Health and Environment
Advocacy for an institutionalized Network of Expertise
Health and environment at a cross-roads. All over the world, people want to live in environments that protect and promote their health. Similarly, they also expect their health systems to be equitable. However, paradoxically, the most powerful determinants of people's health lie in environmental conditions over which the health sector has no control or little influence. How can we overcome this challenge?
For instance, issues as diverse as urbanization, sanitation, food safety and fortication of salt with iodine can profoundly influence the health of entire communities and societies, although the fact that they do not directly depend upon the health system of a given country. Today it is no longer to address such crucial issues without sustained intersectoral collaboration that gives due weight to "cross-ministry work". Why?
Advancing and sustaining environmental safety. The health of citizens is not merely a product of health sector activities. It is to a large extent determined by environmental factors, and hence by policies that are not necessarily within the remit of the health sector. Thus, it is important for the health sector to engage with the environment sector, not just in order to obtain collaboration on tackling pre-identified priority health problems - e.g. malaria (1) -, but to ensure that health is recognized as one of the socially valued outcomes of all policies - i.e. sanitation (2). In many countries, unfortunately, intersectoral action has often not concentrated on improving the policies of other sectors, but on instrumentalizing their resources...
The way forward. Worldwide, health tends to be fragmented into various sub-institutions dealing with particular aspects and prospects, while the institutional capacity to assemble the numerous and various constituencies of public policy that jointly determine health is underdeveloped. In most countries, therefore, the institutional basis for doing this remains weak. In response to this situation, merging the ministries of health and environment (3,4) can be helpful in creating such a basis, which ranks among the key strategies for making headway in addressing the multiple and complex determinants of ill-health.
Doctor Michel ODIKA, copyright 2010
1. Michel ODIKA, Malaria Observatory ( Slide presentation)
2. Michel ODIKA, Assainissement: vers une nouvelle donne (Tribune de Genève, copyright 2010)
3. Michel ODIKA, Santé et environnement: fusions ministérielles urgentes (La Libre Belgique, copyright 2010)
4. Michel ODIKA, Crucial necessity for merging the Ministries of Health and Environment