National and regional story (Portugal) - Environment and Health in Portugal

In Portugal, the key environmental and health issues were set out in the Portuguese Environmental and Health Action Plan 2008-2013 (PT-NEHAP), approved by Cabinet Resolution No. 91/2008 of 4 June. The Plan was drafted under the coordination of the Ministry of Environment and Spatial Planning / Portuguese Environment Agency and the Ministry of Health / Directorate General for Health, in close cooperation with further eight Ministries: Ministry of the Interior; Ministry of Economic Affairs and Innovation; Ministry of Agriculture, Rural Development and Fisheries; Ministry of Public Works, Transport and Communications; Ministry of Labour and Social Security; Ministry of Education; Ministry of Science, Technology and Higher Education, and the Ministry of Culture, due to the subject matter.

The Plan required a flexible and dynamic structure in order to ensure the best use of efforts and resources by developing and strengthening partnerships. It also required measures to rally Portuguese society, the social partners and individual citizens behind PT-NEHAP actions. A structure was therefore established which brought together different organisational units (coordinating bodies, an interministerial environment and health Working Group, project teams and a strategic social platform), with specific and complementary mandates.

The PT-NEHAP seeks to improve policies for preventing, controlling and reducing the health risks caused by environmental factors by promoting the integration of knowledge and innovation, ensuring consistency with existing policies, plans and programmes, exploiting the best scientific knowledge available and inviting all interested parties to take part. The Plan establishes the following strategic objectives for responding to national and international environmental and health commitments:

I –   To act on environmental factors in order to promote the health of the individual and the health of the communities exposed to such factors;

II – To raise awareness of, and educate and train professionals and the public so as to minimise the health risks associated with environmental factors;

III –   To ensure policy consistency and risks communication;

IV –   To build an information network to strengthen understanding of relationships between the environment and health.

To achieve these objectives, the PT-NEHAP promotes health by means of health education, health protection and disease prevention, based on knowledge and innovation in initiatives focusing on the interface between the environment and health, using resources to their best effect and furthering institutional coordination and community participation based on a five-pronged approach:

I –   Integration of information and applied research;

II –  Risk prevention, control and reduction;

III –   Information, awareness raising, training and education;

IV –   Policy consistency and risk communication; and

V – International environment and health cooperation.

These initiatives are made up of 36 action programmes set out in project sheets which include the objective(s) of the action concerned, stages of implementation, the implementation schedule and target(s) to be achieved. A list of action programmes among the nine PT-NEHAP initiatives and priority fields (water, air, soil and sediments, chemicals, food, noise, housing, radiation and meteorological events) is presented in Annex II.

Progress Reports (produced every two years, the first scheduled for the end of 2010) and a Final Report will be drafted to monitor PT-NEHAP implementation. These reports seek to identify, in a timely manner, gaps, inefficiencies, inequalities, delays in implementation and the need to adjust human and/or financial resources, and to propose possible corrective/adjustment measures or the rescheduling of projects.

The approval of the PT-NEHAP was preceded by a process of public consultation and a cost/benefit analysis was carried out which showed that the gains would be around five times greater than the investment costs.

The international financial crisis imposed constraints at national level which affected the implementation of the Plan and which required action programmes to be prioritised, and nine of the 36 actions provided for are at an advanced stage of implementation.

The following global PT-NEHAP outcomes are expected: the furthering of knowledge and closing of gaps; the organisation and integration of dispersed information; the stepping up of research and the identification of emerging issues; a focus on risk prevention, control and reduction; consultation and policy consistency by priority area; increased awareness raising, training and education of professionals and the public, and closer cooperation with international environmental and health initiatives.

Given its ultimate objective, the implementation of the PT-NEHAP is expected to ensure the following health outcomes:

·         the measurement and assessment of the volume of diseases caused by environmental risk factors, or prompted and/or exacerbated by such factors;

·         an assessment of the efficiency and effectiveness of actions affecting the interface between the environment and health;

·         the provision of tools and capacities allowing people to control and improve their health;

·         a reduction in the fraction attributable, i.e. a proportional reduction in the number of health problems or deaths associated with environmental risk factors;

·         a reduction in the economic costs associated to the provision of healthcare as a result of implementing prevention strategies;

·         the achievement of a more sustainable health status due to a longer-lasting impact on health compared to treatment only;

·         a reduction in the proportion of diseases to which environmental factors contribute; and

·         a greater increase in life expectancy and a healthier life.

The coordinating bodies firmly believe that the implementation of the PT-NEHAP will ensure a national, integrated and global environmental and health approach that will increase our understanding of relationships between particular environmental factors and their adverse effects on health so as to achieve gains in the effectiveness of risk prevention, control and reduction policies, with significant environmental and human health benefits.

For further information:

• Plano Nacional de Acção Ambiente e Saúde
• http://dre.pt/pdf1sdip/2008/06/10700/0310603179.PDf
• www.apambiente.pt
  
• www.dgs.pt

Annex I – Structure of the PT-NEHAP