings and Conclusions and Recommendations sections of this report. . '
A field trip was organized to visit the City Hall, squatter settlement, market, urban park, and solid waste landfiU site in K~~la Lumpur to ob~erve urban
environmental problems and measures to mttlgate them.
1.4 Opening ceremony
On behalf of Dr S.T. Han, Regional Director, WHO Regional Office for the Western Pacific, Dr P. Guo, Director of PEP AS welcomed the Working Group members. The opening speech of Dr Han delivered by Dr Guo expressed WHO's concern about the deteriorating quality of the environment and health impacts associated with the rapid urban growth encountered by the countries and areas in the Region. It also stressed the need for expert advice to improve the health of people living in urban areas. The full text of the speech is given in Annex 4.
Professor Dr Syed Jalaludin, Deputy Vice-Chancellor, University of
Agriculture, Malaysia, welcomed the memb~rs to the University ~ampus ~d said the University was pleased to host the meetmg. Dr Syed Jalaludm emphaSized the importance of integration of environmental health consideration into urban. . . planninga rnrdevelopment processes to ensure health and safety of people hvmg rn urban areas. The full text of his address is given in Annex 4.
2. PROCEEDINGS
2.1 Country reports
The members of the Working Group presented their country reports,
highli~hting the relevant national legal and institutional framework for urban planmng and environmental health programmes, past and ongoing efforts by local governments for integration of environmental health into urban development planning and problems and priority considerations in improving environmental health in urban areas.
The country reports revealed a wide range of urban environmental health problems throughout the Region. In the developing countries, rapid urbanization has resulted in severe problems of high population growth, poor housing, increasing sanitation and solid waste problems, lack of safe drinking water, and rising pollution levels. In the developed countries, population growth is less of a problem, and where housing, sanitation and water supply problems are still present, they are not as extreme as in developing countries. Rather, the problems are concerned with ongoins pollution (especially air and noise) related more to motor vehicles than industnal sources; traffic congestion; and emerging social environmental health problems; such as accessibility to, and equitable distribution of, services. The aging of the population was becoming significant in developed countries and this posed special challenges for the health care system.
In all cases, many of the I?roblems arose from either poor planning or
inadeq_uate management practices, and there are ongoing perceiVed conflicts in all countnes between economic development and environmental protection. For the latter, strategies based on the concept of sustainable development promise an improvement but many countries have yet to effectively formulate, let alone implement, such strategies. Nevertheless, it highlights the need for environmental
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health professionals as well as other health and environ.mental profe~sionals to be effectively involved in the development of these strategi~s. Summanes of the country reports are given in Annex 5.
2.2 Summary of papers and discussions
Followin~ the presentation of papers and case-studie~, extensiye discus~ions took place dunng the plenary session on the recommendatiOns. This subsectiOn
summa~izes the presentations and the discussions.
2.2.1 Overview of themes and issues
Dr Simpson presented a brief overview of the themes and issues to be discussed by the Working Group. He pointed out that this meeting was convened because of the serious environmental health problems arising from rapid urban development in the Region. For the purposes of discussion, an urban area was defined as "a man-made environment, encroaching on and replacing a natural setting and havine; a relatively high concentration of people whose economic activity is largely non-agncultural".
A review of the statistics on urban population growth was provided, which reflected the rapid urbanization throughout the Western Pacific Region. The inability o_f some cities to absorb large numbers of people, especially immigrants, has led to a hi~h proportion of them living in "shanty towns". The smaller cities are also experiencmg a population growth that far outstrips the ability of urban services to cope with the increase, leading to a wide variety of health problems.
Dr Simpson identified a wide variety of urbanization factors givine; rise to environmental health problems. The WHO definition of health is that It is not merely the absence of illness but also a state of complete physical, mental and social wellbeing. The environmental factors of concern therefore rncluded physical, social and economic forces. He stressed that for this meeting the emphasis will be on physical environmental health factors which arise from urban development planning failing to provide adequate controls on and/ or provision for such areas as a safe water sup_ply; sanitary excreta disposal; surface water drainage; solid waste management; safe food supply; industrial discharges (air, wa:ter,noise); traffic volume and emissions; and housing.
It was_note.d_tbat many countries have adopted national health development policies based on the World Health Assembly's global strategy for "Health for All by the Year 2000''. The operational health development concept is Primary Health Care which Dr Lee described in her paper. Except for water supply and sanitation activities in some developing countries, environmental health has not been strongly supported in most national and state health sectors. Those sectors in health
departments associated with environmental health are often in low-status divisions separated from "mainstream" health care units. Therefore, the most serious
component missing in health development programmes is intersectoral cooperation between health agencies and other key sectors, such as planning, transport, resource and industrial development, and housmg.
The WHO ."Healthy Cities" Project adopted in Europe and now extending to Canada, Australia and New Zealand, recogmzes the need for a broad intersectoral based approach. The community-based approach of this programme recognizes
another weakness in urban health development programmes, i.e. the need for health care services more attuned to community needs (especially the urban poor), and the need to build strong communities vital to effective health promotion and health education programmes.
The session concluded by identifying the key issues to be discussed by this Working Group: multisectoral cooperation and intersectoral coordination; public participation; and information, monitoring and evaluation.
2.2.2 Recent developments of WHO's programmes for environmental health in urban development
This paper; written by Mr E. Giroult, Division of Environmental Health, WHO Headquarters in Geneva, was presetnted by Dr H. Ogawa.
The paper discussed the activities carried out under the WHO programme for environmental health in rural and urban development and housing (RUD). The objectives of the programme are (1) to promote human health through improving )jvmg conditions; and (2) to mitigate the adverse environmental and health input of socioeconomic development actions. The programme's approaches include
(1) advocacy and support; and (2) technology development and information exchange.
Specific activities in this programme, which have recently been carried out, were then introduced to highlight WHO's initiatives in improving the health of·
people living in urban areas. These activities include the Healthy Cities project being developed in Europe and other industrialized countries; the Interregional · Meeting on City Health held in Karachi which focused on problems of the urban poor; the Expert Committee on Environmental Health in Urban Development which issued various recommendations for future action, particularly on research and applied studies; the WHO Commission on Health and the Environment, in particular the Panel on Urbanization; the Technical Discussion of the 44th World Health Assembly on strategies for health for all in the face of rapid urbanization;
RUD global network of experts and institutions with its newsletter distribution; and development of various gUidelines on environmental heallh aspects of urban
development and housing.
The presentation also introduced briefly the programmes and activities in urban environmental improvement carried out by other international organizations such as the Economic and Social Commission for Asia and the Pacific (ESCAP), United Nations Centre for Human Settlements (UNCHS), United Nations · Development Programme (UNDP), United Nat10ns Environment Programme (UNEP) and the World Bank.
2.2.3 Overview of WHO urban environmental health activities in the Western Pacific Region: Towards a healthy urban environment
Mr Tamplin discussed the role of WHO in the Region. The approach taken by WHO is to set up programmes such as that for Environmental Health in Rural and Urban Development and Housing and develop appropriate strategies and activities suitable for promoting the programmes, mdependently of other programmes. ·
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The new approach promoting environmental health through urban planning now focuses on intersectoral coordination. The challenge is to ensure political support for this process, especially with sectors whose activities have health
implications hut whose primary goal is not related to health. Environmental impact assessment procedures attempt to achieve a level of integration and the· community based European Healthy Cities approach has such aims. Mr Tamflin stressed the
nee~ _to incorporate enviro~mentaJ and ~ealth values into politica structures and
dectston-rnak~ng processes m order to bnng about fundamental changes. . 2.2.4 WHO's approaches and programme for urban primacy health care
development in the Western Pacific Region
The Primary Health Care concept and approach as well as the concept of district health system in support of primary health care.were briefly introduced.
Urban health problems are manifestations of social and environmental problems which in turn were created by uncontrolled urbanization and population growth. In order to address urban health problems properly, the root causes must be dealt with which are in most cases created outside the health sector. Urban health development therefore must take a holistic approach including issues of (1) physical and social environm~nt, (2) health infrastructure development, (3) life styles that affect the health of the individuals, and ( 4) public policies.
The effort made in the past focused on health services delivery without consolidating the efforts of relevant programmes of other relevant sectors. The approaches in urban primary health care development in th~ Western Pacific Region and current actions taken were briefly mentioned. To ensure consolidated and concerted efforts in urban health development, a conceptual framework has been developed which could serve as basis for developing an integrated approach to urban health development activities in dealing with four above-mentioned issues.
Primary health care approaches such as community participation and
social/political mobilization can be most useful in initiating successful urban health development activities. In this context, a "clean cities movement" is proposed for implementation in selec~ed cities of developing countries in the Reg1on. The proposed project must be designed in such a way that it is politically highly visible and enlists strong public support with a sustained high level of interest of all parties concerned. The proposed "clean cities movement" project can serve as an entry point for comprehensive urban health development which requires consolidated, concerted efforts of relevant disciplines and sectors.
2.2.5 Environmental planning and management at the United Nations Centre for Regional Development
Dr Fernandez presented a paper describing two relevant activities carried out by the Environmental Planning and Management Unit (EPMU) of the United Nations Centre for Regional Development (UNCRD): a river/lake basin approach to water resources management, and a project in solid waste management.
The river /lake basin approach to water resources management stressed that many environmental problems arise from projects such as irrigation and dam construction. These projects ignore the impacts on the whol~ basin area of the project, such as downstream flooding and water degradation. The approach stresses the following issues: linkages between water and land-use interactions; social
conflicts between GO!npeting uses/users; and environmental and social
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consequences of water r.esou~ce developn:ent schemes. ~-he project is ~eing develo_ped in collaboration w1th UNEP and the ~nter~attonal Lake Envuonme!lt Comm1ttee (ILEC). UNCRD is also collaboratmg w1th the East-West Centre m managing water-use conflicts in Asia-Pacific Metropolises.
UNCRD has also developed a three-year project in 20 cities on solid waste
mana~ement. The project addresses: waste reductiOn and resource recovery;
selectwn of appropriate solid waste management technology; institutional arrangements; financial arrangements; and citizen participation andpublic awareness building. A meeting held in Kitakyushu in 1989 identified a range of policy responses to solid waste management.
Dr Fernandez also mentioned the lack of expertise on environmental impact assessment throughout the Region. He concluded by stressing the cyclical and multi-sectoral nature of planning; ~he need for integration of both the social and physical aspects of planning; and the need for clear policy guidelines.
2.2.6 Australian experience in the Healthy Cities Project
Mr Townson presented a paper on the experience in Australia of the adoption of the Healthy CiUes Project. The essential elements of the European Healthy Cities Project have been retained, namely encouragin~ intersectoral collaboration;
promoting supportive environments; developin~ indiv1dual skills; re-orienting health care services; and promoting healthy public _policies.
In 1987, the Australian Government funded a three-year pilot project to test the concept in three cities- Canberra (the National Capital), Illawarra (an industrial region), and Noarlunga (a coastal urban area south of Adelaide). The project had the fo11owing objectives: to define and implement action strategies for health promotion; to coordinate intersectoral activities; to develop a range of core rndicators; and to create and monitor a national network of Healthy Cities. In addition to the Healthy Cities Project, a Healthy Localities Project was set up by the Municipal Association of Victoria to adapt the I leal thy Cities ideas to encourage local councils to take a more active role in health promotion. Several other areas have also adopted a similar approach, the most notable of these being the
Nganampa Health Council, which represents several groups of Aboriginal people.
Since the end of the pilot phase, the Commonwealth Government has funded a national secretariat to help establish a network of Healthy Cities around the
country, and the State Government of Queensland has funded a slate project office
for Healthy Cities. . ·
Mr Townson noted the following points arising from the Australian.experience with the Healthy Cities Project: resources may be an ongoing problem although the pilot project was successfuJ in raising funds from various sources; the pilot project was quite successful in encouraging genuine intersectoral collaboration, as the appeal of the process was its perceived neutrality; there was varying success in tackling difficult environmental problems, partly due to the difftculty in establishing a clear relationship between the global environmental problems and the local ones;
no one model of a Healthy City would fit all situations, especially in Australia;
Healthy Cities exhjbited a potential to be a politically popular concept; the project evaluation was not a simple task; and equity issues were confronted but not easily resolved. The Australian experience shows that the Healthy Cities approach has some appeaUn confronting the issues raised in this meeting, but clearly adaptations
to local conditions would be essential. · ·
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2.2.7 ··Technical options
Dr Simpson presented a paper detailing the technical options available in integrating environmental health into planning for urban development. _The paper covered the broad areas of environmental impact assessment (EIA), especially environmental health impact assessment (EHIA); the relationship between EIA and planning; the use of health information; the need for community mput, especially in risk assessment and management; and management strategies, especially the use of standards, in legislation. Problems identified included the lack of health
information and its quality; weaknesses in assessment methodologies in estimating . the ma~nitude of health impacts; the problems of technical risk assessment; the lack
of momtorin~ and evaluation of planning and management strategies; the lack of public participation; and political nature of policy and planning processes.
It was stressed that the policy formulation process could not be a completely . rational process because of the uncertainties in (and often lack of) scientific
information and the political nature of setting goals for planning. The political process had to be acknowledged in using the technical options available, and the assumption had to be made that the best and most complete information would lead to the best result, if only by making the uncertainties more explicit. Therefore it was stressed that it is essential to have political commitment for effective planning and implementation of activities. Effective planning also requires input by community groups and the public throughout the plannin~ process. Public participation ensures effective implementation of the planned activ1t1es. Problems w1th public
participation include: all community groups may not be represented, especially disadvantaged groups (e.g. poor, disabled); lack of mechanism/support to community groups to participate in the process; the information provided to the public is often too technical and not comprehensible; and lack of effective negotiation and mediation procedures.
In particular, it was stressed that the need for effective community
participation paralleled the developments in primary health care where intersectoral collaboration allowing full participation by community groups was being developed.
Clearly the environmental health and primary health care areas could profit by close collaboration and the exchange of expertise, mformation and methodologies.
It was recognized that the effective integration of environmental health into urban planning requires the following: knowledge data bases and information networks on indicators for environmental health (this would include community data); comprehensive monitoring of indicators of environmental health; trained staff in monitonng; trained staff in environmental assessment, urban planning and
evaluation techniques; research programmes for indicators of environmental health, environmental assessment and evaluation techniques.
2.2.8 Institutional options·
Dr Simpson presented a paper on the institutional options available in
integrating environmental health into planning for urban development. It was clear from the previous papers that the relationship between urban development and health is complex and multisectoral coordination is needed. It ensures that decisions at any level are based on the full range of information relevant to the issue; that policy issues ar~ considered as comprehensive and coherent alternatives, rather than isolated claims; and that the norms used to guide decision-making at lower levels take into account the full range of factors pertinent to the subject.
It was stressed that intersectoral collaboration must develop through joint
.Pro~rammes of action among the relevant agencies, and aimed at solving specific envtronmental health problems. There are a number of institutional difficulties in developing the required levels of cooperation: the separation of functions among agencies according to various national schemes of ~overnment organization; and the compounding of such separations by the division of powers and responsibilities between central, local, and one or more intermediate levels of government.
Therefore the first challenge is to develop, or strengthen, intersectoral programmes to manage urban environmental health problems at all levels of government. Where necessary, such programmes· should include vertical links
between all levels of governmen_t. There is a need for a unit at the city level to be responsible for developing and coordinating activities which irnJ?rove urban
environmental health tn the city. The unit may be new or an existing one which is to be strengthened, and should have the responsibility of acting as the secretariat for intersectoral coordinating bodies, and for providing technical assistance where necessary. lt would also be desirable to set up a unit/body, or to strengthen an existing unit/body at the national level to coordinate and facilitate intersectoral programmes/activities to improve urban environmental health.
In summary, integrated approaches would not succeed unless the following conditions were met at the ~i(y level: .
(a) existence of,. or willingness to formulate and implement, an intersectoral plan, incorporating health and urban development and environmental
management;
(b) commitment to developing a vision of a healthy urban environment and specific strategies to carry out such a plan;
(c) ability to allocate resources to the implementation of these strategies;
(d) strong political commitment to improvement in health and the environment; and
(e) existence of mechanisms to mobilize resources and encourage participation at the community level. · ·
2.2.9 Environmental impact assessment for the Bundang New Village
Construction Project ·
Mr Ko presented a paper describing the EIA proces adopted for the Bundang New Village Construction Project in the Republic of Korea. The presentation
began with an explanation of the law and procedures in the country governing EIA, followed by the background of the project. The need for decentralization of urban areas to relieve the problems arising from hjgh population densities and large cities was noted. Plans were being developed to create New Urban Areas near large cities, aD:d build two million new housing facilities. In the case of the Seoul metropolitan area, five new residential areas will be constructed, one of which is Bundang.
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The major environmental impacts perceived to arise from the Bundang
development included: ecological damage (reduction of vegetation, flora and fauna;
loss of agricultural land); air pollution (mainly"from motor vehicles); water quality (mainly from sewage); waste generation; and noise (traffic). Various
countermeasures have been designed; however, EIA processes often follow planning decisions and this makes the task more difficult.
2.2.10 Discussion during paper presentation and plenary sessions
A consensus emerged that one of the main problems with attempting to promote and improve urban health in general was the fact that both environmental
and health concerns were usually peripheral to policy-making and planning processes. The p·tanning in many sectors, such as housing, agriculture,
transportation, industrial development, economic development, water supply ~nd
sewerage, and solid waste management, affected urban environmental health but health matters were not usually a primary concern. Although planning procednres in principle should include all such concerns, the continuing urban environmental health problems even in the developed countries in the Region indicated a serious gap between theory and practice. A recurring theme thrm1~hout the presentations and di.scussions was that the primary reason for poor planmng practices was a lack of political commitment. It was continually stressed that the political sectors at the highest level (for example, Presidents, Prime Ministers, Mayors, and their
Departments) need to agree to a common set of health targets or goals to direct the planning in all public and private sectors to guide multisectoral coordination and mlersectoral collaboration.
A number of the Working Group members, especially those with a planning and policy background, stressed a need to set general targets for a healthy urban envirorunenl rather than proceed piece-meal with separate sets of environmental health, primary health care and health promotion targets. The overlap in these areas, especially when confronting the problems of c;ommunity participation and the questions concerning acceptable environmental health risks, makes a coordinated strategy of formulating a comprehensive set of targets and indicators for a healthy 11rban environment desirable. Discussion then focused on the aims of the meeting, given that the title of the Working Group mentioned the integration of
environmental health into planning for urban development. It was noted that the traditional definition of environmental health referred to physical factors, not including social factors, or biological interventions (such as immunization and treatment). It was stressed that effective integration would require intersectoral collaboration within the health sector, between the environmental health, primary health care and health promotion professionals, as well as multisectoral
coordination between the health sector and other sectors.
Therefore, one of the recommendations from the group tJiscussions was to propose that WHO set up a multidisciplinary technical advisory group which would, as part of its mandate, develop a set of urban health indicators which could be used to set urban health targets, as well as to monitor and evaluate urban health. The need to include "process" indicators, was stressed, for example to measure the level
of community participation or political support. It was also pointed out that the development of such a targets and indicators should allow for the wide differences between the countries in the Region, and that a three-tier system of targets and indicators, starting with a basic set of essential health targets and indicators, is
preferred. It was clear that, from the developing country perspective, there needs to be a basic set of urban health indi~ators which they could use m practice.
One of the problems identified by the Working Group was the lack of
expertise, especially at the local government level, of trained personnel to carry out the necessary planning, monitoring and implementation tasks required. This . concern led to a recommendation to WHO to collaborate with Member States m
the Region to provide training courses and, where necessary, support research programmes. ·For example, training courses would be useful in EIA and health Impact assessment, and environmental health monitoring and evaluation, for a range of professionals- urban planners, environmental health staff and personnel with responsibilities in the formulation of environmental health policies.
Most members of the Working Group supported the idea that WHO set up a regional network of cities and towns to market strategies for a healthy urban environment. The need for marketing strategies was stressed to encourage the political support of key people in each country and city. There was also a need for WHO to promote inforrnat1on shar.ing and to provide guidelines [or citizen
participation in planning for both private and public development. As part of this process, it was suggested that WHO support the development, at the country level, of computer-based systems to manage, monitor, nnd evaluate progress towards the targets of a healthy urban environment. Through the regional network, WJ 10 could collec.t an~ dissemi~ate information on urban h~al.~h develo{Jments i_n the Regi~m, espec1ally mformat10n of models of "good practice of planmng and unplementmg
strategies for healthy urba': eiwironment. ·
As part of these initiatives, there was strong support for the introduclion of a project to promote the development of clean, environmentally sound and
sustainable, and healthy cities and towns throughout the Region. However there was a strong feeling that not all cities and towns should be allowed to join this project. A detailed set of guidelines was developed by one group (see Table 1 attached), recognizing that effective urban heallh initiatives would require strong political support; the commitment of sufficient resources and adequate
Implementation mechanisms; and the development of adequate monitoring and evaluation strategies. This framework received wide support.
However, once these conditions are met, the project should be open to all cities and towns in the Region. This would require the flexibility of usmg different sets of targets and priorities for di((erent countries, and for evaluation strategies to·
emphasize the rate of progress towards different priorities rather tl1an the attainment of one total set of target . It was recognized that the goal of moving towards attaining a healthy urban environment would require collaboration of the environmental health, primary health care and health promotion sections of WHO, and the forthcoming WHO Regional Working Group meetings in the primary
healtl~ care and health proi?olion areas ~hould build upon t~e proposals of this Workmg Group. The nammg of the proJect would necessanly be part of the
marketing process developed by WHO, but a number of parttcipants indicated that the word, "environment", should be included if possible, because of the higb level of political commitment to environmental issues throughout the Region. It was also preferable to build on existing city ftown networks in countries (e.g. the Sanitary City network in China, the Healthy Cittes network in Australia) or between countries (e.g. Sister City arrangements).
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TABLE 1: HEALTHY URBAN ENVIRONMENT PROGRAMME FRAMEWORK
Desired outcome: A Healthy Urban Environment
Actions: I.
II.
IlL
Articulate and market to targets throughout the
Region ·
1. The Healthy Urban Environment Vision 2. The WHO technical assistance programme Select cities for initial programme
1. Criteria- political commitment resource commitment implementation mechanism 2. Targets- set tarpets for timescales and
rate o adoption of Healthy Urban Environment princt pies by cities in the Region
WHO methodology
1. Audit agencies (domestic and international) whose programmes do/should impact on I- ealthy Urban Environment In the city
2. Establish framework for each city to prepare annual project plans as part of programme
3. Provide technical assistance for
preparation of project plans (if needed) IV. Provide independent monitoring of the
Healthy Urban Environment programme V. Improve and expand the programme
.
1. Continue to market the Healthy Urban Environment Vision 2. Develop "good practice" notes
and database
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3. CONCLUSIONS AND RECOMMENDATIONS
· Achieving acceptable and desirable levels of health in the context of an urban environment requires consideration of a wide range of issues affecting the physical environment, life styles, health care services and public policy. Effectively dealing with these issues requires successful integration of environment and health
considerations into urban planning and development processes. This requires prominent leadership, a significant commitment of organizational resources, and defined mechanisms for achieving integration. In this regard, a new WHO initiative which focuses on the important issues related to the development of healthy urban environments is deemed necessary in the Western Pacific Region.
The Working Group made recommendations with the understanding that two related meetings will be sponsored by WI 10 later this year: a working group on urban health development1 and another on health promotion. The efforts of these working groups will provide excellent fora for refining the framework developed by
this meeting as the integrating mechanism for creating clean, healthy and . environmentally sound and sustainable urban areas.
'
The following recommendations address the institutional arrangements required to strengthen intersectoral cooperation; tJ1e supportive mechanisms necessary to enhance advocacy participation; and, the monitoring, training and
research components essential to effective pro~ramme implementation. The
recommendations reflect the need for developmg a clear understanding of what is to be accomplished; delineating a programme to achieve this understanding; effectively marketing both the benefits and the programme to key decision-makers and target populations; securin~ the resources necessary to implement the programme; and establishing an ongmog mechanism for information dissemination and programme evaluation.
(1) Unless there is a clear commitment to targetting urban health concerns in planning for urban development at the highest level of government, usually at the Head of State level in the national government, integration would be ineffective. AJso, as an effective strategy to prevent future environmental health and health problems; long-term planning (5-20 years) should be encouraged.
Recommendation 1: WHO should strengthen its advocacy at the highest level of Government of the need to ensure that planning for urban
development and management produces a healthy and sustainable urban environment. Planning for healthy urban environments should include long- term strategies to prevent health and social problems as well as measures to correct existing problems.
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(2) WHO will not be effective in promoting health concerns in planning for urban development if it makes contacts only with the national government health agency. It is crucial to establish or enhance contacts with other relevant agencies at the national government level, and other levels of government if necessary, through the national health agency, jn order to allow effective involvement of the WHO initiatives in the formulation of urban development policies.
Recommendation 2: In carrying out its advocacy role, WHO should contact the authorities responsible for formulating and implementing urban
development policies and for urban management to promote healthy urban environments.
(3) In many countries, multinational companies play a key role in urban development and are responsible for resultant health and environmental problems. As WIIO is not an aid agency for urban infrastructure
development, it is necessary for WIIO to actively cooperate with other international agencies in attempting to influence multinational companies to incorporate WI 10 health goals into their planning activities.
Recommendation 3: WHO sho'uld collaborate with other external support agencies to encourage multinational companies to take account of healthy urban environments in their development, planning and marketing strategies.
(4) Information is required to formulate the health taTgets to gujde policy development at the highest level, and to develop indicators to monitor and evaluate progress towards these tar~ets. Development of such targets and indicators requires efforts of a multidisciplinary ,team to ensure that the information is in a form which can be used by all key players in the urban development process.
Recommendation 4: . WI IO should form a multidisciplinary technical advisory group (comprising planners, environmental scientists and public health experts) to help formulate, develop and monitor the implementation of healthy urban environment programmes. The work of this group shottld
include the development of a set of indicators to be used throu~hout the
Region to assess and monitor the status of a healthy urban envuonment. Such a set of indicators should be subject to periodical review and evaluation and be disseminated throughout the Region.
(5) Given the lack of expertise, especially at the local government level, training of personnel and research activities are considered as priority areas in monitoring and evaluation, environmental and health impact assessment, and planning and policy formulation. Training for the wide range of professionals mvolved in urban health and development planning requires broad
interdisciplinary-based courses, as well as specialized courses for upgrading their skills. The training courses are necessary to allow ·more effective communication between the different professional groups involved. Also· in some areas, detailed research programmes may be needed to collect the information required for the indicators.
Recommendation 5: WHO should collaborate with Member States in the Region and international organizations to provide training courses to upgrade technical and professional skills required to resolve conflicts in achieving a healthy urban environment, to facilitate the exchange of expertise, and to support related research programmes.
(6) To develop and implement activities to attain healthy urban
environments in cities and towns of the Region, close links between WHO and local authorities (or others) responsible for urban development and
management are required.
Recommendation 6: To promote healthy urban environments, WHO should establish a regional network of cities and towns. Marketing strategies for a healthy urban environment should be part of this promotional effort.
(7) There is a need for extensive involvement of most sectors in integrating health concerns into planning for urban development. Public participation, especially at the local level of decision-ma-king, was seen as essential and beneficial. To facilitate intersectoral collaboration and community
participation, it is pertinent that technical information be made available to all relevant se~tors and the general public in a form comprehensible to them.
Recommendation 7: WHO should provide guidelines and promote information sharing to strengthen intersectoral collaboration and citizen participation in planning for both private and public development.
(8) Recommendations 4, 6 and 7 indicate a need for collecting, processing and disseminatjng the information required to effectively monitor and
evaluate progress towards the targets of a healthy urban environment within each Member State.
Recommendation 8: WI-10 should support the development of information systems at the country level, including computer-based systems, to manage, monitor, and evaluate the progress towards a healthy urban environment.
(9) The cities and towns involved in the regional networking, outlined in Recommendation 6, have much to offer by sharing their experiences with other cities and towns. It is especially appropriate for WHO to identify examples of "~ood practice" as a way to promote better planning as well as to provide practical examples of effective planning and management of urban health problems.
Recommendation 9: WI 10 should disseminate information on the relationship between environmental and health issues; the link of
environmental health programmes wilb urban development planning; and developments in healthy urban environment activities, including information on "good practice" examples in the Region.
(10) To implement the above-mentioned recommendations, it is expected that WHO should intensify its efforts and allocate sufficient resources.
Recommendation 10: WHO should introduce a regional project to promote clean, healthy environmentally sound and sustainable cities and towns
th.r:oughout the Region. This project should:
(a) allow for the participation of all cities throughout ~he Region;
(b) consider the use of competitive selection processes;
(c) ensure that the selected cities demonstrate firm political
commitment, sufficient resource support, and adequate implementation mechanisms;
~.
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(d) include technical collaboration between WHO and the cities in the preparation of annual project plans;
(e) provide for independent monitoring and evaluation of the project;
(f) provide for ongoing networking of participating cities and towns;
and · .
(g) encourage existing country programmes to be built upon and incorporated into the project.
ANNEX 1
LIST OF MEMBERS, REPRESENTATIVE, OBSERVER AND SECRETARIAT
Temporacy advisers Designation and address
1. Mr John Butler
2. Mr Hayden Raysmith
3. Dr Lu Zhiping
4. Mr He Gong Li
5. Dr Takashi Yam ada
6. Dr Toru Furuichi
Director of Town Planning Brisbane City Council GPO Box 1434
Brisbane Q 4001 Australia
Director
Statewide Operations
Health Department Victoria GPO Dox 4057, Melbourne Victoria 3001
Australia
Doctor-in-Charge
National Patriotic Health Campaign Committee
Provincial Bureau of Public Health of Jiangxi
Nanchang, Jiangxi
People's Republic of Chi~a Research Associate
Institute of Environmental Health and Engineering
Chinese Academy of Preventive Medicine 29 Nan Wei Road
Beijing
Pe<iple's Republic of China
Chief Director of Abeno Health Center Osaka City Hall
Nakanoshima, 1-3-20, Kitaku Osaka
Japan
Senior Research Official
Department of Sanitary Engineering Institute of Public Health
4-6-1 Shirokanedai Minato-ku 108 Tokyo
Japan
7. Raja Data' Mohd Ali bin Raja Osman
8. Mr M. Sugunan Pillay
9. Mr Mike Richardson
10. Mr Jonathan Fletcher
11. Ms Beta P. Balagot
12. Mr Antonino A.
I Iormillosa
13. Dr Pock-Sao Kang
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Director of Planning City Hall Kuala Lumpur P.O. Box 11022
50732 Kuala Lumpur · Malaysia
Chief Public Health Engineer Ministry of Health
Block E, Jalan Dungun 50490 Kuala Lumpur Malaysia
Group Manager Development Christchurch City Council P.O. Box 237
Christchurch New Zealand Unit Manager
Environmental Health Policy Group Department of Health
P.O. Box 5013 Wellington · New Zealand Acting Director
Environmental Mana~ement Bureau
6th Floor, PHC Buildmg, East Ave, Diliman Quezon City
Philippines Chief ··
Policy Formulation and Enforcement Section
Programme/Project Support Division Environmental Health Service
Department of Health San Lazaro Compound Rizal Avenue, Sta. Cruz Manila
Philippines Project Director
WHO Collaborative Activity on Urban Primary Health Care
Department of Preventive Medicine and Public Health
College of Medicine Yeungnam University 317-1, Daemyung Dong Nam Ciu, Taegu
Republic of Korea
14. Mr J ae-Y oung Ko
15. Mr Wong Kan Por
16. Dr Nguyen Thi Hong Tu
17. Dr Le Dinh MinU
Representative/ Observer 1.
2.
Dr Antonio L.
Fernandez
Mr Trevor Townson
Director
Technology Development Division Ministry of Environment
7-16 Siilcheon-dong Songpa-gu
Seoul 134-240 Repubiic of Korea
Assistant Commissioner of Public Health Ministry of the Environment
40 Scotts Road Singapore 0922
Republic of Singapore Medical Doctor
Department of I Jygiene and Environment Ministry of Health
13RA Giang Vo Str.
Hanoi
Socialist Republic of Viet Nam Medical Doctor
Department o( Hygiene and Environment Ministry of Health
138A Giang Vo Str.
Hanoi
Socialist Republic of Viet Nam
Fellow
United Nations Centre for
Regional Development (UNCRD) Nagono 1-47-1, Nakamura-ku Nagoya 450
Japan
National Project Manager of . Healthy Cities Australia
Australia Community Health Association P.O. Box 657, Bondi Junction
2022 Sydney New South Wales Australia
Secretariat 1. DrP. Guo 2. Dr H. Ogawa 3. Ms L.Y. Chan 4. Ms Y.M. Tan
5.
Mr S.A. Tamplin 6. Dr K.S. Lee 7. Dr R. Simpson**Dr Rodney Simpson
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Director, PEP AS
Environmental Systems Engineer, PEP AS Administrative Officer, PEP AS
Special Assistant, PEP AS
Regional Adviser in Environmental Health, WPRO
Scientist, Primary Health Care, WPRO WHO Consultant
Deputy Dean (Academic) .
Division of Australian Environmental Studies Griffith University
Nathan Q 4111 Australia
Monday. 25 February 1991 0900-0930
0930-0945 0945- 1000 1000- 1015 1015- 1030
1030- 1045 1045- 1100 1100- 1130 1130- 1200
1200- 1330 1330- 1400
. 1400- 1430
AGENDA
Inaugural session - Introductory remarks
Dr P. Guo, Director, .PEP AS - Opening speech
Dr P. Guo, on behalf of the Regional Director, WHO Western Pacific Region
- Welcome address
Professor Dr Syed Jalaludin Syed Salim, Deputy Vice-Chancellor, University of Agriculture, Malaysia
Group photograph
· Coffee/tea break Administrative briefing
L.Y. Chan, Administrative Officer, PEP AS Introduction of consultant and temporary advisers
H. Ogawa, Environmental Systems Engineer, PEP AS
Election of officers
Adoption of provisional agenda Themes and issues of the meeting
R. Simpson, WHO consultant
Recent developments in WHO's programme for environmental heallh in urban development by E. Giroult, WHO/Headquarters
(presented by .H. Ogawa) Lunch
Overview of WHO urban environmental health activities in the Western Pacific Region:
Towards a healthy urban environment
S. Tamplin, Regional Adviser in Environmental Health, Western Pacific Regional Office (WPRO) WHO's approaches and programme for urban pdmary health care development in the Western
· Pacific Region
K.S. Lee, Scientist, Primary Health Care/WPRO
1430- 1530 1530- 1600 1600- 1700
Tuesday. 26 February 1991 0900- 1030
1030- 1100 1100- 1200 1200- 1330 1330- 1345 1345- 1400 1400- 1430
1430 -1500
1500- 1530 1530- 1700
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Country report - Coffee/tea break Country reports-
Country reports -
Coffee/tea break Country reports - Lunch
Country report -
Australia
Japan Malaysia
New Zealand Philippines
Republic of Korea
Singapore VietNam
China Summary of country reports
S. Tamplin
Environmental Planning and Management at the United Nations Centre for Regional Development (UNCRD)
A. Fernandez, Fellow, UNCRD
Australian experienc:e in the Healthy Cities Project T. Townson, National Project Manager of
Healthy Cities Australia Coffee/tea break
Technical options R. Simpson Wednesday. 27 February 1991
0900- 1030 1030- 1100 1100- 1130
1130- 1200
Institutional options R. Simpson
Coffee/tea break
Environmental impact assessment for the Bundang New Village Construction Project
J.Y. Ko, temporary adviser from the Republic of Korea
Briefin~ on group discussions: Regional strategies for tbe tmprovement of environme-ntal health management through integrated planning
H. Ogawa and R. Simpson
1200- 1330 1330- 1500
1500- 1530 1530- 1700
Lunch
Group discussions
Group I: Institutional arrangement to strengthen multisectoral cooperation
- promotion of communication and
.
information exchange- roles and functions of local, provincial, national and international agencies - mobilization of NGOs and community
organizations
- regional networking of cities, etc.
Group II: Supportive mechanism to enhance advocacy and participation
- political commitment
- public awareness and education
. - promotion of pubHc participation in planning
· and information collection
- support of national and international agencies, etc.
·Group III: Monitoring and evaluation of programmes, and research and training - development of indicators
- research needs
- development of skills, etc.
Coffee/tea break
Group discussions (Cont'd) Thursday. 28 February 1991
0900- 1030 1030- 1100 1100- 1200 1200- 1330 1330- 1510 1510- 1530 1530- 1700
Group discussions (Cont'd) Coffee/tea break
Drafting of reports on group discussions Lunch
Plenary session - presentation and discussion on group discussion reports
Coffee/tea break
Plenary session (Cont'd)
Friday. 1 March 1991 0900- 1030
1030- 1100 1100- 1200 1200- 1400 1400- 1510
1510- 1530 1530- 1600
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Field trip
Formulation of draft recommendations for specific activities
Coffee/tea bre_ak
Formulation of draft recommendations (Cont'd) Lunch
Review, discussion and adoption of recommendations
Closing session Coffee/tea break
LIST OF DOCUMENTS DISTRIBUTED DURING THE WORKING GROUP MEETING
Working papers
WPR/RUD /PEP AS( 1 )91.2 WPR/RUD /PEP AS( 1)91.3
WPR/RUD/PEPAS(1)91.4
WPR/R UD /PEP AS( 1 )91.5
WPR/R UD /PEP AS( 1 )91.6
WPR/RUD /PEP AS( 1 )91. 7
WPR/RUD /PEP AS( 1 )91.8 WPR/RUD/PEPAS(1)91.9 WPR/RUD /PEP AS( 1 )91.10
Country reports
Themes and issues of the meeting.
By Dr R. Simpson.
Recent developments in WHO's programme for environmental health in urban
development.
By Mr E. Giroult.
Overview of WHO urban environmental health activities in the Western Pacific Region: Towards a healthy urban environment.
By MrS. Tamplin.
WHO's approaches and programme for urban primary health care development in
the Western Pacific Region.
By Dr K.S. Lee.
Enviroilmenal planning and management at the United Nations Centre for Regional Development (UNCRD).
By Drs A. Fernandez/H. Sazanami.
Australian experience in the Healthy Cities Project.
By Mr T. Townson.
Technical options.
By Dr R. Simpson.
Institutional options.
By Dr R. Simpson.
Environmental impact assessment for the Bundang New Village construction project.
By Mr J.Y. Ko.
WPR/RUD/PEPAS(1)/INF./1 Australia
By Mr H. Raysmith WPR/RUD/PEPAS(l)/INF./2 China
By Dr Z.P. Lu & Mr G.L. He WPR/RUD/PEPAS(1)/INF./3 Japan
By Drs T. Yamada & T. Furuichi
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WPR/RUD/PEPAS{l)/INF./4 WPR/RUD/PEPAS{l)/INF./5 WPR/RUD/PEPAS(l)/INF./6 WPR/R UD /PEP AS( 1 )/INF./7 WPR/R UD /PEP AS( 1) /INF./8 WPR/R UD /PEP AS( 1) /INF./9
Publications
Malaysia By MrS. Pillay
New Zealand
By Messrs J.-Fletcher & M. Richardson Philippines
By Ms B. Balagot & Mr A. ·Hormillosa Republic Of Korea
By Mr J.Y. Ko Singapore Mr K.P. Wong
Socialist Republic Of VietNam Drs T.l-I.T. Nguyen & D.M. Le
1. WHO Healthy Cities Project No. 1-5.
2. Spotlight on the cities: Improving urban health in developing countries.
3. WHO Healthy Cities Project: A project becomes a movement (Review of progress 1987 to 1990).
4. Report of the Interregional Meeting on City Health: The challenge of social justice.
5.' Health and the cities: A global overview.: Background document for technical discussion on strategies for health for all in the face of urbanization.
6. Report of WHO Expert Committee on environmental health in urban development (Draft).
7. Housing and Health: An agenda for action.
INAUGURAL ADDRESSES
Opening speech of Dr S.T. Han, Regional Director. WHO Western Pacific Region. delivered on bis behalf. by Dr P. Guo. Director. PEP AS
On behalf of Dr S.T. Han, WHO's Regional Dkector for the Western Pacific, I have pJeasure in welcoming you all to this five-day Working Group Meeting on Integration of Environmental Health into Planning for Urban Develo_pment. Dr Han is sorry he is unable to attend this opening today, but sends h1s best wishes to you all.
The Western Paciric Re~ion has some of the world's most urbanized countries and areas. [n Australia, Hong Kong, Japan, New Zealand, Republic of Korea and Singapore, over 70% of the total population live in urban areas. The urban areas of the developing countries are growing at the rate o£3-6% a year.
Rapid urban growth has led to severe overloading in facilities and services such as housing, transportation, water and energy supplies, waste clisposal, medical care, and parks and recreational areas. This means that the quality of the
environment in many cities has seriously deteriorated, posing a great threat to the health of those who live in ~hem. ln particular, disadvantaged urban groups such as squatters and slum dwellers often live in an extremely unheal.thy environment and without access to essential services. WHO has cooperated with various international agencies to find ways of dealing with such problems. For
instance it is working with the United Nations Environment Programme (UNEP)
to produce guidelines on environmental health aspects of housing and urban planning. Last year, h convened an Expert Commitlee on Environmental Health m Urban Development in April and a Commission on Health and Environment in June which also stressed that environment~ll health must be recognized as an essential aspect of urban development planning. This year the health impact of rapjd urbanization will be discussed at the World Health Assembly in May. In Europe, WHO has been playing a coordinatin~ role in the Healthy Cities Project,
and in Karachi, Pakistan, WHO or~anized an International meeting on improving urban environmental health, espec1ally for the urban poor.
In the Western Pacific Region too, WHO has been collaborating with Member States in many ways to improve the health of people Jiving in urban areas, and now we are preparing for the Healthy Urban Environment Project.
We have brought this Working Group together to provide expert advice and on how WHO can best promote the ProJect. To do this you will be looking at the experience already ~ained in this area, discussing what can be done, outlining strategies, and makmg some fairly detailed and specific recommendations.
I wish you all a fruitful week of discussions and a pleasant stay in Kuala Lumpur.
Thank you.
-30-
Welcome address by Professor Dr Syed Jalaludin Syed Salim.
Deputy Vice-Chancellor. University of Agriculture Ma!aysia
It is yet another pleasant duty that I have been called upon to perform.
You see, l have been so often invited by Dr Guo to officiate PEP AS meetings such as this one. Slowly but steadily, I am turning to become a student of some standing, I hope, in matters pertaining to environmental issues. ·I am, however, delighted to be given the honour to address the gathering.
As I understand, the working group focuses on the Integration of
Environmental Health into the Planning for Urban Development. More often than not, issues relating to environmental health are not clearly defined in urban development. In a way, it is a reflection of how we all think. The hazards of environmental health are not immediately felt and only become issues once they reach critical stage. And by that time, it is sometimes too late to do very much.
Urban development ought to be viewed in the long-term perspective and should include measures to ensure no matter how large the cities grow, the environment remains clean and healthy for all to live in. At all cost, we must not allow our environment to deteriorate as we progress along. The importance of maintaining a clean and healthy environment need not be stressed further. It is our fervent hope that this important working group can provide the necessary impetus to stimulate the discussion on the manner urban planning and
development can be undertaken while maintaining environmental health.
In reflection, one often wonders whether the environmental deterioration are not in fact the products of our very own civilization. For instance, the build- up of vehicles is growing in virtually every city. How do we intend to control ajr pollution in such a state? It is worthwhile thoughts but I do not think any
authority can do very much in the short term since the transportation industry is a major economic activity of every nation. Perhaps we will only respond when calamity strikes. It is always the case - there must be a necessity for any new invention to occur. For the time being, let us believe or make believe that the worst has yet to come.
I wish all participants every success in the deliberation.
I
