Division For Sustainable Development
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Johannesburg Plan of Implementation 

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 health-care 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 their healthy lives, 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/AIDS34 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.


34  General Assembly resolution S-26/2, annex. 


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15 December 2004