who regional office for europe, division of technical support sustainable management of...

WHO Regional Office for Europe, Division of Technical Support

Sustainable Management of Transboundary Waters in Europe

Dr. R. Bertollini

Director

Division for Technical Services

WHO Regional Office for Europe


Programme

• Review of policy • WHO EURO Region• Future work• Discussion


Policy Formulation Timeline2000 2001 2002

Jan Report by the Sec Gen to CSD

FebMar Ministerial

Declatarion of the Hage 22 March

AprMayJunJulAug WSSD

Sep UN Millennium Summit

UNECE Regional Committee for the WSSD and WHO RC 51

Oct WHO RC 50

NovDec International

Freshwater Conference


Protocol on Water and Health - Article 1 Objective

The objective of this Protocol is to promote at all appropriate levels, as well as in transboundary and international contexts, the protection of human health and well-being, both individual and collective, within a framework of sustainable development, through improving water management, including the protection of water ecosystems, and through preventing, controlling and reducing water-related diseases.


Protocol 3 - Scope

• Surface freshwater• Groundwater• Estuaries• Coastal waters (recreation, aqua)• Enclosing waters (bathing)• Water during abstraction, transport, treatment,

supply• Waste water


Protocol 4 - Provisions

a) Adequate supplies of wholesome drinking water

b) Adequate sanitation protecting health and environment

c) Effective protection of resources

d) Protection of disease from recreational waters

e) Monitoring systems


Protocol 5 - approaches

f) Management action at lowest administrative level

g) Social, economic and environmental values

h) Economic instruments & awareness

i) Access to information and public participation in decision making needed


Protocol 5 - Approaches

j) Integrated management on catchment basis

k) Special consideration to vulnerable populations

l) Equitable access to water for all, especially socially disadvantaged and (economically excluded)


UN Millennium Declaration

Art 19: We resolve further to halve, by 2015, the proportion of the world’s people whose income is less than US$1/d and the proportion of people who suffer from hunger and, by the same date, to halve the proportion of people who are unable to reach or to afford safe drinking water

Poor people are powerless to prevent degradation of resources on which their health depends.


UN Millennium Declaration

Art 23 We resolve … to stop the unsustainable exploitation of water resources by developing management strategies at the regional, national, and local levels, which promote both equitable access and adequate supplies


WHO Regional Committee 51EUR/RC51/R7 WSSD

• Recognizing that many health problems will be exacerbated by inadequate water and sanitation … urges MS to

a) Actively involve the Health Sector in national preparations of the WSSD

b) Address the links between health, environment, and development in particular health and poverty alleviation


Bonn Freshwater Conference 8. Protect Water Quality and Ecosystems

• Drinking water quality should be safeguarded because it is essential for human health

• Water supplies should be protected from pollution from the source to the user

• Treatment of wastewater to be intensified and made more affordable


Bonn Freshwater Conference15. Improve economic efficiency

• Cost recovery objectives should be no barrier to poor people’s access to water supply and sanitation. Where the poor can not afford to pay the full cost of water supply and sanitation, tariff systems that allow social targeting should be established.


Report of UN Secretary General II Major Trends

33. Contaminated water, inadequate sanitation, and poor hygiene cause a large proportion of ill health and disease… Malaria… cholera, typhoid, viral hepatitis A, dysentery, intestinal worms, trachoma, river blindness, schistosomiasis, arsenic poisoning, and dengue fever, and other water-related diseases affect millions of people in developing countries


Report of UN Secretary General II Major Trends (cont)

38. Areas of water scarcity are increasing … One third of the countries in the water-stressed regions of the world are expected to face severe water shortages in the twenty-first century. By 2025, as much as two-thirds of the world’s population could live in countries with moderate or severe water stress


Report of UN Secretary General III.B. Urban poverty

59. Number of urban dwellers lacking access to safe drinking water increased by 62 million. Providing safe water and adequate sanitation to urban and peri-urban population will be a major challenge.

61. Sustainability of urban development threatened by wastewater treatment capacity.


Member States of the WHO EURO Region


The Six Sub-regions

1. High Human Development and High Income2. High Human Development and Upper Middle Income3. High Human Development and Lower Middle Income 4. Medium Human Development and Upper Middle Income5. Medium Human Development and Lower Middle Income 6. Medium Human Development and Low Income

High Human Development (HHD): Human Development Index (HDI) value 0.800 and upMedium Human Development (MHD): HDI value 0.500-0.800High Income (HIC): GNP per capita US$9,266 and upUpper Middle Income (UMI): GNP per capita US$2,996-9,265Lower Middle Income (LMD): GNP per capita US$756-2,995Low Income (LIC): GNP per capita US$755 or less

Distribution of Population by Levels of Human Development and Income (1998)

12.40%105.8 million

25.02%213.5 million

7.56%64.5 million

0.43%3.7 million

8.25%70.4 million

46.34%395.5 million

High Human Development & High Income

High Human Development & Upper Middle Income

High Human Development & Lower Middle Income

Medium Human Development & Upper Middle Income

Medium Human Development & Lower Middle Income

Medium Human Development & Low Income

74.6078.71

64.60

71.0773.60

80.10

73.10

84.50

57.52

63.49

53.11

60.84

0

10

20

30

40

50

60

70

80

90

High HumanDevelopment & High

Income

High HumanDevelopment & Upper

Middle Income

High HumanDevelopment & Lower

Middle Income

Medium HumanDevelopment & Upper

Middle Income

Medium HumanDevelopment & Lower

Middle Income

Medium HumanDevelopment & Low

Income

Percentage of Urban Population by Levels of Human Development and Income

1998

2015

75.0

80.9

68.4

77.1

66.9

77.2

66.8

72.5

63.5

72.3

62.5

69.7

0

10

20

30

40

50

60

70

80

90


Income

High HumanDevelopment & Upper

Middle Income

High HumanDevelopment & Lower

Middle Income

Medium HumanDevelopment & Upper

Middle Income

Medium HumanDevelopment & Lower

Middle Income


Income

Life Expectancy at Birth by Levels of Human Development and Income (2000)

Male

Female

3.1

7.8

18.0

22.7

26.0

0

5

10

15

20

25

30

Su

b-r

egio

nal

Ave

rag

e P

ove

rty

Lev

el M

easu

red

at

Po

pu

lati

on

B

elo

w $

2 p

er D

ay (

%)


Income

High HumanDevelopment &

Upper Middle Income

High HumanDevelopment &Low er Middle

Income

Medium HumanDevelopment &

Upper Middle Income

Medium HumanDevelopment &Low er Middle

Income


Income

Sub-regional Comparison of Average Poverty Levels (Collected data varying from those of 1992 through 1999)

N/A

11

2

13

5

2

4

1 1 11

7

1

7

0

5

10

15

20

25


High Income

High HumanDevelopment &Upper Middle

Income

High HumanDevelopment &Lower Middle

Income

Medium HumanDevelopment &Upper Middle

Income

Medium HumanDevelopment &Lower Middle

Income


Low Income

Water availability of countries in sub-regions

no data

2500-

1700-2500

1000-1700 (w ater stress)

-1000 (w ater scarce)

22.68

236.3

26.00

163.2

81.00

150.9

14.00

162.0

11.63

290.1

0

50

100

150

200

250

300

Lit

ers

per

cap

ita p

er

day


Income


Upper Middle Income


Low er Middle Income


Upper Middle Income


Low er Middle Income


Income

Domestic Use of Water and Its Percentage of Total

Domestic Use as Percentage of Total

Domestic Use per Capita per Day

N/A


WHO Information Systems

• Health for All• Computerized Information Systems for

Infectious Diseases - CISID


European Health for All Database

• Provides easy and rapid access to a wide range of basic health statistics for the 51 member states of the WHO European region.

• The data are submitted by the European member states to the Regional Office or collected from other international organizations or other sources and are updated twice a year in January and June.

0

20

40

60

80

100

120

140

160

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Under 5 Mortality Rate from Diarrhoreal Diseases per 100000







0

50

100

150

200

250

300

350

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Viral Hepatitis A Incident per 100000







0

20

40

60

80

100

120

140

160

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Malaria Incidence per 100000








CISID Database

• Computerized Information System for Infectious Diseases (CISID) is a work of the Communicable Disease Surveillance and Response (CSR) Programme and the Informatics Support unit (ISS) of the WHO Regional Office for Europe.

• The first objective is to improve the standardization, timeliness and completeness of data reported by Member States.

• The second objective is to allow sharing of data at the sub-national level to identify specific geographic areas of risk, as well as the identification of risk groups by age and gender.

• CISID eventually aims to monitor some infectious diseases by first (and in some cases, second) administrative level within the region, and provide a detailed description of clusters of cases by time, place and person.

0

5000

10000

15000

20000

25000

30000

35000

Typ

ho

id F

ever

Cases

1998 1999 2000

0

10

20

30

40

50

60

70

80

90

Ch

ole

ra C

ase

s

1998 1999 2000

Cholera and Typhoid Fever from CISID Database


WHO 2000 - 2001

• Protocol– Expert meeting on evidence base

– Expert meeting on surveillance of natural and man-made outbreaks

– Expert meeting on aquifer recharge

– Expert meeting on terrorism

• Bilateral assistance– Tajikistan, Azerbaijan

• Global: DWQG


WHO 2002 – 2003 - BCA

• MALTA Health systems in tourist areas

• ROMANIA Surveillance of wbd

• RUSSIAN FEDERATION Implementation of the Protocol

• TAJIKISTAN dwq

• TURKEMISTAN urban dwq

• CAS Surveillance


IVth Ministerial Conference on Environment and Health

• Children and future generations• Transport, environment and health• Water and health• Local activities• NEHAPNew issue: Sustainable resource management Harmonizing reporting systems


THANK YOU

who regional office for europe, division of technical support sustainable management of...

Documents

regional office

europe slide

water management

regional committee

technical services

inadequate water

supply waste water slide

needed slide