European Environment and Health priorities

29 November 2017

John F Ryan

Director Public Health

What's the basis for EU health action? 1

• As always, EU action has its roots in the EU treaties.

• Article 168 provides that a high level of human health protection shall be ensured in the definition and implementation of all Union policies.

What's the basis for EU Health action? 2

• Union action shall be directed to improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health, covering the major health scourges.

• Promoting research into causes, transmission and prevention, health information and education, early warning and combatting cross border threats.

How?

• For the areas mentioned, incentive measures (for instance, health programme).

• Exceptions: legislation possible for cross border health threats, pharma, blood, organs, tissues and cells, veterinary and phytosanitary fields, tobacco, medicinal products and devices, cross border health services.

• International treaties, for instance the Paris agreement on climate Change

• Supporting mechanism such as European Centre for disease control (ECDC) for communicable disease, the European Environment Agency

Other legal tools:

• Health is also concerned by:

– Health and safety at work legislation,

– The Common agricultural policy (school fruit and vegetables scheme, wine sector, sugar sector etc.),

– The media directive (advertising to children of foods rich in sugar, salt, trans fats, alcohol),

– The excise directives (taxes on sugar, alcohol, tobacco, duty free),

– Environmental law (noise directive, water directive, air quality directive for example),

– Chemical legislation.

Sustainable development goals

• The Commission and Member States are committed to achieving the sustainable development goals.

• 2016 communication SDG 3: Ensure healthy lives and promote well-being for all at all ages : initiatives on public health, health systems and environmental related health problems (air quality, chemicals and waste)

• "By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being".

Commission response 1

• Next steps for a sustainable European future.

• The EU's answer to the 2030 Agenda will include two work streams: the first is to mainstream the Sustainable Development Goals in the European policy framework and current Commission priorities; the second is to launch reflection on further developing our longer term vision and the focus of sectoral policies after 2020.

Commission response 2

• The Commission will use all the instruments at its disposal, including its better regulation tools to ensure that existing and new policies take into account the three pillars of sustainable development: social, environmental and economic.

• The Commission will provide regular reporting of the EU's progress towards the implementation of the 2030 Agenda as of 2017, and will launch reflection work on developing further a longer term vision with a post-2020 perspective.

What's the basis for EU

environmental action?

Article 191

Union policy on the environment shall contribute to notably preserving, protecting and improving the quality of the environment, protecting human health, combating climate change

How ? 1

Starting with 1976, on air pollution, more than 30 legislative instruments: directives, decisions and regulations on e.g. on ambient air; quality of fuels; automotive exhaust and type-approval; greenhouse gases, water…

The 7th environment action programme – guiding policy at EU level by 2020 with key objectives and a vision for the EU in 2050 which states mainly:

• We live well within the planet’s ecological limits;

• Healthy environments stem from circular economy, nothing is wasted and resources are used sustainably

HOW ? 2

• The European Environment Agency provides sound, independent information on the environment for those involved in developing, adopting, implementing and evaluating environmental policy, and also the general public.

• In close collaboration with the European Environmental Information and Observation Network and its 33 member countries, the EEA gathers data and produces assessments on a wide range of topics related to the environment.

ENVIRONMENT and HEALTH priorities: WHY? 1

• Commissioner Andriukaitis has stressed the potential ofkeeping people in good health for longer

• He also stresses the importance of prevention of chronic non communicable disease and promotion of good health as there is a growing burden of non-communicable diseases that represents 80% of healthcare costs

WHY? 2

• Health impacts concern individuals, groups of the population which are more exposed than others (particularly the deprived)

• They also affect the cost burden on health systems and sustainability

• Finally, they influence the health of the workforce and the economy generally

ENVIRONMENT and HEALTH priorities WHY? 3

• The EU Environnement and Health priorities follow the "health in all policies" approach• There are number of environmental risks that could have an impact on health through non communicable diseases and thus are considered as determinants of health and health inequalities

• That might cause 3–7% of the annual burden of disease

air quality, noise reduction, water quality, waste chemicals, healthy cities, as well as heat waves (climate change issues) …

WATER

• Water is related to human life and plays a fundamental role in the climate regulation cycle.

• The European water policy is a success story, protecting human health and environment.

• There is still to do to improve the quality of our water bodies, to protect our oceans and to maintain also the high performance of our water infrastructure to meet the 2030 SDG targets.

• Access to drinking water its quality is a key healthy lifestyle determinant contributing to fight obesity and reduce inequality

• The Commission will make a Proposal for a revised Drinking Water Directive by the end of this year.

WASTE 1:

The new Circular Economy Package (2015)

Objective: The value of products, materials and resources is maintained in the economy for as long as possible. Waste generation is minimised : food waste and plastics are among the priorities.

Contains: Action Plan Communication/List of Follow-up Initiatives /4 Legislative proposals on waste . The aim is to protect, preserve and improve the quality of the environment, protecting human health

:

WASTE 2:Measures on food waste prevention envisaged

in Circular Economy Communication

• Commission proposal amending the 2008 Waste Framework directive

• EU Platform on food waste prevention• Measure and monitor food waste• EU guidelines to facilitate food donation• Optimize safe use of food in feed• Promote better understanding and use of date

marking

Noise 1

• Noise is the second most dangerous pollutant after particulate matter. Road traffic noise causes a serious threat to human health. Noise contributes to increase health inequalities there evidence that more deprived people leave in nosy areas compared to wealthier ones. Children are at high risk.

• Directive 2002/49/EC on environmental noise = instrument to identify noise pollution levels (exposure to environmental noise, information available to the public, preventing and reducing environmental noise).

Noise 2

• Member States have the obligation to map their territories and to adopt action plans. Last year the Commission evaluated the Directive, and found that action plans and implementation of noise reduction solutions were cost-efficient and cost-effective. This confirms that solutions at-hand exist, but still need to be placed into action.

• The EEA report of 2014 identified noise exposure as a direct determinant of hypertension and cardiovascular risk

• The report on the Directive on environmental noise are good opportunities to raise awareness

Air pollution

• Emissions of air pollutants are the most significant environmental cause of premature death in the EU: more than 400.000 in the EU each year. air pollution leads to – among other impacts – cardiovascular and respiratory diseases, resulting in substantial healthcare costs and lost working days. Poor and vulnerable affected disproportionately. Children are at high risk.

• The Clean Air Package (2013): EC Communication ‘A clean air programme for Europe’ ensure that existing targets are met and setting out objectives up to 2030.

• More effective measures are needed to further reduce air pollution in Europe. Effective action on clean air policy requires decisive action in all economic sectors that contribute most to air pollution (i.e. energy, industry, transport, agriculture) –as well as cooperation across different scales of governance (i.e. at European, national and city level).

• Examples for action include further de-carbonisation of our energy sector, or a focus on a number of means to reduce air pollution in our urban areas (such as include reducing overall traffic volumes, the fuels used, switching to electric cars and/or or urban access restriction schemes, greening spaces, with pathways for cycling or walking, collective transports).

Urban Agenda for Healthy cities 1• Urban areas now house more than 70% of all Europeans.• Since the 2016 Pact of Amsterdam for an Urban Agenda , 12 themes have been developed with dedicated partnerships which brings together urban authorities, Member States and European institutions, finding workable ideas focused on the topics of EU legislation funding and knowledge sharing: air quality, inclusion, poverty….• Urban planning is key for developing healthy cities where citizens can more easily make healthy diet choices, such as avoiding food "deserts", and practicing physical activity through green areas and play grounds, as well as walking, cycling and using public transport to work and school. • Of the many actors at all level of governments, city mayors and local government are uniquely positioned to contribute in a major way to making cities healthier and reducing NCDS via action on risk factors and social determinants of health and thus have a role in delivering on the 2030 Agenda an responsibility to ensure that health becomes an important value of the cities

Urban Agenda for Healthy cities 2The Partnership on Air Quality, an initiative gathering stakeholders :

work on proposals for better regulation, funding and knowledge in this area.

Provided a final draft action last September :

the main objective to improve air quality in cities and to bring the ‘healthy city’ higher on the local, national and EU agendas as part of the Urban Agenda, contributing also to New UN urban agenda and the SDGs

Climate change 1• Global climate change has significantly increased the probability of various recent extreme weather and climate events in Europe. Climate change will continue for many decades.

• The main health effects are related to extreme weather events and changes in the distribution of climate-sensitive diseases. Vulnerable groups might be the most affected.

• The Commission has its EU adaptation strategy, which also involves systematically including climate change considerations in planning and policy making in different areas, including health.

• The Commission funds environment and climate action projects where health and wellbeing is an important priority: For example, projects on measures to improve health and well-being such as through combatting heat wave effects in urban areas.

• The Commission is working with the World Health Organisation on identifying the level of integration of climate change considerations in public health measures in EU countries and developing a compendium of best practices. The initial results: end of 2017.

• Local level for climate action has the most benefit for health and wellbeing of citizens cities: communities can lead the way on the challenge of reducing pollution and promoting healthy, resource efficient and climate resilient communities: the European Commission has launched several initiatives or funds such as the Covenant of Mayors for Climate and energy.

Climate change 2

• Focus on crucial indirect effect is the potential for vectors, such as mosquitoes and ticks to increase their habitat range as environments become warmer and wetter. • The potential for cross-border spread of vector-borne diseases puts them under the scope of Decision on serious cross-border threats to health, allowing improving preparedness and strengthening surveillance, monitoring, and the capacity to coordinate response to health emergencies across the EU.• The Commission closely cooperates with Member States and international partners, in particular WHO, to respond to outbreaks of climate-sensitive infectious diseases • The Commission supports Member States in their responsibility to respond to vector-borne diseases through coordination in the Health Security Committee and technical support from the European Centre for Disease Prevention and Control.• a coordinated, collaborative, multidisciplinary and cross-sectoral approach as a One-health approach is of importance • New or better methods and innovative approaches to address vector-borne disease outbreaks and risks.

Mobilise citizen power

• Mobilizing citizen power and dialogue with stakeholders can help to drive progress, particularly on health issues

• Possibility to use health policy platform as a means to increase awareness and visibility of the environmental issue as a determinant of health

Conclusions

• Health is a cornerstone of sustainable development • Including health in all policies is important for coherent public policies with a major development impact • The aim is to ensure a 'high level of human health protection in all EU policies' (Article 168 Treaty)• Different pieces of legislation exist as good examples of ensuring that effects of environmental risks on health are minimised although there is room for improvement• Engaging local level citizens and communities, involving health sectors together with partnerships remain crucial• A long way to go and potential for improvement both for health and for sustainable environments