Sustainable Management of Transboundary Waters in Europe

1. Sustainable Management of Transboundary Waters in Europe Dr. R. Bertollini Director Division for Technical Services WHO Regional Office for Europe

2. Programme • Review of policy • WHO EURO Region • Future work • Discussion

3. Policy Formulation Timeline

4. 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.

5. Protocol 3 - Scope • Surface freshwater • Groundwater • Estuaries • Coastal waters (recreation, aqua) • Enclosing waters (bathing) • Water during abstraction, transport, treatment, supply • Waste water

6. Protocol 4 - Provisions • Adequate supplies of wholesome drinking water • Adequate sanitation protecting health and environment • Effective protection of resources • Protection of disease from recreational waters • Monitoring systems

7. Protocol 5 - approaches • Management action at lowest administrative level • Social, economic and environmental values • Economic instruments & awareness • Access to information and public participation in decision making needed

8. Protocol 5 - Approaches • Integrated management on catchment basis • Special consideration to vulnerable populations • Equitable access to water for all, especially socially disadvantaged and (economically excluded)

9. 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.

10. 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

11. WHO Regional Committee 51EUR/RC51/R7 WSSD • Recognizing that many health problems will be exacerbated by inadequate water and sanitation … urges MS to • Actively involve the Health Sector in national preparations of the WSSD • Address the links between health, environment, and development in particular health and poverty alleviation

12. 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

13. 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.

14. 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

15. 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

16. 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.

17. Member States of the WHO EURO Region

18. The Six Sub-regions • High Human Development and High Income • High Human Development and Upper Middle Income • High Human Development and Lower Middle Income • Medium Human Development and Upper Middle Income • Medium Human Development and Lower Middle Income • Medium Human Development and Low Income High Human Development (HHD): Human Development Index (HDI) value 0.800 and up Medium Human Development (MHD): HDI value 0.500-0.800 High Income (HIC): GNP per capita US$9,266 and up Upper Middle Income (UMI): GNP per capita US$2,996-9,265 Lower Middle Income (LMD): GNP per capita US$756-2,995 Low Income (LIC): GNP per capita US$755 or less

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27. WHO Information Systems • Health for All • Computerized Information Systems for Infectious Diseases - CISID

28. 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.

32. 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.

33. Cholera and Typhoid Fever from CISID Database

34. 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

35. 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

36. IVth Ministerial Conference on Environment and Health • Children and future generations • Transport, environment and health • Water and health • Local activities • NEHAP New issue: • Sustainable resource management • Harmonizing reporting systems

37. THANK YOU