UN Economic and Social Development
Division for Sustainable Development

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UN Commission on Sustainable Development
13th Session
New York, 28 February - 4 March & 11-22 April 2005

Report on Commission on Sustainable Development on the Thirteenth session (28 February - 4 March and 11-22 April 2005)

Advance unedited version

1 (c) Investments in water, sanitation and human settlements contribute to economic growth, sustainable development, better health and reduced poverty. The achievement of water, sanitation and human settlements goals, is critical to the implementation of the three pillars of sustainable development and the achievement of all the internationally agreed development goals;

B. Sanitation

(i) Provide adequate sanitation, recognizing the interlinkages among water, sanitation, hygiene and health, including water-borne disease vectors, as well as the positive impacts of access to sanitation on poverty reduction, privacy, dignity, security and education.

(j) Sustain and accelerate progress towards the JPOI sanitation target, supported by increased resources from all sources, including ODA, in response to countries’ needs, with a focus on the following actions:

(i) Establishing an institutional home for sanitation, prioritizing sanitation in national development plans, and incorporating sanitation in integrated water resources management plans;

(ii) Allocating a specific and adequately resourced budget for sanitation;

(iii) Prioritizing investments to areas of greatest need and greatest impact, notably in schools, work places and health centres;

(iv) Employing cost recovery, where appropriate, to contribute to the sustainability of services, with targeted subsidies for the poor;

(v) Instituting economic incentives to encourage the participation of small-scale sanitation and hygiene service providers;

(vi) Conducting assessment of the health impacts of the lack of sanitation at community level;

(vii) Supporting existing regional and inter-regional initiatives such as the Global WASH Programme for water and sanitation;

(viii) Promoting and supporting on-site sanitation infrastructure, especially in rural areas;

(ix) Supporting the provision and maintenance of sanitation services to refugees and refugee host countries;

(m) Support countries in promoting sanitation and hygiene education and awareness raising, focusing on the following measures:

(i) Promoting gender-sensitive sanitation and hygiene education and awareness, including through social marketing and public information campaigns such as Water, Sanitation and Hygiene for All (WASH), and improve understanding of the linkages among sanitation, hygiene and health;

(ii) With an emphasis on children and youth, incorporating gender-sensitive hygiene education in school curricula and ensuring the provision of separate sanitation facilities for boys and girls in all schools;

(iii) Promoting the involvement of women, youth and community groups in sanitation and hygiene education programmes;

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World Summit on Sustainable Development
Johannesburg, South Africa 26 August - 4 September 2002

Plan of Implementation of the World Summit on Sustainable Development

II. Poverty eradication

7 (c) Develop national programmes for sustainable development and local and community development, where appropriate within country-owned poverty reduction strategies, to promote the empowerment of people living in poverty and their organizations. These programmes should reflect their priorities and enable them to increase access to productive resources, public services and institutions, in particular land, water, employment opportunities, credit, education and health;

(d) Promote women’s equal access to and full participation in, on the basis of equality with men, decision-making at all levels, mainstreaming gender perspectives in all policies and strategies, eliminating all forms of violence and discrimination against women and improving the status, health and economic welfare of women and girls through full and equal access to economic opportunity, land, credit, education and health-care services;

(f) Deliver basic health services for all and reduce environmental health threats, taking into account the special needs of children and the linkages between poverty, health and environment, with provision of financial resources, technical assistance and knowledge transfer to developing countries and countries with economies in transition;

(m) Increase access to sanitation to improve human health and reduce infant and child mortality, prioritizing water and sanitation in national sustainable development strategies and poverty reduction strategies where they exist.

8. The provision of clean drinking water and adequate sanitation is necessary to protect human health and the environment. In this respect, we agree to halve, by the year 2015, the proportion of people who are unable to reach or to afford safe drinking water (as outlined in the Millennium Declaration) and the proportion of people who do not have access to basic sanitation, which would include actions at all levels to:

(a) Develop and implement efficient household sanitation systems;

(b) Improve sanitation in public institutions, especially schools;

(c) Promote safe hygiene practices;

(d) Promote education and outreach focused on children, as agents of behavioural change;

(e) Promote affordable and socially and culturally acceptable technologies and practices;

(f) Develop innovative financing and partnership mechanisms;

(g) Integrate sanitation into water resources management strategies.

III. Changing unsustainable patterns of consumption and production

15 (c) Develop production and consumption policies to improve the products and services provided, while reducing environmental and health impacts, using, where appropriate, science-based approaches, such as life-cycle analysis;

(e) Develop and adopt, where appropriate, on a voluntary basis, effective, transparent, verifiable, non-misleading and non-discriminatory consumer information tools to provide information relating to sustainable consumption and production, including human health and safety aspects. These tools should not be used as disguised trade barriers;

21. Promote an integrated approach to policy-making at the national, regional and local levels for transport services and systems to promote sustainable development, including policies and planning for land use, infrastructure, public transport systems and goods delivery networks, with a view to providing safe, affordable and efficient transportation, increasing energy efficiency, reducing pollution, congestion and adverse health effects and limiting urban sprawl, taking into account national priorities and circumstances. This would include actions at all levels to:

(a) Implement transport strategies for sustainable development, reflecting specific regional, national and local conditions, to improve the affordability, efficiency and convenience of transportation as well as urban air quality and health and reduce greenhouse gas emissions, including through the development of better vehicle technologies that are more environmentally sound, affordable and socially acceptable;

23. Renew the commitment, as advanced in Agenda 21, to sound management of chemicals throughout their life cycle and of hazardous wastes for sustainable development as well as for the protection of human health and the environment, inter alia, aiming to achieve, by 2020, that chemicals are used and produced in ways that lead to the minimization of significant adverse effects on human health and the environment, using transparent science-based risk assessment procedures and science-based risk management procedures, taking into account the precautionary approach, as set out in principle 15 of the Rio Declaration on Environment and Development, and support developing countries in strengthening their capacity for the sound management of chemicals and hazardous wastes by providing technical and financial assistance. This would include actions at all levels to:

(a) Promote the ratification and implementation of relevant international instruments on chemicals and hazardous waste, including the Rotterdam Convention on Prior Informed Consent Procedures for Certain Hazardous Chemicals and Pesticides in International Trade10 so that it can enter into force by 2003 and the Stockholm Convention on Persistent Organic Pollutants11 so that it can enter into force by 2004, and encourage and improve coordination as well as supporting developing countries in their implementation;

(b) Further develop a strategic approach to international chemicals management based on the Bahia Declaration and Priorities for Action beyond 2000 of the Intergovernmental Forum on Chemical Safety12 by 2005, and urge that the United Nations Environment Programme, the Intergovernmental Forum, other international organizations dealing with chemical management and other relevant international organizations and actors closely cooperate in this regard, as appropriate;

(c) Encourage countries to implement the new globally harmonized system for the classification and labelling of chemicals as soon as possible with a view to having the system fully operational by 2008;

(d) Encourage partnerships to promote activities aimed at enhancing environmentally sound management of chemicals and hazardous wastes, implementing multilateral environmental agreements, raising awareness of issues relating to chemicals and hazardous waste and encouraging the collection and use of additional scientific data;

(e) Promote efforts to prevent international illegal trafficking of hazardous chemicals and hazardous wastes and to prevent damage resulting from the transboundary movement and disposal of hazardous wastes in a manner consistent with obligations under relevant international instruments, such as the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal;

(f) Encourage development of coherent and integrated information on chemicals, such as through national pollutant release and transfer registers;

(g) Promote reduction of the risks posed by heavy metals that are harmful to human health and the environment, including through a review of relevant studies, such as the United Nations Environment Programme global assessment of mercury and its compounds.

IV. Protecting and managing the natural resource base of economic and social development

25 (d) Intensify water pollution prevention to reduce health hazards and protect ecosystems by introducing technologies for affordable sanitation and industrial and domestic wastewater treatment, by mitigating the effects of groundwater contamination and by establishing, at the national level, monitoring systems and effective legal frameworks;

30 (f) Strengthen regional cooperation and coordination between the relevant regional organizations and programmes, the regional seas programmes of the United Nations Environment Programme, regional fisheries management organizations and other regional science, health and development organizations;

35. Governments, taking into account their national circumstances, are encouraged, recalling paragraph 8 of resolution GC (44)/RES/17 of the General Conference of the International Atomic Energy Agency, and taking into account the very serious potential for environment and human health impacts of radioactive wastes, to make efforts to examine and further improve measures and internationally agreed regulations regarding safety, while stressing the importance of having effective liability mechanisms in place, relevant to international maritime transportation and other transboundary movement of radioactive material, radioactive waste and spent fuel, including, inter alia, arrangements for prior notification and consultations done in accordance with relevant international instruments.

39 (a) Strengthen capacities of developing countries and countries with economies in transition to measure, reduce and assess the impacts of air pollution, including health impacts, and provide financial and technical support for these activities;

46 (a) Support efforts to address the environmental, economic, health and social impacts and benefits of mining, minerals and metals throughout their life cycle, including workers’ health and safety, and use a range of partnerships, furthering existing activities at the national and international levels among interested Governments, intergovernmental organizations, mining companies and workers and other stakeholders to promote transparency and accountability for sustainable mining and minerals development;

VI. Health and sustainable development

53. The Rio Declaration on Environment and Development states that human beings are at the centre of concerns for sustainable development, and that they are entitled to a healthy and productive life, in harmony with nature. The goals of sustainable development can only be achieved in the absence of a high prevalence of debilitating diseases, while obtaining health gains for the whole population requires poverty eradication. There is an urgent need to address the causes of ill health, including environmental causes, and their impact on development, with particular emphasis on women and children, as well as vulnerable groups of society, such as people with disabilities, elderly persons and indigenous people.

54. Strengthen the capacity of health-care systems to deliver basic health services to all in an efficient, accessible and affordable manner aimed at preventing, controlling and treating diseases, and to reduce environmental health threats, in conformity with human rights and fundamental freedoms and consistent with national laws and cultural and religious values, and taking into account the reports of relevant United Nations conferences and summits and of special sessions of the General Assembly. This would include actions at all levels to:

(a) Integrate the health concerns, including those of the most vulnerable populations, into strategies, policies and programmes for poverty eradication and sustainable development;

(b) Promote equitable and improved access to affordable and efficient health-care services, including prevention, at all levels of the health system, essential and safe drugs at affordable prices, immunization services and safe vaccines and medical technology;

(c) Provide technical and financial assistance to developing countries and countries with economies in transition to implement the Health for All Strategy, including health information systems and integrated databases on development hazards;

(d) Improve the development and management of human resources in healthcare services;

(e) Promote and develop partnerships to enhance health education with the objective of achieving improved health literacy on a global basis by 2010, with the involvement of United Nations agencies, as appropriate;

(f) Develop programmes and initiatives to reduce, by the year 2015, mortality rates for infants and children under 5 by two thirds, and maternal mortality rates by three quarters, of the prevailing rate in 2000, and reduce disparities between and within developed and developing countries as quickly as possible, with particular attention to eliminating the pattern of disproportionate and preventable mortality among girl infants and children;

(g) Target research efforts and apply research results to priority public health issues, in particular those affecting susceptible and vulnerable populations, through the development of new vaccines, reducing exposures to health risks, building on equal access to health-care services, education, training and medical treatment and technology and addressing the secondary effects of poor health;

(h) Promote the preservation, development and use of effective traditional medicine knowledge and practices, where appropriate, in combination with modern medicine, recognizing indigenous and local communities as custodians of traditional knowledge and practices, while promoting effective protection of traditional knowledge, as appropriate, consistent with international law;

(i) Ensure equal access of women to health-care services, giving particular attention to maternal and emergency obstetric care;

(j) Address effectively, for all individuals of appropriate age, the promotion of healthy living, including their reproductive and sexual health, consistent with the commitments and outcomes of recent United Nations conferences and summits, including the World Summit for Children, the United Nations Conference on Environment and Development, the International Conference on Population and Development, the World Summit for Social Development and the Fourth World Conference on Women, and their respective reviews and reports;

(k) Launch international capacity-building initiatives, as appropriate, that assess health and environment linkages and use the knowledge gained to create more effective national and regional policy responses to environmental threats to human health;

(l) Transfer and disseminate, on mutually agreed terms, including through public-private multisector partnerships, with international financial support, technologies for safe water, sanitation and waste management for rural and urban areas in developing countries and countries with economies in transition, taking into account country-specific conditions and gender equality, including specific technology needs of women;

(m) Strengthen and promote programmes of the International Labour Organization and World Health Organization to reduce occupational deaths, injuries and illnesses, and link occupational health with public health promotion as a means of promoting public health and education;

(n) Improve availability and access for all to sufficient, safe, culturally acceptable and nutritionally adequate food, increase consumer health protection, address issues of micronutrient deficiency and implement existing internationally agreed commitments and relevant standards and guidelines;

(o) Develop or strengthen, where applicable, preventive, promotive and curative programmes to address non-communicable diseases and conditions, such as cardiovascular diseases, cancer, diabetes, chronic respiratory diseases, injuries, violence and mental health disorders and associated risk factors, including alcohol, tobacco, unhealthy diets and lack of physical activity.

55. Implement, within the agreed time frames, all commitments agreed in the Declaration of Commitment on HIV/AIDS (General Assembly resolution S-26/2, annex) adopted by the General Assembly at its twenty-sixth special session, emphasizing in particular the reduction of HIV prevalence among young men and women aged 15 to 24 by 25 per cent in the most affected countries by 2005, and globally by 2010, as well as combat malaria, tuberculosis and other diseases by, inter alia:

(a) Implementing national preventive and treatment strategies, regional and international cooperation measures and the development of international initiatives to provide special assistance to children orphaned by HIV/AIDS;

(b) Fulfilling commitments for the provision of sufficient resources to support the Global Fund to Fight AIDS, Tuberculosis and Malaria, while promoting access to the Fund by countries most in need;

(c) Protecting the health of workers and promoting occupational safety, by, inter alia, taking into account, as appropriate, the voluntary Code of Practice on HIV/AIDS and the World of Work of the International Labour Organization, to improve conditions of the workplace;

(d) Mobilizing adequate public, and encouraging private, financial resources for research and development on diseases of the poor, such as HIV/AIDS, malaria, and tuberculosis, directed at biomedical and health research, as well as new vaccine and drug development.

56. Reduce respiratory diseases and other health impacts resulting from air pollution, with particular attention to women and children, by:

(a) Strengthening regional and national programmes, including through public-private partnerships, with technical and financial assistance to developing countries;

(b) Supporting the phasing out of lead in gasoline;

(c) Strengthening and supporting efforts for the reduction of emissions through the use of cleaner fuels and modern pollution control techniques;

(d) Assisting developing countries in providing affordable energy to rural communities, particularly to reduce dependence on traditional fuel sources for cooking and heating, which affect the health of women and children.

57. Phase out lead in lead-based paints and in other sources of human exposure, work to prevent, in particular, children’s exposure to lead and strengthen monitoring and surveillance efforts and the treatment of lead poisoning.

VII. Sustainable development of small island developing States

(e) Effectively reduce, prevent and control waste and pollution and their health-related impacts by undertaking initiatives by 2004 aimed at implementing the Global Programme of Action for the Protection of the Marine Environment from Land-based Activities in small island developing States;

60. Provide support to small island developing States to develop capacity and strengthen:

(a) Health-care services for promoting equitable access to health care;

(b) Health systems for making available necessary drugs and technology in a sustainable and affordable manner to fight and control communicable and noncommunicable diseases, in particular HIV/AIDS, tuberculosis, diabetes, malaria and dengue fever;

(c) Efforts to reduce and manage waste and pollution and building capacity for maintaining and managing systems to deliver water and sanitation services, in both rural and urban areas;

64. Mobilize financial and other support to develop and strengthen health systems that aim to:

(a) Promote equitable access to health-care services;

(b) Make available necessary drugs and technology in a sustainable and affordable manner to fight and control communicable diseases, including HIV/AIDS, malaria and tuberculosis, and trypanosomiasis, as well as noncommunicable diseases, including those caused by poverty;

(c) Build capacity of medical and paramedical personnel;

(d) Promote indigenous medical knowledge, as appropriate, including traditional medicine;

(e) Research and control Ebola disease.

X. Means of implementation

100. Address the public health problems affecting many developing and least developed countries, especially those resulting from HIV/AIDS, tuberculosis, malaria and other epidemics, while noting the importance of the Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) and public health,42 in which it was agreed that the TRIPS Agreement does not and should not prevent WTO members from taking measures to protect public health. Accordingly, while reiterating our commitment to the TRIPS Agreement, we reaffirm that the Agreement can and should be interpreted and implemented in a manner supportive of WTO members’ right to protect public health and, in particular, to promote access to medicines for all.

102. Take steps with a view to the avoidance of, and refrain from, any unilateral measure not in accordance with international law and the Charter of the United Nations that impedes the full achievement of economic and social development by the population of the affected countries, in particular women and children, that hinders their well-being or that creates obstacles to the full enjoyment of their human rights, including the right of everyone to a standard of living adequate for their health and well-being and their right to food, medical care and the necessary social services. Ensure that food and medicine are not used as tools for political pressure.

117. Provide financial assistance and support to education, research, public awareness programmes and developmental institutions in developing countries and countries with economies in transition in order to: (a) Sustain their educational infrastructures and programmes, including those related to environment and public health education

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UN Commission on Sustainable Development
9th Session
New York, 5 May 2000 & 16-27 April 2001

Report of the Commission on Sustainable Development on the Ninth Session (5 May 2000 and 16-27 April 2001)

Decision 9/1: Energy for sustainable development

21. Governments, taking into account their national circumstances, are encouraged to:

(h) Recalling paragraph 8 of the Governing Council of the International Atomic Energy Agency (IAEA) resolution GC (44)/RES/17 and taking into account the very serious potential for environment and human health impacts of radioactive wastes, make efforts to examine and further improve measures and internationally agreed regulations regarding safety, while stressing the importance of having effective liability mechanisms in place, relevant to international maritime transportation and other transboundary movement of radioactive material, radioactive waste and spent fuel, including, inter alia, arrangements for prior notification and consultations done in accordance with relevant international instruments.

23. Governments, taking into account their national circumstances, are encouraged to:

(d) Take into consideration the health and safety concerns of women and children in rural energy programmes;

(k) Promote efforts to address the disproportionate burdens experienced by women in rural areas, including carrying loads of fuelwood over long distances and suffering adverse health effects from prolonged exposure to open fires.

Decision 9/2: Protection of the atmosphere

4. Air pollution has negative impacts on human health, socio-economic development, ecosystems and cultural heritage. Many countries face major challenges in managing the impact of pollution, especially in big cities. Since air pollutants may cause negative environmental impacts, in some cases thousands of kilometres from the source, besides national efforts to reduce pollution there is need for appropriate regional and international cooperation.

10. At the national level, Governments, taking into account their respective national priorities and circumstances, are encouraged, with the support of the international community, to consider, as appropriate:

(a) Improving data compilation and monitoring of air quality;

(b) Publicizing the work of the World Health Organization (WHO) to develop guidelines for air quality and working towards their application;

(c) Further developing and implementing air quality strategies which include air pollution control and air quality management;

(d) Identifying, assessing and addressing the adverse effects of air pollution on human health, socio-economic development, ecosystems and cultural heritage;

(e) Improving policies that reduce environmental health hazards, including through plans and strategies to prevent, mitigate and respond to diseases resulting from indoor and outdoor air pollution, giving special attention to the health of women and children;

(f) Increasing public participation of and access of all persons, including major groups, to information on how to reduce health risks caused by air pollution and ozone depletion;

Decision 9/3: Transport

4. The challenges of policy-making in the transport sector are complex and multidimensional. Transport-related activities affect economic growth, social development and the environment in many diverse ways. They pose particular problems in the context of urbanization and a separate set of challenges in rural and remote areas, including in mountainous areas. Land, maritime and aviation transport present different issues for resolution but also need to be considered. The social dimensions of transport include affordability and the impact on, inter alia, community health and safety of transport services, infrastructure, gender and age aspects, employment and labour conditions and providing for those with special needs.

5. There are many facets to the impact on the environment of transport-related activities and infrastructure. Accidents, noise and air pollution are adverse impacts associated with the transport sector. Emissions from vehicles and other modes of transport are harmful to human health and the environment. The demand for transport services is significant and likely to rise. Transport systems affect human settlements in various ways, including urban conditions and land use.

7. Lack of access to transport significantly impacts women’s health and limits their having access to markets and other income-generating activities. Transport should be made available and accessible to women in order to facilitate social and economic progress.

10. Aware of the risk to human health, safety and the environment from transboundary movements of hazardous substances, States should act in a manner consistent with their respective obligations under relevant international instruments. 

15. The Commission encourages regional cooperation through the better utilization of the regional commissions, existing regional development banks and existing regional organizations and mechanisms, by:

(b) Examining the possibility of strengthening existing transboundary agreements for reducing pollution and its implications for health and environment, in accordance with the needs and characteristics of each region;

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UN Commission on Sustainable Development
8th Session
New York, 30 April 1999 & 24 April-5 May 2000

Report of the Commission on Sustainable Development on the Eighth Session (30 April 1999 and 24 April-5 May 2000)

Decision 8/3: Integrated planning and management of land resources

3. The challenge is to develop and promote sustainable and productive land-use management systems as part of national and local strategies for sustainable development and to protect critical natural resources and ecosystems through balancing land, water and other natural resources. Governments are encouraged to provide transparent, effective, participatory and accountable governance conducive to sustainable development and responsive to the needs of people. Social and health aspects of land-use systems deserve particular attention and should be integrated into the overall planning process.

5. Critical sectors and issues

(a) Biodiversity

14. Governments and United Nations organizations are encouraged to promote only those applications of biotechnology that do not pose unacceptable risks to public health or the environment, bearing in mind ethical considerations, as appropriate.

Decision 8/4: Agriculture

2. Priorities for action

(a) Implementation of sustainable agriculture and rural development (SARD) goals

10. Governments are urged to pay particular attention to the social dimension of SARD, including health protection. Governments should take fully into account the interests of small-scale farmers and agricultural workers, including the effects of agricultural practices on human health and safety in terms of both consumption and production.

(f) Biotechnology

24. Governments are encouraged to explore, using transparent science-based risk assessment procedures, as well as risk management procedures, applying the precautionary approach, as articulated in principle 15 of the Rio Declaration and recalled in the Cartagena Protocol on Biosafety to the Convention on Biological Diversity, the potential of appropriate and safe biotechnology for enhancing food security for all and sustainable agricultural techniques and practices, taking into account possible effects on the environment and human health. 

27. Governments and United Nations organizations are encouraged to promote only those applications of biotechnology that do not pose unacceptable risks to public health or the environment, bearing in mind ethical considerations as appropriate.

(l) Water resources

34. Water resources are essential for satisfying basic human needs, health and food production, energy, and the restoration and maintenance of ecosystems, and for social and economic development in general, and SARD.

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UN Commission on Sustainable Development
7th Session
New York, 1 May & 27 July 1998, & 19–30 April 1999

Report of the Commission on Sustainable Development on the Seventh Session (21 May and 27 July 1998, and 19–30 April 1999)

Draft resolution I: Expansion of the United Nations guidelines on consumer protection to include sustainable consumption

III. Guidelines

F. Education and information programmes

37. Consumer education and information programmes should cover such important aspects of consumer protection as the following:

(a) Health, nutrition, prevention of food-borne diseases and food adulteration;

46. Governments should promote the development and use of national and international environmental health and safety standards for products and services; such standards should not result in disguised barriers to trade.

49. Governments should promote awareness of the health-related benefits of sustainable consumption and production patterns, bearing in mind both direct effects on individual health and collective effects through environmental protection.

H. Measures relating to specific areas

56. In advancing consumer interests, particularly in developing countries, Governments should, where appropriate, give priority to areas of essential concern for the health of the consumer, such as food, water and pharmaceuticals. Policies should be adopted or maintained for product quality control, adequate and secure distribution facilities, standardized international labelling and information, as well as education and research programmes in these areas. Government guidelines in regard to specific areas should be developed in the context of the provisions of this document.

57. Food. When formulating national policies and plans with regard to food, Governments should take into account the need of all consumers for food security and should support and, as far as possible, adopt standards from the Food and Agriculture Organization of the United Nations and the World Health Organization Codex Alimentarius or, in their absence, other generally accepted international food standards. Governments should maintain, develop or improve food safety measures, including, inter alia, safety criteria, food standards and dietary requirements and effective monitoring, inspection and evaluation mechanisms.

61. Pharmaceuticals. Governments should develop or maintain adequate standards, provisions and appropriate regulatory systems for ensuring the quality and appropriate use of pharmaceuticals through integrated national drug policies which could address, inter alia, procurement, distribution, production, licensing arrangements, registration systems and the availability of reliable information on pharmaceuticals. In so doing, Governments should take special account of the work and recommendations of the World Health Organization on pharmaceuticals. For relevant products, the use of that organization’s Certification Scheme on the Quality of Pharmaceutical Products Moving in International Commerce and other international information systems on pharmaceuticals should be encouraged. Measures should also be taken, as appropriate, to promote the use of international non-proprietary names (INNs) for drugs, drawing on the work done by the World Health Organization.

62. In addition to the priority areas indicated above, Governments should adopt appropriate measures in other areas, such as pesticides and chemicals in regard, where relevant, to their use, production and storage, taking into account such relevant health and environmental information as Governments may require producers to provide and include in the labeling of products.

III. Areas of particular concern

B. Land-based activities

30. The Commission welcomes the agreement by the recent UNEP Governing Council to explore the feasibility for UNEP to convene by 2000 a global conference to address sewage as a major land-based source of pollution affecting human and ecosystem health. In this context, the Commission encourages the establishment of links between this conference and both the first intergovernmental review of the Programme of Action, planned for 2001, and related intergovernmental conferences on the sustainable management of freshwater and oceans.

IV. International coordination and cooperation

Decision 7/2. Changing consumption and production patterns

Urbanization and its impacts on consumption and production patterns

13. Governments, in cooperation with relevant international organizations and in partnership with major groups, while particularly taking into account the work of the Commission on Human Settlements, should:

(a) Assess and address, in the context of sustainable development, the impacts of urbanization, in particular those related to energy, transport, sanitation, waste management and public health;

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UN Commission on Sustainable Development
6th Session
New York, 22 December 1997 & 20 April–1 May 1998

Report of the Commission on Sustainable Development on the Sixth Session (22 December 1997 and 20 April–1 May 1998)

Chapter I

A. Industry and economic development

3. In this regard, the Commission reaffirms that water resources are essential for satisfying basic human needs, health and food production, energy, and the restoration and maintenance of ecosystems, and for social and economic development in general. Agriculture accounts for a major part of global freshwater use. It is imperative that freshwater resources development, use, management and protection be planned in an integrated manner, taking into account both short- and long-term needs. Consequently, the priority to be accorded to the social dimension of freshwater management is of fundamental importance. This should be reflected in an integrated approach to freshwater in order to be coherent, aimed at achieving truly people-centred sustainable development in accordance with their local conditions. It is important that consideration of equitable and responsible use of water become an integral part in the formulation of strategic approaches to integrated water management at all levels, in particular in addressing the problems of people living in poverty. The development, management, protection and use of water so as to contribute to the eradication of poverty and the promotion of food security is an exceptionally important goal. The role of groundwater; rivers, lakes, streams and wetlands; estuaries and the sea; and forests, other vegetation and other parts of their ecosystems in the water cycle and their importance to water quality and quantity should be acknowledged and protected. Another set of crucial issues relates to the links between water quality, sanitation and protection of human health.

10. The Commission therefore:

(a) Urges Governments, with the technical and financial support of the international community, where appropriate, to address the numerous gaps identified in the path towards integrated water resources development management, protection and use. Areas that require further attention include (i) meeting basic health education needs and raising awareness of the scope and function of surface and groundwater resources; (ii) the need for human resources development and participatory approaches, notably including women and local communities and integrating freshwater issues into local Agenda 21 processes; (iii) the role of ecosystems in the provision of goods and services; (iv) balancing structural and non-structural approaches; (v) explicit linkages with socio-economic development, for equitable utilization and efficient freshwater allocation and use; (vi) improved sanitation and waste-water treatment and recycling; (vii) conserving the biological diversity of freshwater ecosystems; (viii) conservation and sustainable use of wetlands; (ix) the understanding of hydrology and the capacity to assess the availability and variability of water resources; (x) mobilization of financial resources and mainstreaming of gender issues into all aspects of water resources management; and (xi) wasteful water usage. Strategic and integrated actions are still needed in order to adapt to ever-changing social and environmental circumstances and to address fundamental concerns for combating poverty, ensuring adequate provision of public health, food security and energy, and to protect the environment better. International cooperation and action needs to address effectively the above issues, building on existing consensus for the successful implementation of integrated water resources development, management, protection and use; 

16. Official development assistance should be provided for and complement, inter alia, programmes and frameworks for promoting integrated water resources development, management, protection and use that (a) meet basic needs; (b) safeguard public health;

B. Industry and social development

8. The Commission recognized that there is a mutually reinforcing relationship between social and industrial development, and that industrialization has the potential to promote, directly and indirectly, a variety of social objectives such as employment creation, poverty eradication, gender equality, labour standards, and greater access to education and health care. In this regard, the overriding policy challenge is to promote the positive impacts while limiting or eliminating the negative impacts of industrial activities on social development. The Commission noted that improved access to education and health care has, in general, been associated with the pace of industrialization and recommended that Governments continue to give them priority.

C. Recommendations for Governments

27. Governments, at the national level, are encouraged to address the issue of occupational health and safety standards in small and medium-sized enterprises and in industry.

30. Social objectives should be an integral part of sustainable development, and the overriding social policy challenge for Government and industry is to promote the positive impacts of industrial activities on social development, while limiting or eliminating the negative impacts. This can be achieved by various means, in particular through improved access to education and health care. Governments should give priority to ensuring universal access to basic education and to expanding access to secondary education. Tax incentives, for example, may be useful to encourage companies to invest in training and education for their workers. Governments and civil society should also address the problem of rapidly expanding labour forces, especially youth labour.

J. Human resources development

44. The limited human resources and other constraints facing small island developing States and the difficulties that those constraints exert on their sustainable development objectives are recognized. The Commission acknowledges the efforts by small island developing States and the progress made, and encourages them to continue to accord high priority to the comprehensive development of a strong and effective human resources base in all fields and across all sectors, giving particular attention to building health standards and care, development of education with specific environmental components and awareness-raising, the empowerment of women, and the provision of adequate training opportunities for all sectors. The establishment of incentive measures would help to retain key personnel in the public sector. Human resources development is an essential component in building the institutional capacity of small island developing States for delivering sustainable development.

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United Nations General Assembly
19th Special Session
New York, 23-27 June 1997

Resolution Adopted By The General Assembly for the Programme for the Further Implementation of Agenda 21

Health

31. The goals of sustainable development cannot be achieved when a high proportion of the population is afflicted with debilitating illnesses. An overriding goal for the future is to implement the Health for All strategy 21/ and to enable all people, particularly the world's poor, to achieve a higher level of health and well-being, and to improve their economic productivity and social potential. Protecting children from environmental health threats and infectious disease is particularly urgent since children are more susceptible than adults to those threats. Top priority should be attached to supporting the efforts of countries, particularly developing countries, and international organizations to eradicate the major infectious diseases, especially malaria, which is on the increase, to improve and expand basic health and sanitation services, and to provide safe drinking water. It is also important to reduce indigenous cases of vaccine-preventable diseases through the promotion of widespread immunization programmes, promote accelerated research and vaccine development and reduce the transmission of other major infectious diseases, such as dengue fever, tuberculosis and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Given the severe and irreversible health effects of lead poisoning, particularly on children, it is important to accelerate the process of eliminating unsafe uses of lead, including the use of lead in gasoline worldwide, in light of country-specific conditions and with enhanced international support and assistance to developing countries, particularly through the timely provision of technical and financial assistance and the promotion of endogenous capacity-building. Strategies at the regional, national and local levels for reducing the potential risk due to ambient and indoor air pollution should be developed, bearing in mind their serious impacts on human health, including strategies to make parents, families and communities aware of the adverse environmental health impacts of tobacco. The clear linkage between health and the environment needs to be emphasized and the lack of information on the impact of environmental pollution on health should be addressed. Health issues should be fully integrated into national and subnational sustainable development plans and should be incorporated into project and programme development as a component of environmental impact assessments. Important to efforts at national levels is international cooperation in disease prevention, early warning, surveillance, reporting, training and research, and treatment.

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UN Commission on Sustainable Development
3rd Session
New York, 11-28 April 1995

Report of the Commission on Sustainable Development on the Third Session (11-28 April 1995)

8. Progress in the implementation of decisions on sectoral issues adopted by the second session of the Commission on Sustainable Development

97.    The Commission recalls the decisions taken on the sectoral clusters of "Health, human settlements and freshwater" and "Toxic chemicals and hazardous wastes" at the second session of the Commission on Sustainable Development, requests detailed consideration regarding the follow-up activities thereon and urges further efforts to ensure the full implementation of these decisions.

98.    The Commission notes that in the area of health a joint WHO/UNDP interregional initiative has succeeded in incorporating health-and-environment concerns in the preparation of national plans for sustainable development in 12 countries so far. Regional initiatives relating health and environment within the context of sustainable development have led to the creation of an Environment Health Action Plan for Europe and the preparatory work for a Pan-American Conference on Health and the Environment in Sustainable Development is under way.

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UN Commission on Sustainable Development
2nd Session
New York, 16-27 May 1994

Report of the Commission on Sustainable Development on its Second Session
(New York, 16-27 May 1994)

D. Review of sectoral cluster: health, human settlements and freshwater

1. Protecting and promoting human health

92.    The Commission on Sustainable Development takes note of the report of the Secretary-General (E/CN.17/1994/3) as well as a background paper on health, environment and sustainable development prepared by the World Health Organization (WHO) as task manager.

93.    The Commission takes note, with appreciation, of the outcome of the Inter-sessional Workshop on Health, the Environment and Sustainable Development, held in Copenhagen from 23 to 25 February 1994 and organized by the Government of Denmark. In that context, the Commission particularly underlines the importance of the recommendations of the Copenhagen meeting focusing on the need to integrate health, environment and sustainable development goals and activities through innovative and holistic approaches.

94.    The Commission reaffirms that the promotion and protection of human health is of central concern in sustainable development, as reflected in the very first principle of the Rio Declaration on Environment and Development, which states that human beings are at the centre of concern for sustainable development and are entitled to a healthy and productive life in harmony with nature. In that context, the Commission stresses the fact that the protection and promotion of human health depend on activities stemming from all sectors.

95.    The Commission welcomes the Global Strategy for Health and Environment developed by WHO and endorsed by the World Health Assembly.

96.    The Commission recognizes the critical importance of funding for health and highlights the need to focus funding on preventive measures. While emphasizing the importance of adopting a preventive approach to building health-related services, the Commission also stresses the necessity of responding to the needs of curative medicine. To meet those requirements, the Commission calls for the strengthening of the health infrastructure, particularly in developing countries, with the cooperation of the international community where necessary.

97.    The Commission has identified the rural sector and urban slums as particular social sectors that would benefit from the strengthening of health systems because special attention in those areas will strengthen the implementation of the priorities identified in the Commission decisions on human settlements.

98.    Poverty is an underlying significant element to be addressed in the integrated implementation of health aspects of Agenda 21. Eradicating malnutrition and hunger, which affects some one billion people in the world, is a fundamental prerequisite to providing health for all. The Commission therefore reaffirms the commitments to poverty eradication in the context of sustainable development contained in the Rio Declaration, and the fundamental relationship of the eradication of poverty to the overall goals of health promotion and protection.

99.    While recognizing the impact of population growth on health, environment and development, and vice versa, and looking forward to the outcome of the International Conference on Population and Development, the Commission recognizes that the provision of basic and assured health care, particularly to women and children, is a vital prerequisite to the reduction of high rates of population growth.

100.    The specific needs of vulnerable groups are recognized as priority areas. In addition to the three vulnerable groups identified in chapter 6 of Agenda 21 (women, children and indigenous people), the Commission takes note of the similarly special health needs of the aged, the disabled, and the displaced. The Commission further notes the contribution of food aid as an important aspect of efforts directed at the improvement of the nutritional and overall health of vulnerable groups.

101.    The Commission notes that traditional health-related knowledge, borne especially by women and indigenous people, makes a contribution to overall health and stresses the need for increased research in that field with a view to supporting its use where adequately validated. The Commission also notes that the work-place is a source of health-related problems and at the same time provides a useful community basisfor implementing and monitoring preventive health programmes through the participation of workers.

102. The Commission underlines that it is of crucial importance to change consumption patterns, in particular in developed countries, as well as production patterns, in order to ensure that products and production processes with adverse health and environmental effects gradually disappear. Detailed and specific product information, such as adequate labelling, can therefore create changes in the market towards cleaner products. In that context, the Commission stresses the need for continually updating the Consolidated List of Products Whose Consumption and/or Sale Have Been Banned, Withdrawn, Severely Restricted or Not Approved by Governments", and for undertaking further measures to broadly disseminate information contained in that list. Furthermore, the Commission stresses the need for assisting countries to implement the set of guidelines for consumer protection adopted by the General Assembly in 1985.

103.    The Commission expresses deep concern about chemical substances with potential health hazards that are widely used in industry, consumer products and food production and processing. The impact on human health, especially of long-term exposure to low doses of synthetic chemicals with potential neurotoxic, reproductive or immunotoxic effects, and their synergistic effects on nature, is not yet sufficiently understood. The Commission therefore emphasizes the need to control their use and to minimize the emission of hazardous chemicals to prevent increasing concentrations in the environment.

104.    The Commission recognizes the ongoing health reform efforts and emphasizes the need for further concrete actions in the follow-up to the first review of progress in implementing the activities of chapter 6, particularly for the 1997 review of Agenda 21. In that context, the Commission recognizes four lines of health reform identified by WHO as constituting a suitable programme of action for Governments to pursue within the framework of their national sustainable development programmes:

(a) Community health development: undertaking health promotion and protection as part of more holistically conceived community-based development programmes;

(b) Health sector reform: increasing the allocation of resources to the most cost-effective health protection and promotion programmes as seen in the longer run and in the interest of attaining sustainable development;

(c) Environmental health: increasing the understanding of the impact of policies and programmes of other sectors upon human health and mobilizing financing and action in those sectors accordingly;

(d) National decision-making and accounting: health impact assessments, accounting and other means of promoting the integration of health, the environment and sustainable development into national decision-making with a view to strengthening health-sector representation and incorporating health and its financing in development planning.

105. The Commission concludes that the following priorities should receive particular attention from Governments and the relevant international organizations:

(a) Strengthening health-sector representation in national decision-making, including the full participation of major groups;

(b) Establishing a firm partnership between health/health-related services, on the one hand, and the communities being served, on the other, that respects their rights and local traditional practices, where adequately validated;

(c) Including population issues in basic health systems, as approved in chapter 6, paragraphs 6.25 and 6.26 of Agenda 21 and without prejudice to the outcome of the International Conference on Population and Development;

(d) Including food security, the improvement of the population's nutritional status, food quality and food safety in national development plans and programmes aimed at improved health in the context of sustainable development;

(e) Reassessing health expenditures with a view to more cost-effective health protection and promotion measures, including, where appropriate, the increasing use of economic instruments, such as user fees and insurance systems, in order to generate funds for efficient health systems;

(f) Assuring that health is integrated into environmental impact assessment procedures;

(g) Enhancing efforts to prevent and eradicate communicable diseases, including acquired immunodeficiency syndrome (AIDS) and malaria;

(h) Establishing adequate structures for environmental health services at the local and, where appropriate, provincial levels in order to further encourage decentralization of health-related programmes and services and to take full advantage of the potentials within the sphere of the local authorities;

(i) Increasing public awareness for health aspects, especially with respect to nutrition, communicable diseases, population issues and health hazards from modern lifestyles through primary, secondary and adult education. Special effort should be made to incorporate environmental health issues in the training of all professionals directly or indirectly faced with environmental and health problems (e.g., medical professionals, architects and sanitary engineers);

(j) Enhancing multidisciplinary research into the linkages between health and environment;

(k) Assuring access, exchange and dissemination of information on health and environment parameters for everyone, with particular attention to the needs of vulnerable groups and other major groups;

(l) Ensuring that knowledge of clean technology is disseminated in such a way that it contributes to the prevention of man-made health problems, especially concerning the use of pesticides and food production and processing;

(m) Ensuring close collaboration and coordination of concerned United Nations organizations in the implementation of those priorities;

(n) Building, where possible, on the achievements of existing programmes developed individually and jointly by United Nations agencies, Governments and relevant groups in civil society;

(o) Promoting the participation of non-governmental organizations and other major groups in the health sector as important partners in the development of innovative action, and strengthening a bottom-up community involvement;

(p) Encouraging further partnerships between the public and the private sectors in health promotion and protection;

(q) Building up greater institutional capacity in the tangible implementation of those priorities from the point of conception and planning to the management and evaluation of appropriate health and environmental policies and operational elements at community, local, national, regional and international levels.

106. The Commission takes note of the relevant provisions of the Programme of Action for the Sustainable Development of Small Island Developing States and urges that adequate support be given to the overall goals of health promotion and protection identified in the Programme of Action.

107. The Commission invites the Inter-Agency Committee on Sustainable Development (IACSD) to consider in its follow-up work on chapter 6 of Agenda 21 and in the preparation of the 1997 review, the following priority areas:

(a) Supporting developing countries and economies in transition in the development of national environmental health plans as part of national sustainable development programmes; such plans should (i) address the cross-sectoral aspects of environmental health and identify action by other sectors for health protection and promotion, and (ii) emphasize the provision of environmental health services at the local level, along with the development of primary environmental care;

(b) Extending scientific and public understanding of the cumulative effects of chemicals in consumer products, plant and animal-based food, water, soil and air on human health. Those chemicals include agricultural and non-agricultural pesticides, as well as other chemicals with, inter alia, neurotoxic, immunotoxic and allergic effects. Special attention should be given to the impacts on vulnerable groups;

(c) Determining mechanisms that identify and control newly emerging infectious diseases and their possible environmental linkages;

(d) Providing a status report on the health implications of the depletion of the ozone layer based on epidemiological studies in the context of the INTERSUN project, involving, inter alia, WHO, the International Agency for Research on Cancer (IARC), the United Nations Environment Programme (UNEP) and the World Meteorological Organization (WMO), taking into account ongoing work under the Montreal Protocol;

(e) Developing an effective and efficient environmental health information system to collect and disseminate national, regional and international information on newly emerging environmental health problems by 1997.

108. The Commission requests that information on the status of community participation in the health sector be included in the report of the Secretary-General to be submitted for the 1997 review of Agenda 21.

109. The Commission invites WHO, as task manager, to continue to monitor progress made by the United Nations and other international agencies in implementing chapter 6 of Agenda 21. The Commission requests WHO to report periodically to IACSD on that matter and to make such reports available to the Commission.

110. The Commission requests countries to include in their national reports for the 1997 review session of the Commission a specific section on steps taken to promote and protect human health, highlighting the positive examples and models, indicating progress achieved and experience gained, particularly experience from which others might benefit, and the specific problems and constraints encounter specific problems and constraints encountered.

111. The Commission calls upon Governments to strengthen their commitments to the health reform process, inter alia, through national, regional and international inter-sessional meetings that focus on special linkages between the health sector and other sectors.

112. The Commission stresses the need for full implementation of the agreements on technology transfer contained in chapter 34 of Agenda 21 and the relevant decisions of the Commission. In that context, the Commission urges the international community to find concrete ways and means to transfer appropriate health-related technologies, including medical and pharmaceutical technologies, to developing countries and economies in transition.

113. The Commission urges Governments to mobilize financial resources to respond to the above priorities, as agreed in chapter 33 of Agenda 21 and the relevant decisions of the Commission.

114. The Commission invites WHO and other relevant intergovernmental bodies to take those recommendations into full account in their future work.

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