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Environmental groups criticise WHO plans to improve health
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     A World Health Organization action plan to improve the health and environment of children in Europe has been criticised by environmental groups as not going far enough.

    Health and environment ministers from 50 countries, ranging from the United Kingdom to former Soviet states, adopted the Children抯 Environment and Health Action Plan for Europe (CEHAPE) at the fourth ministerial conference in environment and health in Budapest last week.

    The policy document highlights action in four priority areas: provision of safer water and sanitation; fewer injuries; cleaner air; and reduced exposure to hazardous chemicals. Measures recommended in the action plan include banning smoking in public places, developing sanitation, promoting safety devices in cars, limiting access of cars in streets near schools, and establishing smog alert systems in cities.

    However, Chris Church, co-chairman of ANPED, the Northern Alliance for Sustainability, described the declaration as merely "an expression of goodwill and a wish list" at the concurrent Healthy Planet Forum and said the plan was ineffective because it was not legally binding. He also pointed out that the legislative Protocol on Water and Health signed in 1999 was yet to be ratified by many countries.

    Mr Church said: "It would seem logical if they seriously care about environment and health that they set some goals and targets. What is the point in ministers saying that they would like to ban smoking across Europe if they抮e not making any commitment to doing it? They抮e not committing any resources, or saying when it could be done. They抮e simply saying, 憌ouldn抰 it be nice if . . . ?

    But Lucianne Licari, WHO European regional adviser for environment and health, reacted angrily to the claims. She emphasised that governments and non-governmental organisations have participated fully in drafting the plan and feel a "great deal of ownership." She added that legislation does not guarantee commitment—evidence suggests that a declaration is more effective.

    She also said that the action plan reflected individual countries?own needs and priorities and that each of the measures is graded according to the scientific evidence available about its effectiveness.

    Ms Licari told the BMJ: "The countries in this declaration go from the UK to former Soviet states, and it抯 very difficult to set the same quantitative targets for different extremes. For example, a 1% reduction in air pollution in one country is not the same as a 1% reduction in another."

    Marc Danzon, WHO regional director for Europe, also added that governments have to report back the changes to their national policies in 2007. He said: "Governments have signed this and said they抮e going to do it. Governments don抰 like to say that they抳e done nothing."

    However, European commissioner Margot Wallstrom admitted that that WHO doesn抰 have all the evidence about the cost effectiveness of all the measures and more research is needed. She also said that non-governmental organisations had expressed concern that no money had been earmarked for any necessary policy changes.(BMJ Deborah Cohen)