Road map to enhance health sector engagement in the Strategic Approach to International Chemicals Management towards the 2020 goal and beyond
WORKBOOK
Road map to enhance health sector engagement in the Strategic Approach to International Chemicals Management towards the 2020 goal and beyond
Chemicals Road MapWorkbook
Chemicals road map: workbook ISBN 978-92-4-151363-0
© World Health Organization 2018
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iii
CONTENTS
.............................................................................................................................................................iv
Background and context ............................................................................................. 1
About the road map ....................................................................................................... 3
Overview of the workbook ........................................................................................ 5
Step 1 Overview .................................................................................................................. 8
Guidance for completing Step 1 .......................................................................... 9
Step 1 tables for each road map action area ....................................... 11
Step 2 Overview .............................................................................................................. 42
Guidance for completing Step 2 ....................................................................... 43
Step 2 prioritization tool .......................................................................................... 44
Step 3 Overview .............................................................................................................. 50
Guidance for completing Step 3 ....................................................................... 51
Step 3 tables ........................................................................................................................ 52
Step 4 Overview ............................................................................................................... 58
Guidance for completing Step 4 ....................................................................... 59
Step 4 templates ............................................................................................................. 61
Annex 1: Useful resources ..................................................................................... 67
Annex 2: Road map ....................................................................................................... 69
Introduction
Annexes
Acknowledgements
STEP 1 Determining
potential activities
STEP 2Prioritization
STEP 3Implementation
planning
STEP 4Communication
and sharing
iv
AcknowledgementsThe World Health Organization (WHO) wishes to express its appreciation to all whose efforts made the production of this publication possible. The publication was created jointly by Victoria Tunstall (on assignment to WHO from Health Canada through a collaborative arrangement), Thomas Scalway (Lushomo), and Carolyn Vickers (WHO). This publication responds to requests from countries for assistance in using the WHO Chemicals road map.
We also acknowledge the reviews and suggestions provided by the following people at various stages during the development of this publication: Mr Charles Akong (World Health Organization, African Region), Mr Karma Wangdi (Ministry of Health, Bhutan), Ms Nina Pajovic (Ministry of Health and Social Welfare of the Republic of Srpske, Bosnia and Herzegovina), Ms Thais Cavendish (Ministry of Health, Brazil), Ms Sarah Coombs (Health Canada, Canada), Dr Dongqun Xu (National Institute of Environmental Health, China), Mr Arturo Diaz (Ministry of Health, Colombia), Ms Aive Telling (Ministry of Social Affairs, Estonia), Dr Norohasina Rakotoarison (Ministry of Public Health, Madagascar), Mr Rachid Wahabi (Ministry of Health, Morocco), Ms Maria Ines Esquivel Garcia (Ministry of Health, Panama), Dr Luis Mayorga (Ministry of Health, Panama), Mr Szymon Domagalski (Bureau for Chemical Substances, Poland), Dr Tamader Saeed Kurdi (Ministry of Health, Saudi Arabia), Dr Aminata Touré (Ministry of Health, Senegal), Mr Steffen Wengert (Federal Office of Public Health, Switzerland), Ms Amornrat Leenanithikul (Ministry of Public Health, Thailand), Professor Samwel Victor Manyele (Ministry of Health and Social Welfare, United Republic of Tanzania), Dr Tran Anh Dzung (Ministry of Health, Viet Nam), Mr Teddy Wakunuma (Ministry of Health, Zambia).
The World Health Organization gratefully acknowledges the financial support provided for this publication by the German Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety and the in-kind support provided by Health Canada through a collaborative arrangement.
1
INTRODUCTION
Background and context The engagement of all relevant sectors and stakeholders in government, intergovernmental and nongovernmental organizations (NGOs) is vital to achieve the sound management of chemicals. The health sector is central to this given its key roles and responsibilities.
As demonstrated in the 2016 WHO publication The public health impact of chemicals: knowns and unknowns (http://www.who.int/ipcs/publications/chemicals-public-health-impact/en/), chemicals management is a health issue and sound management practices can bring substantial health benefits.
The important role of the health sector in the sound management of chemicals is further recognized by the inclusion of the sound management of chemicals in health-related goals and targets under the 2030 Agenda for Sustainable Development agreed to in 2015.
The Strategic Approach to International Chemicals Management (SAICM) is a voluntary international policy framework established to foster the sound management of chemicals worldwide. It is designed to support multisectoral, multistakeholder efforts towards the goal agreed to at the 2002 World Summit on Sustainable Development that, by the year 2020, chemicals are produced and used in ways that minimize significant adverse impacts on the environment and human health.
Implementation of SAICM is overseen and monitored by the International Conference on Chemicals Management (ICCM) – a multisectoral, multistakeholder forum.
In 2016, the World Health Assembly (WHA) adopted resolution WHA69.4 entitled: The role of the health sector in the Strategic Approach to International Chemicals Management towards the 2020 goals and beyond. The resolution calls directly on ministries of health to further engage in SAICM at the national, regional and global levels.
Resolution WHA69.4 also requested WHO to develop a road map outlining concrete actions to enhance health sector engagement towards meeting the 2020 goal and contributing to relevant targets of the 2030 Agenda for Sustainable Development.
In May 2017, the Seventieth World Health Assembly approved the Road map to enhance health sector engagement in the Strategic Approach to International Chemicals Management towards the 2020 goal and beyond (the road map).
During discussion of the road map at the WHO Executive Board and the World Health Assembly, a number of countries requested assistance in implementing the road map. This workbook is intended, in part, to respond to these requests by offering a structured way to work through the road map, choose priorities and plan activities.
It is hoped that use of the workbook will facilitate the sharing of information and contribute to the identification of shared priorities and collaboration both within the health sector and with external partners.
2
WSSD 2002Johannesburg Plan of Implementation paragraph 23 sets the goal for sound management of chemicals and hazard-ous waste by 2020, and calls for the development of a “strategic approach to international chemicals management”
UNGA 66The Future We Want paragraphs 213 and 214 reaffirm the 2020 goal and SAICM
UNGA 702030 Agenda for Sustainable Development
Target12.4
Target3.9
Target6.3
ICCM1: The Strategic Approach to International Chemicals Management is
adopted
WHA56: Resolution WHA56.22 called for
inclusion of health in SAICM
ICCM3: WHO’s Strategy for strengthening the
engagement of the health sector in implementation of
SAICM is adopted
WHA59: Resolution WHA59.15 officially
recognized SAICM
WHO: Health sector priorities are updated
ICCM4: The overall orientation and guidance
document is endorsed
WHA69: Resolution WHA69.4: The role of the health sector in
SAICM towards the 2020 goal and beyond
WHA70: WHO Chemicals road map is approved
CHEMICALS SUSTAINABLE DEVELOPMENT
ICCM5 SAICM 2020 Goal
2030 Sustainable Development Goals
ICCM: International Conference on Chemicals ManagementSAICM: Strategic Approach to International Chemicals ManagementUNGA: United Nations General Assembly
WHA: World Health AssemblyWSSD: World Summit on Sustainable Development
2002
2006
2016
2017
Global policy context for the road map
2003
2012
2020
2030
2015
3
As requested in paragraph 2(1) of resolution WHA69.4 the road map was developed in consultation with Member States and others. The WHO Secretariat took into account the Strategic Approach’s Overall orientation and guidance document and the Intersessional process to prepare recommendations regarding the Strategic Approach and the sound management of chemicals and waste beyond 2020. The road map also built on WHO’s existing relevant work, as well as on the Strategy for strengthening engagement of the health sector in implementation of the Strategic Approach, with particular emphasis on the specific areas described in paragraphs 2(1)(a)–(h) of resolution WHA69.4.
The resulting road map identifies concrete actions where the health sector has either a lead or important supporting role to play in the sound management of chemicals, recognizing the need for multisectoral cooperation.
The actions are organized into four areas: risk reduction; knowledge and evidence; institutional capacity; and, leadership and coordination. Because these areas are interlinked, there are many actions that could have been included in a number of different places within the road map. To avoid repetition, each action has been included only once.
The road map was designed to be applicable to and used by Member States at all stages of development, as well as a broad range of stakeholders.
Since individual Member States and other stakeholders have different priorities, based on their specific contexts, the actions are not presented in priority order.
Furthermore, some of the actions are very broad, while others are quite specific. This variation is intentional and recognizes that Member States and other stakeholders have chosen different approaches to chemicals management and are at different stages of implementation.
The inclusion of broader actions makes it possible for countries to tailor the implementation of the road map to their own context.
Risk reduction: Reduced risk is an outcome of all the road map activities. Some activities directly reduce risk, and all activities contribute to reduced risk in the long term.
Institutional capacity: Institutional capacity develops around a base of evidence and knowledge and strong leadership. It includes legislative frameworks and proper enforcement, strong policies, guidelines, laboratories, poison centres, emergency response systems and an educated workforce.
Leadership and coordination:Is required to ensure road map actions are part of the policy/ political agenda, are adequately funded, include the contribution of multiple sectors and deliver on national and international targets.
Knowledge and evidence: Knowledge and evidence, on chem-icals, health vulnerabilities, which interventions work best, on current gaps and priorities etc, is needed to guide all the other interventions.
About the road map
Interlinkages between road map action areas
4
For each road map action, the main actor, or lead, within the health sector has been identified, as follows:
Member States (MS): These actions are mostly the responsibility of governments, with a focus on
ministries with responsibilities for human health.
The World Health Organization Secretariat (WHO Sec): The World Health Organization Secretariat holds
the lead responsibility for these actions.
All: Member States, the WHO Secretariat and other relevant intergovernmental organizations and bodies,
as well as nongovernmental organizations, industry and other stakeholders.
These different components of the health sector have varying mandates with respect to the actions identified in the road map. Nevertheless, even when an action is not completely within their mandate, they may still have an important role to play and there needs to be an awareness of the importance of the activity and active support for delivering the action. The identification of a ‘lead’ within the health sector, where possible, is intended to be helpful and facilitate progress by the health sector, not to create duplication with others.
It is hoped that the road map will be a useful tool to assist Member States and other health sector stakeholders in identifying areas of primary focus for engagement and additional actions relevant for chemicals management at the national, regional and international levels.
It is envisaged that the various components of the health sector will define their own implementation plans for this road map, which will take into account the need to engage and cooperate with others as appropriate.
In addition, the road map could be useful for identifying actions for collaboration with other sectors and for advocating action from decision-makers. Capacity-building and the need for support to implement the road map, and the value of sharing experiences, for example through regional and subregional networking, are also important considerations.
The road map contains many important actions to consider. The workbook will help you choose which ones to prioritize.
A C T I O N A R E A S
2030 Agenda for Sustainable Development
RISK REDUCTION
KNOWLEDGE AND EVIDENCE
INSTITUTIONAL CAPACITY
LEADERSHIP AND COORDINATION
Health protection strategies
Healthy health care settings
Raising awareness
Risk assessment, biomonitoring and surveillance
Measuring progress
Sharing and collaborating
National policy and regulatory frameworks
International Health Regulations (2005)
Training and education
Health in all chemicals policies
Health sector engage-ment and coordination
Engagement with other sectors and stakeholders
Overall objective of the Strategic ApproachTo achieve the sound management of chemicals throughout their life cycle so that, by 2020,
chemicals are used and produced in ways that lead to the minimization of significant adverse effects on human health and the environment.
Goal 3Target 3.9
Goal 6Target 6.3
Goal 12Target 12,4
Achieving the sound management of chemicals throughout their life cycle is a cross-cutting issue that will contribute to achieving many, if not all, 17 Sustainable Development Goals.
The targets below are only those that specifically mention chemicals.
By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
Road map to enhance health sector engagement in the strategic approach to international chemicals
management towards the 2020 goal and beyond
1. ROAD MAP
The road map lays out actions to prevent the negative impact of dangerous chemicals.
2. WORKBOOK
The workbook helps countries to prioritize and plan work on actions outlined in the road map.
3. IMPLEMENTATION PLAN
The workbook output is a high-level implementation plan. This identifies areas of focus, opportunities for collaboration and highlights where support is needed.
WHOSec
MS
All
USE OF THE WORKBOOK CAN SUPPORT A WIDE RANGE OF PROCESSES:
Regional and international National policy,
planning and budgeting
Stakeholder or sector specific
5
This workbook is designed to assist health sector planners, coordinators and policy analysts from government, civil society, industry or other organizations to use the road map to identify priorities and to plan activities around these priorities.
The final output of using the workbook is a high-level implementation plan that can be used to communicate priorities and planned activities to a variety of audiences, including decision-makers and colleagues both internally and externally.
The implementation plan can also be used to feed into broader, organization-wide, national, regional, international and/or intersectoral planning processes.
A great deal of guidance already exists on the various tasks involved in creating implementation plans as well as on various strategies and approaches for managing chemicals (see Annex 1: Useful resources). As well, stakeholders are at different stages and have varying processes and approaches to planning.
Furthermore, priority actions, objectives and the type of activities planned will differ depending on the individual stakeholder context – for example the type of stakeholder or organization, approaches to chemicals management, identified priority issues, chemicals or exposures, stage of development or level of resources.
Therefore this workbook is not intended to be an in-depth guide on how to develop an implementation plan or on specific strategies and approaches for the
many road map actions. Rather, it is intended to be a simple, practical and flexible tool to assist health sector stakeholders in using the WHO Chemicals road map.
The workbook offers a structured way to work through the road map, choose priorities and plan activities. Completing the workbook will require preliminary work and will likely be an iterative process that could take time.
As well, while the road map and this workbook are intended for the health sector, it is expected that others will need to be engaged and consulted; this could include specialists, other sectors and stakeholders, especially if their support is required to undertake an activity.
Although not covered by this workbook, consideration will need to be given on how to share experiences from using the workbook and undertaking the activities included in the resulting implementation plans, as well as measuring progress.
Use of the workbook will facilitate information sharing, identification of shared priorities and collaboration both within the health sector and with external partners.
Overview of the workbook
Before you start
To complete this workbook you will need to have a good understanding of the following:
● �The strategies and plans that already exist for chemicals management within your country or organization and the main objectives, challenges and priorities that have been identified for the health sector within these strategies or plans.
● �The main health risks and vulnerabilities in relation to chemicals management in your country or within the scope of your organization.
● �The general current level of information, evidence or engagement in each of the four road map action areas, and where are the main gaps.
● �The capacities and resources that are available or accessible.
● �Main partners for chemicals management – both within and outside the health sector – and their respective roles. This would include within your own ministry or organization, and in other ministries, organizations or sectors.
6
Introducing the 4 Steps
Four steps lead the user through a sequence for developing and sharing implementation plans
STEP 1 Determining
potential activities
During this step you will select the road map actions that are the highest priority for your organization or country, and briefly describe potential activities you would like to undertake for each action selected. This step is key and will likely take the most time. In some cases it may be useful to consult with external partners.
STEP 2Prioritization
If you have identified more activities than you can manage, this step can help you to further prioritize by considering additional criteria. It may be helpful to consult external partners to confirm their support where necessary.
STEP 3Implementation
planning
This step involves the creation of a high-level implementation plan for your prioritized activities. You will need to identify outcomes/deliverables, roles and responsibilities of partners, required resources and time frames.
STEP 4Communication
and sharing
Guidance is provided about how you can communicate your implementation plan with a variety of audiences and for a variety of purposes; for example, to colleagues, potential partners and decision-makers, both internal and external, to inform them and/or gain their support.
For each step, a table or template is provided for completion. Guidance is provided on how to complete each step, including a list of questions or things to consider.
The tables and templates for each step are available for download in MS Word and Excel at: http://www.who.int/ipcs/en/
Hard copies of the workbook can be used as a discussion tool during meetings and for taking notes, while the electronic tables and templates can be customized and shared for gathering and consolidating input electronically.
For example, for Step 1 you could organize a meeting with colleagues to discuss priority road map actions and identify potential activities. Before the meeting, you could send each person a copy of the workbook along with the electronic Step 1 table. You could ask them to complete the Step 1 table for their top 10 priority actions for discussion by the group during the meeting. You could then gather and consolidate the input using the electronic tables and circulate for comment.
When working through the steps
8
Step 1 is the key step in completing this workbook and is where most of your time will be spent. It involves going through the road map, reviewing the actions in each area of the road map and choos-ing the actions of highest priority based on your national or organizational context.
You can complete the Step 1 table for your highest priority actions by briefly summarizing the current situation, describing potential new activities and outlining any important considerations.
By the end of this step, you should have a good idea of your top road map actions and potential activities. If necessary, these potential activities can be further prioritized in Step 2.
CURRENT SITUATION
● �What is the current level of activity with respect to this action?
● �Who is involved in undertaking these activities?
● �How successful have the activities been? Has there been a lot of support, in general?
● �Are there any known major gaps or areas in need of improvement in relation to this activity?
POTENTIAL ACTIVITIES
● �What new activities could be undertaken?
● �How can potential activities address the gaps in the current situation?
TIPS FOR COMPLETING STEP 1
● �You may wish to start by doing an initial triage of all the road map actions using a simple high, medium or low rank to identify which are of most interest. Your ranking could be based on your known priorities or risks, level of resources, mandate, political realities and other factors.
● You may want to focus your initial attention on actions your organization would lead, but should not overlook any potentially important supporting roles for other actions.
● �You would then fill in the Step 1 table based on the results of your triage. You do not need to complete the Step 1 table for all 64 road map actions.
● �You can complete the Step 1 table in whatever order makes the most sense to you. For example, if you know your overall priority is institutional capacity you may wish to start reviewing the actions in this area first.
Step 1 Overview
Questions to askCONSIDERATIONS
● �What are the main milestones? What is the time frame for the activity?
● �What capacity/resources are required for carrying out these activities? Are these resources available or accessible?
● �What is the role of the health sector and/or your organization in relation to the action and potential activity?
● �What are the major opportunities or obstacles for completing this activity?
● �Who are your main partners and what is their role?
Do they have the necessary resources/capacity for this action?
● �Would completing this activity contribute to other road map actions? Are there other opportunities to leverage this activity in the short or long term?
● �Has anyone already done something similar that you could learn from?
9
CURRENT SITUATION:
In this column you would summarize or briefly describe the current situation with respect to each road map action.
POTENTIAL ACTIVITIES:
In this column, you would describe potential new activities to undertake for this road map action..
CONSIDERATIONS:
In this column, you would describe important considerations for moving forward with these activities.
ROAD MAP ACTION
MS Develop and implement health promotion and protection strategies and programmes for the life cycle of high-priority chemicals, particularly for vulnerable populations.
PRIORITY: LOW/MED/HIGH
● Lead poisoning in children is a known priority.
● Various NGOs are assisting but coverage is uneven and uncoordinated.
● Health worker knowledge and ability to diagnose and treat is uneven.
● Do not yet have legal limits on lead in paint.
CURRENT SITUATION
● Develop and implement a strategy to prevent childhood lead exposure from known sources (paint, domestic battery recycling, contaminated soil and water).
POTENTIAL ACTIVITIES
● Multifaceted e.g. regulations; education and training, monitoring, awareness campaigns; can be modified to fit available resources.
● 2 years to develop and implement plan; but work will be ongoing.
● Consult WHO guidelines on prevention of lead poisoning (links to road map action on lead).
● Some domestic resources available; external sources possible since child health is a global priority; include in National Development Plan – contact Foreign Affairs Ministry.
● May need industry engagement (paint, batteries); engaged NGOs; many opportunities to learn from others; WHO has tools/guides/expertise.
CONSIDERATIONS
ILLUSTRATIVE EXAMPLE
Guidance for completing Step 1:
11
RISK REDUCTION
Outcome:Improved health, in both the short and the long term and for future generations through the reduction of risk to health from exposure to chemicals throughout their life cycle, including as waste, resulting from increased health protection activities by the health sector at the national, regional and international level, as well as from greater interest and awareness within the health sector and in the general community.
Actions focused on risk management by and within the health sector, including health protection strategies, regulating chemicals, public education, and sharing information and best practices.
HEALTH PROTECTION STRATEGIES
HEALTHY HEALTH CARE SETTINGS
RAISING AWARENESS
Step 1 tables for each road map action area
12
910H
EA
LTH
PR
OTE
CTI
ON
STR
ATE
GIE
S
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
MS
Dev
elop
and
impl
emen
t hea
lth p
rom
otio
n an
d pr
otec
tion
stra
tegi
es a
nd p
rogr
amm
es fo
r th
e lif
e cy
cle
of h
igh-
prio
rity
che
mic
als,
par
ticul
arly
for
vuln
erab
le p
opul
atio
ns.
MS
Act
ivel
y en
gage
in a
nd s
uppo
rt th
e im
plem
en-
tatio
n of
the
chem
ical
s an
d w
aste
-rel
ated
mul
tilat
eral
en
viro
nmen
tal a
gree
men
ts, p
artic
ular
ly h
ealth
pr
otec
tive
aspe
cts.
Sup
port
ratifi
catio
n an
d im
plem
enta
tion
of th
e M
inam
ata
Conv
entio
n on
M
ercu
ry a
nd b
uild
cap
acity
to a
sses
s an
d ad
dres
s he
alth
impa
cts
of m
ercu
ry e
xpos
urei
n li
ne w
ith
reso
lutio
n W
HA6
7.11
(201
4).
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Col
labo
rate
to id
entif
y an
d pr
omot
e re
duce
d-ri
sk a
ltern
ativ
es, t
akin
g in
to a
ccou
nt th
e lif
e cy
cle
of s
ubst
ance
s an
d pr
oduc
ts, i
nclu
ding
was
te, a
nd
prom
otin
g th
e us
e of
thes
e al
tern
ativ
es.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
13
HE
ALT
H P
RO
TEC
TIO
N S
TRA
TEG
IES
WH
O
Sec
Pro
vide
gui
danc
e on
the
prev
entio
n of
neg
ativ
e he
alth
impa
cts
from
spe
cific
ch
emic
als
of c
once
rn.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
WH
O
Sec
Fin
aliz
e gu
idel
ines
on
the
prev
entio
n an
d m
anag
emen
t of l
ead
pois
onin
g; M
S Im
plem
ent f
orth
com
ing
guid
elin
es, a
nd p
hase
out
pai
nts
cont
aini
ng
lead
by
2020
as
per
the
obje
ctiv
es o
f the
G
loba
l Alli
ance
to E
limin
ate
Lead
Pai
nt.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
14
10H
EA
LTH
Y H
EA
LTH
CA
RE
SETT
ING
S
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
MS
Pro
vide
gui
danc
e fo
r hea
lth c
are
sett
ings
to
prom
ote
and
faci
litat
e th
e us
e of
saf
er a
ltern
ativ
es
and
soun
d m
anag
emen
t of h
ealth
car
e w
aste
, dr
awin
g on
rele
vant
gui
danc
e fr
om W
HO
and
ot
hers
, suc
h as
that
ado
pted
und
er m
ultil
ater
al
envi
ronm
enta
l agr
eem
ents
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Dev
elop
and
impl
emen
t aw
aren
ess
cam
paig
ns fo
r hea
lth c
are
wor
kers
abo
ut
chem
ical
s of
con
cern
and
est
ablis
hed
best
pr
actic
es fo
r saf
e ch
emic
als
man
agem
ent w
ithin
th
e he
alth
sec
tor,
incl
udin
g oc
cupa
tiona
l, pa
tient
/co
mm
unity
and
env
ironm
enta
l im
pact
s in
hea
lth
care
set
tings
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Use
WH
O g
uida
nce
to re
duce
the
use
of
mer
cury
in h
ealth
car
e an
d m
anag
e m
ercu
ry-
cont
amin
ated
was
tes
(in li
ne w
ith A
rtic
les
4,
10 a
nd 1
1 of
the
Min
amat
a Co
nven
tion
and
reso
lutio
n W
HA6
7.11
).
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
15
10R
AIS
ING
AW
AR
ENES
S
All
Dev
elop
and
laun
ch p
ublic
aw
aren
ess
cam
paig
ns fo
r prio
rity
heal
th is
sues
rela
ted
to
chem
ical
s th
roug
hout
thei
r life
cyc
le (e
.g. e
-was
te,
high
ly h
azar
dous
pes
ticid
es, l
ead,
mer
cury
and
ot
her c
hem
ical
s of
maj
or p
ublic
hea
lth c
once
rn),
occu
patio
nal h
azar
ds, c
hem
ical
s su
bjec
t to
inte
rnat
iona
l act
ions
, and
mat
erna
l and
chi
ld
heal
th.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Pro
mot
e co
mm
unic
atio
n of
rele
vant
in
form
atio
n, in
clud
ing
trai
ning
, on
chem
ical
s us
ed in
pro
duct
s an
d pr
oces
ses,
to e
nabl
e in
form
ed d
ecis
ion-
mak
ing
by a
ll ac
tors
th
roug
hout
the
prod
uct l
ife c
ycle
, and
to p
rom
ote
safe
r alte
rnat
ives
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Pub
lish
and
use
artic
les
on c
hem
ical
s-re
late
d he
alth
sec
tor i
ssue
s in
pee
r-re
view
ed
heal
th c
are,
med
ical
, tox
icol
ogy
and
othe
r re
late
d jo
urna
ls, i
nclu
ding
thos
e of
pro
fess
iona
l bo
dies
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
16
10R
AIS
ING
AW
AR
ENES
S
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
WH
O
Sec
Sup
port
dev
elop
men
t of t
he h
ealth
-re
late
d co
mpo
nent
s of
the
Stra
tegi
c Ap
proa
ch
info
rmat
ion
clea
ring
hous
e.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Doc
umen
t exp
erie
nces
with
and
eff
ectiv
enes
s of
var
ious
aw
aren
ess-
rais
ing,
risk
-re
duct
ion
actio
ns a
nd p
reve
ntio
n st
rate
gies
an
d sh
are
this
info
rmat
ion
with
oth
ers.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
17
KNOWLEDGE AND EVIDENCE
Outcome:Enhanced engagement of the health sector in cooperative efforts to fill current gaps in knowledge and methodologies for risk assessment, biomonitoring, surveillance, estimating the burden of disease, and measuring progress. This includes greater participation in networks and development of new cooperative mechanisms, as necessary, to facilitate knowledge sharing and collaboration within the health sector on specific technical issues.
Actions focused on filling gaps in knowledge and methodologies for risk assessment based on objective evidence, increasing biomonitoring and surveillance, estimating the burden of disease from chemicals, and measuring progress.
Knowledge and Evidence
RISK ASSESSMENT, BIOMONITORING
AND SURVEILLANCE
MEASURING PROGRESS
SHARING AND
COLLABORATING
18
9R
ISK
ASS
ESSM
ENT,
BIO
MO
NIT
OR
ING
AN
D S
UR
VEI
LLA
NC
E
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Eng
age
in e
ffor
ts to
fill
gaps
in s
cien
tific
know
ledg
e, in
clud
ing
wor
k ta
king
pla
ce u
nder
th
e St
rate
gic
Appr
oach
, (e.
g. o
n en
docr
ine-
activ
e ch
emic
als,
nan
omat
eria
ls, e
nvir
onm
enta
lly
pers
iste
nt p
harm
aceu
tical
s, c
ombi
ned
expo
sure
s to
mul
tiple
che
mic
als,
gen
der,
links
to n
on-
com
mun
icab
le d
isea
ses)
.
All
Con
trib
ute
to th
e de
velo
pmen
t of g
loba
lly
harm
oniz
ed m
etho
ds, a
nd n
ew to
ols
and
appr
oach
es, f
or r
isk
asse
ssm
ent (
e.g.
inte
grat
ed
appr
oach
es, c
ombi
ned
expo
sure
s to
mul
tiple
ch
emic
als)
that
take
into
acc
ount
use
pat
tern
s,
clim
atic
con
ditio
ns, g
ende
r an
d co
untr
y ca
paci
ties,
w
here
app
ropr
iate
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Inve
stig
ate
the
link
betw
een
expo
sure
and
he
alth
impa
cts
at th
e co
mm
unity
leve
l, in
clud
ing
from
pol
lutio
n an
d co
ntam
inat
ed s
ites.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
19
RIS
K A
SSES
SMEN
T, B
IOM
ON
ITO
RIN
G A
ND
SU
RV
EILL
AN
CE
MS
Iden
tify
prio
rity
che
mic
als
for
natio
nal
asse
ssm
ent a
nd m
anag
emen
t fro
m a
hea
lth
pers
pect
ive.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Wor
k to
war
ds in
tegr
ated
hea
lth a
nd
envi
ronm
enta
l mon
itori
ng a
nd s
urve
illan
ce
syst
ems
for
chem
ical
s th
roug
hout
thei
r lif
e cy
cle
at th
e na
tiona
l, re
gion
al a
nd in
tern
atio
nal l
evel
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
20
RIS
K A
SSES
SMEN
T, B
IOM
ON
ITO
RIN
G A
ND
SU
RV
EIL
LAN
CE
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
WH
O
Sec
Fac
ilita
te c
oord
inat
ion
of h
ealth
m
inis
trie
s, h
ealth
car
e es
tabl
ishm
ents
, poi
son
info
rmat
ion
cent
res,
and
oth
ers
to e
nhan
ce
toxi
covi
gila
nce/
toxi
cosu
rvei
llanc
e.
All
Fur
ther
exp
lore
the
rela
tions
hips
bet
wee
n cl
imat
e ch
ange
and
che
mic
als,
and
the
pote
ntia
l im
pact
s on
hea
lth.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
21
10M
EA
SUR
ING
PR
OG
RES
S
MS
Impr
ove
syst
ems
for c
ivil
regi
stra
tion
and
vita
l sta
tistic
s, a
nd s
tren
gthe
n sy
stem
s to
do
cum
ent c
ause
s of
hos
pita
l adm
issi
ons
and
deat
hs d
ue to
che
mic
al e
xpos
ures
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
WH
O
Sec
Dev
ise
bett
er a
nd s
tand
ardi
zed
met
hods
to
est
imat
e th
e im
pact
s of
che
mic
als
on h
ealth
fo
r im
prov
ed b
urde
n-of
-dis
ease
est
imat
es a
nd
pred
ictio
ns.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Dev
ise
bett
er a
nd s
tand
ardi
zed
met
hods
to
estim
ate
the
soci
oeco
nom
ic im
pact
of d
isea
se
from
che
mic
al e
xpos
ures
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
22
9
MEA
SUR
ING
PR
OG
RES
S
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
WH
O
Sec
Col
labo
rate
with
the
inte
rnat
iona
l co
mm
unity
to im
prov
e gl
obal
indi
cato
rs to
bet
ter
mea
sure
pro
gres
s to
war
d th
e 20
20 g
oal a
nd th
e 20
30 A
gend
a fo
r Sus
tain
able
Dev
elop
men
t with
re
spec
t to
heal
th im
pact
s of
che
mic
als.
MS
Iden
tify
and
desc
ribe
natio
nal i
ndic
ator
s of
pr
ogre
ss in
redu
cing
the
burd
en o
f dis
ease
from
ch
emic
als,
alig
ned
with
glo
bal i
ndic
ator
s w
here
po
ssib
le.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Dev
elop
mec
hani
sms
to c
olle
ct a
nd m
anag
e he
alth
dat
a an
d in
form
atio
n ne
cess
ary
for r
epor
ting
prog
ress
on
the
Stra
tegi
c Ap
proa
ch a
nd o
ther
in
tern
atio
nal i
nstr
umen
ts.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
23
10SH
AR
ING
AN
D C
OLL
AB
OR
ATI
NG
MS
Par
ticip
ate
and
activ
ely
enga
ge in
and
co
ntri
bute
to n
etw
orks
incl
udin
g th
e W
HO
Ch
emic
al R
isk
Asse
ssm
ent N
etw
ork
and
the
WH
O
INTO
X ne
twor
k of
poi
son
cent
res.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Par
ticip
ate
in o
r, if
nece
ssar
y, fo
ster
th
e cr
eatio
n of
inte
ract
ive
web
site
s an
d/or
di
scus
sion
foru
ms
for
spec
ific
issu
es r
elat
ed to
ch
emic
als
and
heal
th.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Mak
e he
alth
-rel
ated
che
mic
als
data
ava
ilabl
e (e
.g. r
isk
asse
ssm
ent,
hum
an a
nd e
nvir
onm
enta
l m
onito
ring
, dis
ease
sur
veill
ance
), w
here
pos
sibl
e an
d ap
prop
riat
e, a
nd e
asily
acc
essi
ble
to th
e lo
cal
and
inte
rnat
iona
l com
mun
ities
, inc
ludi
ng r
elev
ant
inte
rnat
iona
l sci
entifi
c an
d te
chni
cal c
omm
ittee
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
24
9
SHA
RIN
G A
ND
CO
LLA
BO
RA
TIN
G
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Col
labo
rate
with
oth
er s
cien
tific
foru
ms
stud
ying
che
mic
als
rela
ted
dise
ases
, in
part
icul
ar,
nonc
omm
unic
able
dis
ease
s.
All
Sha
re e
xper
ienc
es o
n es
tabl
ishi
ng a
nd u
sing
in
dica
tors
for
mea
suri
ng p
rogr
ess.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
25
INSTITUTIONAL CAPACITY
Outcome:Increased capacity and resilience of health systems in order to address all aspects of chemical safety.
Actions to strengthen national institutional capacities to address health threats from chemicals, including in response to chemical incidents and emergencies.
NATIONAL POLICY AND REGULATORY
FRAMEWORKS
INTERNATIONAL HEALTH
REGULATIONS (2005)
TRAINING AND
EDUCATION
Institutional Capacity
26
9
NA
TIO
NA
L P
OLI
CY
AN
D R
EGU
LATO
RY
FR
AM
EWO
RK
S
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Iden
tify
gaps
and
sup
port
str
onge
r na
tiona
l po
licy
and
regu
lato
ry fr
amew
orks
to a
ddre
ss th
e he
alth
impa
cts
of c
hem
ical
s th
roug
hout
the
life
cycl
e of
che
mic
als
with
a fo
cus
on th
e 11
bas
ic
elem
ents
set
out
in p
arag
raph
19
of th
e St
rate
gic
Appr
oach
’s or
ient
atio
n an
d gu
idan
ce d
ocum
ent.
All
Con
trib
ute
to in
tern
atio
nal e
ffor
ts to
dev
elop
to
ols
and
guid
ance
for
deve
lopi
ng n
atio
nal
fram
ewor
ks, s
uch
as th
e IO
MC
Tool
box.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Est
ablis
h he
alth
-bas
ed g
uide
lines
for
wat
er,
air,
soil,
food
, pro
duct
s, a
nd o
ccup
atio
nal
expo
sure
dra
win
g on
WH
O n
orm
s, s
tand
ards
and
gu
idel
ines
, as
appr
opri
ate,
and
par
ticip
atin
g in
th
eir
deve
lopm
ent.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
27
10N
ATI
ON
AL
PO
LIC
Y A
ND
REG
ULA
TOR
Y F
RA
MEW
OR
KS
MS
Sup
port
impl
emen
tatio
n of
the
Glo
bally
H
arm
oniz
ed S
yste
m o
f Cla
ssifi
catio
n an
d La
belli
ng o
f Che
mic
als,
coo
rdin
atin
g in
tern
atio
nally
, whe
re a
ppro
pria
te.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Sup
port
regu
latio
ns to
pre
vent
dis
char
ge
of to
xic
chem
ical
s an
d ad
voca
te a
ppro
pria
te
reco
very
and
recy
clin
g te
chno
logy
, as
wel
l as
safe
sto
rage
and
dis
posa
l, in
line
with
reso
lutio
ns
WH
A63.
25 a
nd W
HA6
3.26
(201
0), a
nd re
leva
nt
mul
tilat
eral
env
ironm
enta
l agr
eem
ents
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Sup
port
str
onge
r m
onito
ring
of p
rodu
ctio
n,
tran
spor
t, us
e an
d re
leas
es o
f haz
ardo
us
chem
ical
s an
d w
aste
, and
pro
mot
e re
gion
al a
nd
inte
rnat
iona
l coo
pera
tion
with
a v
iew
to e
nhan
cing
co
mpl
ianc
e w
ith e
xist
ing
regu
latio
ns a
nd
prev
entin
g ill
egal
traffi
c.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
28
INTE
RN
ATI
ON
AL
HEA
LTH
REG
ULA
TIO
NS
(20
05)
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Est
ablis
h/st
reng
then
cor
e ca
paci
ties
for
chem
ical
inci
dent
and
em
erge
ncy
prep
ared
ness
, de
tect
ion
and
resp
onse
, inc
ludi
ng: c
hem
ical
ev
ent s
urve
illan
ce, v
erifi
catio
n, n
otifi
catio
n, r
isk
asse
ssm
ent a
nd c
omm
unic
atio
n, a
nd in
spec
tion
capa
citie
s at
por
ts o
f ent
ry.
WH
O
Sec
Con
tinue
to d
evel
op a
nd e
nhan
ce to
ols,
gu
idan
ce a
nd o
ther
sup
port
to c
ount
ries
, in
orde
r to
str
engt
hen
core
cap
aciti
es fo
r ch
emic
al in
cide
nts
and
emer
genc
ies,
and
pro
mot
e aw
aren
ess
amon
g al
l sta
keho
lder
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
WH
O
Sec
Est
ablis
h an
inte
rnat
iona
l hea
lth
wor
kfor
ce to
be
mob
ilize
d to
res
pond
to c
hem
ical
em
erge
ncie
s, e
.g. c
ontr
ibut
e to
a W
HO
ros
ter
of
expe
rts
for
chem
ical
inci
dent
s an
d em
erge
ncie
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
29
10IN
TER
NA
TIO
NA
L H
EALT
H R
EGU
LATI
ON
S (2
00
5)
MS
Str
engt
hen
exis
ting,
and
est
ablis
h ne
w
pois
on c
entr
es a
nd n
etw
orks
, coo
rdin
atin
g as
ne
cess
ary
to a
chie
ve th
e ob
ject
ive
of a
ll co
untr
ies
havi
ng a
cces
s to
a p
oiso
n in
form
atio
n se
rvic
e.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Dev
elop
or
enha
nce
regi
onal
net
wor
ks
to c
oord
inat
e, s
tren
gthe
n an
d sh
are
exis
ting
labo
rato
ry c
apac
ity.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Impr
ove
com
mun
icat
ion
and
colla
bora
tion
betw
een
natio
nal f
ocal
poi
nts
for
the
Inte
rnat
iona
l H
ealth
Reg
ulat
ions
(200
5), t
he S
trat
egic
App
roac
h,
and
chem
ical
s-an
d w
aste
-rel
ated
mul
tilat
eral
en
viro
nmen
tal a
gree
men
ts to
leve
rage
syn
ergi
es,
e.g.
nee
d fo
r ri
sk a
sses
smen
t, su
rvei
llanc
e,
labo
rato
ry c
apac
ity a
nd r
epor
ting.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
30
TRA
ININ
G A
ND
ED
UC
ATI
ON
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Dis
sem
inat
e tr
aini
ng m
ater
ials
for t
arge
ted
audi
ence
s (e
.g. n
ongo
vern
men
tal o
rgan
isat
ions
, go
vern
men
t offi
cial
s, te
ache
rs, m
edic
al
prof
essi
onal
s, a
nd h
ealth
car
e w
orke
rs) o
n sp
ecifi
c to
pics
(e.g
. ass
essi
ng a
nd m
onito
ring
heal
th ri
sks,
ga
ther
ing
evid
ence
, dia
gnos
ing
and
trea
ting
heal
th
diso
rder
s, c
hem
ical
saf
ety
awar
enes
s, a
nd la
belli
ng).
All
Enh
ance
cur
ricul
a in
med
ical
sch
ools
and
oth
er
acad
emic
inst
itutio
ns to
add
ress
the
heal
th im
pact
s of
che
mic
als,
with
an
emph
asis
on
toxi
colo
gy a
nd
occu
patio
nal a
nd p
ublic
hea
lth, a
nd e
ncou
rage
re
side
ncie
s, fe
llow
ship
s, o
r spe
cial
izat
ions
; en
cour
age
incl
usio
n of
cur
ricul
a in
oth
er a
cade
mic
pr
ogra
mm
es th
at w
ould
pro
mot
e sa
fe a
nd
sust
aina
ble
chem
istr
y (e
.g. S
afer
by
Des
ign)
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
WH
O
Sec
Pro
vide
a p
orta
l of W
HO
trai
ning
mat
eria
ls
on c
hem
ical
s an
d he
alth
as
a co
ntri
butio
n to
the
Stra
tegi
c Ap
proa
ch in
form
atio
n cl
eari
ng h
ouse
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
31
TRA
ININ
G A
ND
ED
UC
ATI
ON
All
Lin
k he
alth
pro
fess
iona
l ass
ocia
tions
w
ith a
cade
mic
env
iron
men
tal h
ealth
or
risk
an
alys
is g
roup
s an
d in
stitu
tions
to s
tren
gthe
n en
gage
men
t on
and
know
ledg
e of
che
mic
als
man
agem
ent i
ssue
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
33
LEADERSHIP AND COORDINATION
Outcome:Increased awareness and integration of health considerations and engagement of the health sector in chemicals management activities at the national, regional and international levels, including engagement with other sectors, leading to an increased profile and priority for the global sound management of chemicals throughout their life cycle.
Actions to promote the inclusion of health considerations in all chemicals policies, engagement of the health sector in chemicals management activities at the national, regional and international levels, and engagement of the health sector with other sectors.
HEALTH IN ALL CHEMICALS POLICIES
HEALTH SECTOR ENGAGEMENT AND
COORDINATION
ENGAGEMENT WITH OTHER
SECTORS AND STAKEHOLDERS
Leadership and Coordination
34
9
HE
ALT
H IN
ALL
CH
EMIC
ALS
PO
LIC
IES
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Impr
ove
awar
enes
s of
the
heal
th im
pact
s of
ch
emic
al e
xpos
ures
thro
ugho
ut th
eir
life
cycl
e,
and
the
resu
lting
cos
ts.
MS
Pro
mot
e in
clus
ion
of h
ealth
pri
oriti
es
in c
hem
ical
s po
licie
s, g
ap a
naly
ses,
pro
files
, im
plem
enta
tion
plan
s an
d st
rate
gies
, at a
ll le
vels
, in
clud
ing
for
the
2030
Age
nda
for
Sust
aina
ble
Dev
elop
men
t.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Pur
sue
addi
tiona
l ini
tiativ
es to
mob
ilize
fin
anci
al r
esou
rces
for
the
heal
th s
ecto
r, in
clud
ing
for
WH
O, f
or th
e so
und
man
agem
ent o
f ch
emic
als
and
was
te.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
35
10H
EALT
H IN
ALL
CH
EMIC
ALS
PO
LIC
IES
All
Org
aniz
e hi
gh-le
vel b
riefi
ng s
essi
ons
on c
hem
ical
s an
d he
alth
for
polit
icia
ns a
nd
seni
or o
ffici
als
at th
e na
tiona
l, re
gion
al a
nd
inte
rnat
iona
l lev
els.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Str
engt
hen
the
chem
ical
s co
mpo
nent
of
natio
nal,
regi
onal
and
inte
rnat
iona
l hea
lth
and
envi
ronm
enta
l pro
cess
es, i
nclu
ding
at t
he
high
est l
evel
s.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Incl
ude
gend
er a
nd e
quity
as
a co
mpo
nent
in
all
polic
ies,
str
ateg
ies
and
plan
s fo
r th
e so
und
man
agem
ent o
f che
mic
als
and
was
te.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
36
9
HE
ALT
H S
ECTO
R E
NG
AG
EMEN
T A
ND
CO
OR
DIN
ATI
ON
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Nom
inat
e a
heal
th m
inis
try
cont
act p
oint
for
issu
es r
elat
ed to
che
mic
als
and
heal
th in
clud
ing
impl
emen
tatio
n of
this
roa
d m
ap, a
nd e
stab
lish
a na
tiona
l che
mic
als
and
heal
th n
etw
ork.
WH
O
Sec
Est
ablis
h a
glob
al c
hem
ical
s an
d he
alth
ne
twor
k, w
ith li
nks
to e
xist
ing
subr
egio
nal,
regi
onal
an
d in
tern
atio
nal n
etw
orks
, to
faci
litat
e he
alth
se
ctor
impl
emen
tatio
n of
this
roa
d m
ap (i
nclu
ding
pa
rtic
ipat
ion
in th
e St
rate
gic
Appr
oach
).
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Par
ticip
ate
in a
nd p
rom
ote
the
incl
usio
n of
hea
lth s
ecto
r pr
iori
ties
in th
e in
ters
essi
onal
pr
oces
s to
pre
pare
rec
omm
enda
tions
reg
ardi
ng
the
Stra
tegi
c Ap
proa
ch a
nd th
e so
und
man
agem
ent o
f che
mic
als
and
was
te b
eyon
d 20
20.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
37
HEA
LTH
SEC
TOR
EN
GA
GEM
ENT
AN
D C
OO
RD
INA
TIO
N
MS
Par
ticip
ate
activ
ely
in d
ecis
ion
mak
ing
and
supp
ort s
tren
gthe
ning
of n
atio
nal p
olic
y an
d re
gula
tory
fram
ewor
ks r
elev
ant f
or c
hem
ical
s an
d he
alth
.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Eng
age
in n
atio
nal,
regi
onal
, and
in
tern
atio
nal c
hem
ical
s fo
rum
s, in
clud
ing
for
Stra
tegi
c Ap
proa
ch e
mer
ging
pol
icy
issu
es
and
othe
r is
sues
of c
once
rn a
s w
ell a
s fo
r no
ncom
mun
icab
le d
isea
ses.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Impl
emen
t the
str
ateg
y fo
r st
reng
then
ing
the
enga
gem
ent o
f the
hea
lth s
ecto
r in
the
impl
emen
tatio
n of
the
Stra
tegi
c Ap
proa
ch a
nd
prom
ote
it to
oth
ers.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
38
ENG
AG
EMEN
T W
ITH
OTH
ER S
ECTO
RS
AN
D S
TAK
EHO
LDER
S
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
MS
Par
ticip
ate
in a
nd e
ncou
rage
the
deve
lopm
ent
of s
usta
inab
le, e
ffec
tive
and
oper
atio
nal
mul
tisec
tora
l coo
rdin
atio
n ne
twor
ks to
max
imiz
e co
llect
ive
effor
ts, a
s en
visa
ged
by th
e St
rate
gic
Appr
oach
.
All
Fac
ilita
te in
clus
ion
and
activ
e pa
rtic
ipat
ion
of
all r
elev
ant s
ecto
rs a
nd s
take
hold
ers
in c
hem
ical
s m
anag
emen
t thr
ough
out t
he li
fe c
ycle
, at a
ll le
vels
, w
hile
rec
ogni
zing
the
shar
ed le
ader
ship
of t
he
heal
th a
nd e
nvir
onm
ent s
ecto
rs.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Hig
hlig
ht th
e m
ultis
ecto
ral i
mpa
ct th
at
heal
th in
vest
men
ts c
an h
ave
on e
cono
mie
s an
d co
mm
uniti
es.
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
39
10EN
GA
GEM
ENT
WIT
H O
THER
SEC
TOR
S A
ND
STA
KEH
OLD
ERS
All
Bui
ld c
apac
ity w
ithin
the
heal
th s
ecto
r fo
r m
ulti-
sect
oral
eng
agem
ent a
nd lo
ok fo
r op
port
uniti
es to
sha
re in
form
atio
n, h
arm
oniz
e an
d le
vera
ge e
ffor
ts o
f net
wor
ks in
oth
er s
ecto
rs.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
All
Act
ivel
y en
gage
in r
elev
ant r
egio
nal
and
inte
rnat
iona
l neg
otia
tions
, inc
ludi
ng
thos
e re
late
d to
mul
tilat
eral
env
iron
men
tal
agre
emen
ts, d
evel
opm
ent fi
nanc
ing
and
tech
nica
l coo
pera
tion,
and
, whe
re p
ossi
ble
and
appr
opri
ate,
est
ablis
h a
stan
ding
item
to
disc
uss
issu
es r
elat
ing
to th
e he
alth
sec
tor.
PR
IOR
ITY:
LO
W /
MED
/ H
IGH
CU
RR
ENT
SITU
ATI
ON
PO
TEN
TIA
L A
CTI
VIT
IES
CO
NSI
DE
RA
TIO
NS
AC
TIO
N
42
● �Does the activity contribute to one or more identified national or organizational priority? Does it contribute to more than one road map action?
● �You may have additional criteria to consider based on your national or organizational context.
● �What is the likelihood of successful completion of the activity? This could depend on a number of factors, such as, ability to get sufficient resources, willingness/capacity of partners, and political support.
● �Are there risks (or potential negative outcomes) associated with undertaking this activity? How large are they? How likely are they to happen?
● �If the activity is successful, what is the likely impact in terms of improving health outcomes?
● �Is the activity modifiable in the case of unforeseen circumstances (e.g. lack of partner support or a reduction in resources)? How time sensitive is the issue?
Flexibility:
Likely impact:
Opportunity to leverage:
Others:
Feasibility:
Risks:
This step provides a structure and a process that prompts you to think critically and more objectively about each potential activity.
Step 2 Overview
While the final scores may be helpful, the analytical process required to weight criteria and compare activities is the most important component of this exercise. In the end, you may still choose to work on an activity that scored lower than others, but your reasons for making this decision will be clearer.
For example, there may be situations where it is appropriate to choose to work on a lower priority activity because it is more likely to succeed and have a positive outcome than a risky higher priority item. Alternately, if the outcome of an activity is uncertain but it is determined to be more urgent with a greater potential for positive impact, it still may be chosen ahead of another more predictable activity.
It may be helpful to consult with partners, especially if you would require their support to carry out the activity.
Potential prioritization criteria
This optional step involves a review of your ‘potential activities’ from Step 1 to determine which will move forward to Step 3 and become ‘planned activities’.
If you feel you already have a manageable number of activities, you can skip Step 2 and go directly to Step 3.
For this exercise, you will choose criteria that are important in your decision-making process and assign a quantitative weight to them based on their relative importance. You will then score each activity for the criteria and add the scores. A higher score should point to a higher priority activity.
Guidance for completing Step 2:The Step 2 tool is an optional step for further prioritizing your activities. If your top priority actions and activities are clear and the number of activities is manageable, you could move directly to the Step 3 implementation planning tables.
POTENTIAL ACTIVITY
CRITERIA
PRIORITY SCORE
Opportunity to
leverageFeasibility Flexibility Likely
impact Low risk
WEIGHTING 15 25 15 25 20 100
Develop and implement a strategy to prevent childhood lead exposure
12 18 15 22 10 77/100
Design a medical waste disposal protocol 7 20 5 12 17 61/100
Create a public awareness campaign addressing mercury usage
8 21 10 12 15 66/100
ILLUSTRATIVE EXAMPLE:
POTENTIAL ACTIVITIES: Enter the potential activities that need to be further prioritized in the first column of the table.
CRITERIA: Identify which criteria are the most important for you (i.e. your country, government department or organization). Enter these as the column headings under ‘criteria’ in the table.
WEIGHTING: For each activity, assign a score for each of the criterion. Add the scores together and enter the total in the last column. Higher scores should point to higher priority items and this should help you choose a manageable number of priority activities to carry forward to implementation planning in step 3.
43
Risk Reduction
PO
TEN
TIA
L A
CTI
VIT
Y
CR
ITER
IA*
P
RIO
RIT
Y
SCO
RE
WEI
GH
TIN
G**
* Cr
iteria
are
to b
e us
er d
efin
ed.
** W
eigh
ting
to b
e de
cide
d by
use
rs.
44
Step
2 p
rior
itiz
atio
n to
ol
PO
TEN
TIA
L A
CTI
VIT
Y
CR
ITER
IA*
P
RIO
RIT
Y
SCO
RE
WEI
GH
TIN
G**
* Cr
iteria
are
to b
e us
er d
efin
ed.
** W
eigh
ting
to b
e de
cide
d by
use
rs.
45
PO
TEN
TIA
L A
CTI
VIT
Y
CR
ITER
IA*
P
RIO
RIT
Y
SCO
RE
WEI
GH
TIN
G**
* Cr
iteria
are
to b
e us
er d
efin
ed.
** W
eigh
ting
to b
e de
cide
d by
use
rs.
46
PO
TEN
TIA
L A
CTI
VIT
Y
CR
ITER
IA*
P
RIO
RIT
Y
SCO
RE
WEI
GH
TIN
G**
* Cr
iteria
are
to b
e us
er d
efin
ed.
** W
eigh
ting
to b
e de
cide
d by
use
rs.
47
50
This step provides a simple tool for starting to define implementation plans for the activities you have prioritized in Step 1 and/or Step 2.
During this step you will complete a high-level road map implementation plan by outlining outputs, roles, partners and responsibilities, resources and timelines for each activity.
Step 3 Overview
Planning and measurement methods for each country are likely to differ, to link to a number of existing national processes, and to be overseen by mechanisms that are unique for each setting, The tools in this workbook are general, basic and adaptable.
A more detailed implementation plan may then be developed to break each activity into identifiable steps, and then, for each step, it would assign responsibilities, identify resources and suggest when each should be completed. Consideration would also be given to how progress and performance could be measured.
The implementation plan you create will summarize your priority activities, help to identify areas of focus, highlight opportunities for collaboration and indicate where further support is needed.
TIMELINE �Outlining the time frame for each activity is important to ensure that the overall workload associated with the implementation plan is manageable for all involved. A Gantt chart can be a useful way of representing this visually. It may also be helpful to map the timeline against resource availability.
PARTNERS �Partners and stakeholders for each activity may come from various parts of government, civil society, the business sector and a range of other groups. It will be important to identify who your partners are and determine their needs, interests and potential roles.
OUTPUTS �You will need a clear concept of the intended outputs for each activity. This will also be helpful for undertaking a more detailed planning process.
RESOURCES � �Resources (or ‘inputs’) may include financial, people and skills (human
resources), and various kinds of institutional capacity. You will need to have an idea of resources available and/or required for each activity. It may also be helpful to identify potential opportunities for new or additional resources.
Things to consider
51
ACTIVITIES
Develop and implement a strategy to prevent childhood lead exposure.
Guidance for completing Step 3:
● A step-by-step guide to preventing childhood lead exposure.
● Regulations to restrict the levels of lead in paint.
OUTPUT
● 2018–2020 (6 months to develop strategy; 18–24 months to implement).
TIMELINE
In this step, the prioritized activities from Steps 1 and/or 2 are transferred into the Step 3 table to form part of a high-level implementation plan. For each planned activity the user will define the output; roles, partners and responsibilities; resources required or available; and the timeline for completion.
ACTIVITIES: These are the activities that were prioritized during Steps 1 and 2.
OUTPUT: What will be delivered as a result of the activity? This could be a document, a study, a campaign, a guideline, etc.
ROLES, PARTNERS AND RESPONSIBILITIES: Who needs to be involved in completing this activity and what are their roles and responsibilities?
RESOURCES: What resources are available and what resources are still required in order to complete the activity?
TIMELINE: This would indicate when the activity will be carried out and does not need to be precise.
● Some internal resources are available.
● Possibility for international assistance.
● Strategy will need to be scalable to resource availability.
RESOURCES
● Department of Health: To draft document and coordinate implementation.
● Department of Education: To assist with communication strategies for target audiences.
● Industry: To provide input on and comply with regulations restricting lead in products, including paints.
● Nongovernmental organizations: To provide expertise and assist with roll-out of specific activities.
ROLES, PARTNERS AND RESPONSIBILITIES
ILLUSTRATIVE EXAMPLE:
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The implementation plan created in Step 3 can be used to communicate priorities and planned activities to a variety of audiences, including de-cision-makers and colleagues both internally and externally. It can also be used to feed into broader, organization-wide, national, regional, international and/or intersectoral planning processes.
This part of the workbook offers general guidance on communication along with some example templates that could be used to communicate your plan to different audiences.
Step 4 Overview
Principles for effective communication of road map implementation plans
Given the diversity of potential audiences, detailed guidance on communication plans and strategies is not provided here. However, below are some basic principles for effective communication (adapted from WHO Princi-ples for effective communications, 2017).
● �The content needs to be tailored for the intended au-dience. For example, high-level decision-makers might want headline points and budget implications whereas programme managers might be more interested in the mechanics of implementation.
● �The information needs to be written in a clear, concise and simple manner.
● �It is important that the information is relevant, up-to-date and accessible for its intended audience in terms of language and format.
Sharing your plans widely will help in identifying shared priorities and opportunities for collaboration. You are encouraged to share your implementation plan with WHO and others.
The templates are available for download in MS Word and Excel at: http://www.who.int/ipcs/en/
Template 1: Detailed Grid
● �This template provides a structured way to share basic information about planned activities in each of the four road map areas. In the example provided you would insert timeline and outcome information but the headings could be changed to suit your needs. (see next page)
Template 2: Activities Grid
● �In this template you would briefly summarize planned activities in each of the four road map areas. You could also include some key information that would be of interest to your audience for example costs and timeline. (see next page)
Template 3: Action Area Grids
● �This template involves separate grids for each of the four road map areas. This template might be useful if your planned activities are concentrated in only one or two road map areas. (see next page)
Example templates to present your implementation plan
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Guidance for completing Step 4:
Template 1: Detailed Grid SUMMARY DIAGRAM OF PLANNED ACTIVITIES
ACTION AREA ACTIVITY TIMELINE OUTCOME
RISK REDUCTION
KNOWLEDGE AND
EVIDENCE
INSTITUTIONAL CAPACITY
LEADERSHIP AND
COORDINATION
HEALTHY HEALTH CARE SETTINGS
RAISING AWARENESS
HEALTH PROTECTION STRATEGIES
Template 3 Action area activity grid
Template 2: Simple Activities Grid SUMMARY DIAGRAM OF PLANNED ACTIVITIES
INSTITUTIONAL CAPACITY
●
●
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KNOWLEDGE AND EVIDENCE
●
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LEADERSHIP AND COORDINATION
●
●
●
RISK REDUCTION
●
●
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IDENTIFY TARGET AUDIENCE
Essential to effective communications is identifying for whom the message is intended and ensuring you understand what information will be of most interest to them.
TAILOR YOUR MESSAGE Once a target audience has been identified, key messages from the implementation plan must be tailored to their interests and summarized clearly and concisely.
SELECT A TEMPLATE
You will also need to decide how to visually present the key messages to the target audience. Three examples are offered in the workbook but many other options are possible.
1 2 3
Template 1: Detailed Grid
SUMMARY OF PLANNED ACTIVITIES
Template 3 Action Area Grid
SUMMARY OF PLANNED ACTIVITIES
Template 2: Activities GridSUMMARY OF PLANNED ACTIVITIES
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SUMMARY OF PLANNED ACTIVITIES
ACTION AREA ACTIVITY TIMELINE OUTCOME
RISK REDUCTION
KNOWLEDGE AND
EVIDENCE
INSTITUTIONAL CAPACITY
LEADERSHIP AND
COORDINATION
Template 1: Detailed Grid
Step 4 templates
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RAISING AWARENESS
HEALTH PROTECTION STRATEGIES
HEALTHY HEALTH CARE SETTINGS
SUMMARY OF PLANNED ACTIVITIES
Template 3: Action Area Grid
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Knowledge and Evidence
RISK ASSESSMENT, BIOMONITORING
AND SURVEILLANCE
MEASURING PROGRESS
SHARING AND
COLLABORATING
SUMMARY OF PLANNED ACTIVITIES
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Institutional Capacity
NATIONAL POLICY AND REGULATORY
FRAMEWORKS
INTERNATIONAL HEALTH REGULATIONS (2005)
TRAINING AND EDUCATION
SUMMARY OF PLANNED ACTIVITIES
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Leadership and Coordination
HEALTH IN ALL CHEMICALS POLICIES
HEALTH SECTOR ENGAGEMENT
AND COORDINATION
ENGAGEMENT WITH OTHER SECTORS
AND STAKEHOLDERS
SUMMARY OF PLANNED ACTIVITIES
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GAP ANALYSES, CAPACITY ASSESSMENTS, PRIORITIZATION
General resources that could be useful for detailed gap analyses, capacity assessments or implementation planning.
● UNEP/UNITAR: Guidance for developing SAICM implementation plans (2009 edition)
This document outlines a range of possible activities and provides practical suggestions, using country-based case studies or examples where possible, including for: establishment of a coordination mechanism and organizational considerations; assessment of infrastructure and capacity; development of action plans, and implementation issues.
http://www.who.int/iomc/publications/publications/en/ (Arabic, Chinese, English, French, Russian, Spanish)
● UNITAR: Preparing a national profile to assess infrastructure and capacity needs for chemicals management - guidance document (2nd edition 2012)
This document provides an overview of the issues and information to consider in developing a national chemicals profile. To access this document and to find out if your country already has a national profile visit:
http://cwm.unitar.org/national-profiles/nphomepage/np3_region.aspx (English, French, Spanish)
GENERAL GUIDANCE
● IOMC: IOMC Toolbox
The IOMC Internet-based Toolbox for decision making in chemicals management identifies additional IOMC resources that will help countries address specific identified national problem(s) or objectives.
Issues covered include: pollutant release and transfer registers (PRTRs) scheme; national management scheme for pesticides; occupational safety and health management scheme for chemicals; chemical accident prevention, preparedness and response; industrial chemicals management scheme; public health management of chemicals; and classification and labelling system management scheme.
To reach the IOMC resources for each specific issue, from the link below click on the circle beside ‘Gap Analysis’ and then click on the circle beside ‘Management objective selection.’
http://iomctoolbox.oecd.org (English only)
● IOMC: National implementation of SAICM: A guide to resource, guidance, and training materials of IOMC participating organisations (2012 edition)
This document provides a useful overview of the various IOMC participating organizations and their roles in chemicals management. Additionally, it provides a listing of resources and tools that could be helpful in road map implementation.
http://www.who.int/iomc/publications/publications/en/ (English and French)
IMPLEMENTATION PLANNING
● UNITAR/UNDP: Guidance on action plan development for sound chemicals management, guidance document (2009 edition)
This document provides a basic overview of the steps involved in developing an action plan, which could be helpful in developing specific project plans for each of your planned activities.
http://cwm.unitar.org/national-profiles/publications/cw/pops/AP_Guidance_01_Apr_09_en.pdf (Arabic, Chinese, English, French, Russian, Spanish)
● UNITAR: Resource mobilization for the sound management of chemicals and waste, guidance document (June 2011 edition)
Chapters 4 and 5 of this document provide general but useful guidance on how to develop and implement a national resource mobilization strategy.
http://cwm.unitar.org/national-profiles/publications/cw/inp/RMS_Guidance_June2011.pdf (English, French, Russian)
ANNEX 1 USEFUL RESOURCES
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BACKGROUND DOCUMENTS
References for further reading:
● Resolution WHA69.4: The role of the health sector in the Strategic Approach to International Chemicals Management towards the 2020 goal and beyond http://www.who.int/ipcs/publications/wha/A69_ R4-en.pdf?ua=1
● A69/19 Role of the health sector in the sound management of chemicals – Report by the WHO Secretariat, 4 March 2016. http://apps.who.int/gb/e/e_wha69.html
● The public health impact of chemicals: knowns and unknowns (2016) http://www.who.int/ipcs/publications/chemicals- public-health-impact/en/#
● Priorities of the health sector towards achievement of the 2020 goal of sound chemicals management (2015) http://www.who.int/ipcs/saicm/saicm/en/
● Strategic Approach’s Overall orientation and guidance for achieving the 2020 goal (2015) www.saicm.org
● Strategy for strengthening the engagement of the health sector in the implementation of the Strategic Approach (2012) http://www.who.int/ipcs/saicm/saicm/en/
● 2030 Agenda for Sustainable Development (2015) http://www.un.org/sustainabledevelopment/ sustainable-development-goals/
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AC T I O N A R E A S
2030 Agenda for Sustainable Development
RISK REDUCTION
KNOWLEDGE AND EVIDENCE
INSTITUTIONAL CAPACITY
LEADERSHIP AND COORDINATION
Health protection strategies
Healthy health care settings
Raising awareness
Risk assessment, biomonitoring and surveillance
Measuring progress
Sharing and collaborating
National policy and regulatory frameworks
International Health Regulations (2005)
Training and education
Health in all chemicals policies
Health sector engage-ment and coordination
Engagement with other sectors and stakeholders
Overall objective of the Strategic ApproachTo achieve the sound management of chemicals throughout their life cycle so that, by 2020,
chemicals are used and produced in ways that lead to the minimization of significant adverse effects on human health and the environment.
Target 3.9Goal 6Target 6.3
Goal 12Target 12,4
Goal 3
Achieving the sound management of chemicals throughout their life cycle is a cross-cutting issue that will contribute to achieving many, if not all, 17 Sustainable Development Goals.
The targets below are only those that specifically mention chemicals.
By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous chemicals and materials, halving the proportion of untreated wastewater and substantially increasing recycling and safe reuse globally
By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
ANNEX 2 Road map to enhance health sector engagement
in the strategic approach to international chemicals management towards the 2020 goal and beyond
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RISK REDUCTIONActions focused on risk management by and within the health sector, including health protection strategies, regulating chemicals, public education, and sharing information and best practices.
HEALTH PROTECTION STRATEGIES
Develop and launch public awareness campaigns for priority health issues related to chemicals throughout their life cycle (e.g. e-waste, highly hazardous pesticides, lead, mercury and other chemicals of major public health concern), occupational hazards, chemicals subject to international actions, and maternal and child health.
Promote communication of relevant information, including training, on chemicals used in products and processes, to enable informed decision-making by all actors throughout the product life cycle, and to promote safer alternatives.
Publish and use articles on chemicals-related health sector issues in peer-reviewed health care, medical, toxicology and other related journals, including those of professional bodies.
Support development of the health-related components of the Strategic Approach information clearing house.†
Document experiences with and effectiveness of various awareness-raising, risk-reduction actions and prevention strategies and share this information with others.
RAISING AWARENESS
Develop and implement health promotion and protection strategies and programmes for the life cycle of high-priority chemicals, particularly for vulnerable populations.
Actively engage in and support the implementation of the chemicals- and waste-related multilateral environmental agreements, particularly health protective aspects. Support ratification and implementation of the Minamata Convention on Mercury and build capacity to assess and address health impacts of mercury exposure in line with resolution WHA67.11 (2014).
Collaborate to identify and promote reduced-risk alternatives, taking into account the life cycle of substances and products, including waste, and promoting the use of these alternatives.
Provide guidance on the prevention of negative health impacts from specific chemicals of concern.
Finalize guidelines on the prevention and management of lead poisoning; Implement forthcoming guidelines, and phase out paints containing lead by 2020 as per the objectives of the Global Alliance to Eliminate Lead Paint.
Outcome:Improved health, in both the short and the long term and for future generations through the reduction of risk to health from exposure to chemicals throughout their life cycle, including as waste, resulting from increased health protection activities by the health sector at the national, regional and international level, as well as from greater interest and awareness within the health sector and in the general community.
All: all stakeholders; MS: Member States; WHO Sec: WHO Secretariat.† Actions that are within the mandate of the WHO Secretariat and also contribute to increasing the capacity of the secretariat of the Strategic Approach to support activities related to the health sector in line with resolution WHA69.4. For actions with more than one lead actor, this note applies only to the WHO Secretariat’s role.
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All
All
All
All
All
Provide guidance for health care settings to promote and facilitate the use of safer alternatives and sound management of health care waste, drawing on relevant guidance from WHO and others, such as that adopted under multilateral environmental agreements.
Develop and implement awareness campaigns for health care workers about chemicals of concern and established best practices for safe chemicals management within the health sector, including occupational, patient/community and environmental impacts in health care settings.
Use WHO guidance to reduce the use of mercury in health care and manage mercury-contaminated wastes (in line with Articles 4, 10 and 11 of the Minamata Convention and resolution WHA67.11).
MS
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HEALTHY HEALTH CARE SETTINGS
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KNOWLEDGE AND EVIDENCEActions focused on filling gaps in knowledge and methodologies for risk assessment based on objective evidence, increasing biomonitoring and surveillance, estimating the burden of disease from chemicals, and measuring progress.
Outcome:Enhanced engagement of the health sector in cooperative efforts to fill current gaps in knowledge and methodologies for risk assessment, biomonitoring, surveillance, estimating the burden of disease, and measuring progress. This includes greater participation in networks and development of new cooperative mechanisms, as necessary, to facilitate knowledge sharing and collaboration within the health sector on specific technical issues.
MEASURINGPROGRESS
Improve systems for civil registration and vital statistics, and strengthen systems to document causes of hospital admissions and deaths due to chemical exposures.
Devise better and standardized methods to estimate the impacts of chemicals on health for improved burden-of-disease estimates and predictions.
Devise better and standardized methods to estimate the socioeconomic impact of disease from chemical exposures.
Collaborate with the international community to improve global indicators to better measure progress toward the 2020 goal† and the 2030 Agenda for Sustainable Development with respect to health impacts of chemicals.
Identify and describe national indicators of progress in reducing the burden of disease from chemicals, aligned with global indicators where possible.
Develop mechanisms to collect and manage health data and information necessary for reporting progress on the Strategic Approach† and other international instruments.
MS
MS
MS
MS
All
All
SHARING AND COLLABORATING Participate and actively engage in and contribute to networks including the WHO Chemical Risk Assessment Network and the WHO INTOX network of poison centres.
Participate in or, if necessary, foster the creation of interactive websites and/or discussion forums for specific issues related to chemicals and health.
Make health-related chemicals data available (e.g. risk assessment, human and environmental monitoring, disease surveillance), where possible and appropriate, and easily accessible to the local and international communities, including relevant international scientific and technical committees.
Collaborate with other scientific forums studying chemicals related diseases, in particular, non-communicable diseases.
Share experiences on establishing and using indicators for measuring progress.
MS
All
MS
All
All
Engage in efforts to fill gaps in scientific knowledge, including work taking place under the Strategic Approach, (e.g. on endocrine-active chemicals, nanomaterials, environmentally persistent pharmaceuticals, combined exposures to multiple chemicals, gender, links to non-communicable diseases).
Contribute to the development of globally harmonized methods, and new tools and approaches, for risk assessment (e.g. integrated approaches, combined exposures to multiple chemicals) that take into account use patterns, climatic conditions, gender and country capacities, where appropriate.
Investigate the link between exposure and health impacts at the community level, including from pollution and contaminated sites.
Identify priority chemicals for national assessment and management from a health perspective.
Work towards integrated health and environmental monitoring and surveillance systems for chemicals throughout their life cycle at the national, regional and international levels.
Facilitate coordination of health ministries, health care establishments, poison information centres, and others to enhance toxicovigilance/toxicosurveillance.
Further explore the relationships between climate change and chemicals, and the potential impacts on health.
All
All
All
RISK ASSESSMENT, BIOMONITORING AND SURVEILLANCE
All
MS
MS
MS WHOSec
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Establish/strengthen core capacities for chemical incident and emergency preparedness, detection and response, including: chemical event surveillance, verification, notification, risk assessment and communication, and inspection capacities at ports of entry.
Continue to develop and enhance tools, guidance and other support to countries, in order to strengthen core capacities for chemical incidents and emergencies, and promote awareness among all stakeholders.
Establish an international health workforce to be mobilized to respond to chemical emergencies, e.g. contribute to a WHO roster of experts for chemical incidents and emergencies.
Strengthen existing, and establish new poison centres and networks, coordinating as necessary to achieve the objective of all countries having access to a poison information service.
Develop or enhance regional networks to coordinate, strengthen and share existing laboratory capacity.
Improve communication and collaboration between national focal points for the International Health Regulations (2005), the Strategic Approach, and chemicals-and waste-related multilateral environmental agreements to leverage synergies, e.g. need for risk assessment, surveillance, laboratory capacity and reporting.
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INSTITUTIONAL CAPACITYActions to strengthen national institutional capacities to address health threats from chemicals, including in response to chemical incidents and emergencies.
Outcome:Increased capacity and resilience of health systems in order to address all aspects of chemical safety.
Disseminate training materials for targeted audiences (e.g. nongovernmental organisations, government officials, teachers, medical professionals, and health care workers) on specific topics (e.g. assessing and monitoring health risks, gathering evidence, diagnosing and treating health disorders, chemical safety awareness, and labelling).
Enhance curricula in medical schools and other academic institutions to address the health impacts of chemicals, with an emphasis on toxicology and occupational and public health, and encourage residencies, fellowships, or specializations; encourage inclusion of curricula in other academic programmes that would promote safe and sustainable chemistry (e.g. Safer by Design).
Provide a portal of WHO training materials on chemicals and health as a contribution to the Strategic Approach information clearing house.†
Link health professional associations with academic environmental health or risk analysis groups and institutions to strengthen engagement on and knowledge of chemicals management issues.
All
All
All
TRAINING AND EDUCATION
MS
MS
MS
MS
MS
INTERNATIONAL HEALTH REGULATIONS (2005)
Identify gaps and support stronger national policy and regulatory frameworks to address the health impacts of chemicals throughout the life cycle of chemicals with a focus on the 11 basic elements set out in paragraph 19 of the Strategic Approach’s orientation and guidance document.
Contribute to international efforts to develop tools and guidance for developing national frameworks, such as the IOMC Toolbox.
Establish health-based guidelines for water, air, soil, food, products, and occupational exposure drawing on WHO norms, standards and guidelines, as appropriate, and participating in their development.
Support implementation of the Globally Harmonized System of Classification and Labelling of Chemicals, coordinating internationally, where appropriate.
Support regulations to prevent discharge of toxic chemicals and advocate appropriate recovery and recycling technology, as well as safe storage and disposal, in line with resolutions WHA63.25 and WHA63.26 (2010), and relevant multilateral environmental agreements.
Support stronger monitoring of production, transport, use and releases of hazardous chemicals and waste, and promote regional and international cooperation with a view to enhancing compliance with existing regulations and preventing illegal traffic.
MS
MS
MS
MS
MS
NATIONAL POLICY AND REGULATORY FRAMEWORKS
All
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Participate in and encourage the development of sustainable, effective and operational multisectoral coordination networks to maximize collective efforts, as envisaged by the Strategic Approach.
Facilitate inclusion and active participation of all relevant sectors and stakeholders in chemicals management throughout the life cycle, at all levels, while recognizing the shared leadership of the health and environment sectors.
Highlight the multisectoral impact that health investments can have on economies and communities.
Build capacity within the health sector for multi-sectoral engagement and look for opportunities to share information, harmonize and leverage efforts of networks in other sectors.
Actively engage in relevant regional and international negotiations, including those related to multilateral environmental agreements, development financing and technical cooperation, and, where possible and appropriate, establish a standing item to discuss issues relating to the health sector.
ENGAGEMENT WITH OTHER SECTORS AND STAKEHOLDERS
LEADERSHIP AND COORDINATIONActions to promote the inclusion of health considerations in all chemicals policies, engagement of the health sector in chemicals management activities at the national, regional and international levels, and engagement of the health sector with other sectors.
Outcome:Increased awareness and integration of health considerations and engagement of the health sector in chemicals management activities at the national, regional and international levels, including engagement with other sectors, leading to an increased profile and priority for the global sound management of chemicals throughout their life cycle.
MS
All
All
All
All
HEALTH IN ALL CHEMICALS POLICIES
Improve awareness of the health impacts of chemical exposures throughout their life cycle, and the resulting costs.
Promote inclusion of health priorities in chemicals policies, gap analyses, profiles, implementation plans and strategies, at all levels, including for the 2030 Agenda for Sustainable Development.
Pursue additional initiatives to mobilize financial resources for the health sector, including for WHO, for the sound management of chemicals and waste.
Organize high-level briefing sessions on chemicals and health for politicians and senior officials at the national, regional and international levels.†
Strengthen the chemicals component of national, regional and international health and environmental processes, including at the highest levels.
Include gender and equity as a component in all policies, strategies and plans for the sound management of chemicals and waste.
All
MS
All
All
All
All
Nominate a health ministry contact point for issues related to chemicals and health including implementation of this road map, and establish a national chemicals and health network.
Establish a global chemicals and health network, with links to existing subregional, regional and international networks, to facilitate health sector implementation of this road map (including participation in the Strategic Approach†).
Participate in and promote the inclusion of health sector priorities in the intersessional process to prepare recommendations regarding the Strategic Approach and the sound management of chemicals and waste beyond 2020.
Participate actively in decision making and support strengthening of national policy and regulatory frameworks relevant for chemicals and health.
Engage in national, regional, and international chemicals forums, including for Strategic Approach emerging policy issues and other issues of concern as well as for noncommunicable diseases.
Implement the strategy for strengthening the engagement of the health sector in the implementation of the Strategic Approach and promote it to others.
MS
MS
MS
MS
All
HEALTH SECTOR ENGAGEMENT AND COORDINATION
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