'AGENDA 21' it took Bill Clinton

[Soldier4Christ]

5.14.  Collaboration and exchange of information should be increased between
research institutions and international, regional and national agencies and
all other sectors (including the private sector, local communities,
non-governmental organizations and scientific institutions) from both the
industrialized and developing countries, as appropriate.

5.15.  Efforts should be intensified to enhance the capacities of national and
local governments, the private sector and non-governmental organizations in
developing countries to meet the growing needs for improved management of
rapidly growing urban areas.


                B.  Formulating integrated national policies for
                    environment and development, taking into
                    account demographic trends and factors

Basis for action

5.16.  Existing plans for sustainable development have generally recognized
demographic trends and factors as elements that have a critical influence on
consumption patterns, production, lifestyles and long-term sustainability.
But in future, more attention will have to be given to these issues in general
policy formulation and the design of development plans.  To do this, all
countries will have to improve their own capacities to assess the environment
and development implications of their demographic trends and factors.  They
will also need to formulate and implement policies and action programmes where
appropriate.  Policies should be designed to address the consequences of
population growth built into population momentum, while at the same time
incorporating measures to bring about demographic transition.  They should
combine environmental concerns and population issues within a holistic view
of development whose primary goals include the alleviation of poverty; secure
livelihoods; good health; quality of life; improvement of the status and
income of women and their access to schooling and professional training, as
well as fulfilment of their personal aspirations; and empowerment of
individuals and communities.  Recognizing that large increases in the size and
number of cities will occur in developing countries under any likely
population scenario, greater attention should be given to preparing for the
needs, in particular of women and children, for improved municipal management
and local government.

Objective

5.17.  Full integration of population concerns into national planning, policy
and decision-making processes should continue.  Population policies and
programmes should be considered, with full recognition of women's rights.

Activities

5.18.  Governments and other relevant actors could, inter alia, undertake the
following activities, with appropriate assistance from aid agencies, and
report on their status of implementation to the International Conference on
Population and Development to be held in 1994, especially to its committee on
population and environment.


(a)  Assessing the implications of national demographic trends and factors

5.19.  The relationships between demographic trends and factors and
environmental change and between environmental degradation and the components
of demographic change should be analysed.

5.20.  Research should be conducted on how environmental factors interact with
socio-economic factors as a cause of migration.

5.21.  Vulnerable population groups (such as rural landless workers, ethnic
minorities, refugees, migrants, displaced people, women heads of household)
whose changes in demographic structure may have specific impacts on
sustainable development should be identified.

5.22.  An assessment should be made of the implications of the age structure
of the population on resource demand and dependency burdens, ranging from
educational expenses for the young to health care and support for the elderly,
and on household income generation.

5.23.  An assessment should also be made of national population carrying
capacity in the context of satisfaction of human needs and sustainable
development, and special attention should be given to critical resources, such
as water and land, and environmental factors, such as ecosystem health and
biodiversity.

5.24.  The impact of national demographic trends and factors on the
traditional livelihoods of indigenous groups and local communities, including
changes in traditional land use because of internal population pressures,
should be studied.

(b)  Building and strengthening a national information base

5.25.  National databases on demographic trends and factors and environment
should be built and/or strengthened, disaggregating data by ecological region
(ecosystem approach), and population/environment profiles should be
established by region.

5.26.  Methodologies and instruments should be developed to identify areas
where sustainability is, or may be, threatened by the environmental effects
of demographic trends and factors, incorporating both current and projected
demographic data linked to natural environmental processes. 

5.27.  Case-studies of local level responses by different groups to
demographic dynamics should be developed, particularly in areas subject to
environmental stress and in deteriorating urban centres.

5.28.  Population data should be disaggregated by, inter alia, sex and age in
order to take into account the implications of the gender division of labour
for the use and management of natural resources.

(c)              Incorporating demographic features into policies and plans

5.29.  In formulating human settlements policies, account should be taken of
resource needs, waste production and ecosystem health.

5.30.  The direct and induced effects of demographic changes on environment
and development programmes should, where appropriate, be integrated, and the
impact on demographic features assessed.

5.31.  National population policy goals and programmes that are consistent
with national environment and development plans for sustainability and in
keeping with the freedom, dignity and personally held values of individuals
should be established and implemented.

5.32.  Appropriate socio-economic policies for the young and the elderly, both
in terms of family and state support systems, should be developed.

5.33.  Policies and programmes should be developed for handling the various
types of migrations that result from or induce environmental disruptions, with
special attention to women and vulnerable groups.

5.34.  Demographic concerns, including concerns for environmental migrants and
displaced people, should be incorporated in the programmes for sustainable
development of relevant international and regional institutions.

5.35.  National reviews should be conducted and the integration of population
policies in national development and environment strategies should be
monitored nationally.

Means of implementation

(a)  Financing and cost evaluation

5.36.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$90 million from the international community on grant or concessional terms.
These are indicative and order-of-magnitude estimates only and have not been
reviewed by Governments.  Actual costs and financial terms, including any that
are non-concessional, will depend upon, inter alia, the specific strategies
and programmes Governments decide upon for implementation.

(b)  Raising awareness of demographic and sustainable development
     interactions

5.37.  Understanding of the interactions between demographic trends and
factors and sustainable development should be increased in all sectors of
society.  Stress should be placed on local and national action.  Demographic
and sustainable development education should be coordinated and integrated in
both the formal and non-formal education sectors.  Particular attention should
be given to population literacy programmes, notably for women.  Special
emphasis should be placed on the linkage between these programmes, primary
environmental care and the provision of primary health care and services.

(c)  Strengthening institutions

5.38.  The capacity of national, regional and local structures to deal with
issues relating to demographic trends and factors and sustainable development
should be enhanced.  This would involve strengthening the relevant bodies
responsible for population issues to enable them to elaborate policies
consistent with the national prospects for sustainable development.
Cooperation among government, national research institutions, non-governmental
organizations and local communities in assessing problems and evaluating
policies should also be enhanced.

5.39.  The capacity of the relevant United Nations organs, organizations and
bodies, international and regional intergovernmental bodies, non-governmental
organizations and local communities should, as appropriate, be enhanced to
help countries develop sustainable development policies on request and, as
appropriate, provide assistance to environmental migrants and displaced
people.

5.40.  Inter-agency support for national sustainable development policies and
programmes should be improved through better coordination of population and
environment activities.

(d)  Promoting human resource development

cont'd

[Soldier4Christ]

5.41.  The international and regional scientific institutions should assist
Governments, upon request, to include concerns regarding the
population/environment interactions at the global, ecosystem and micro-levels
in the training of demographers and population and environment specialists.
Training should include research on linkages and ways to design integrated
strategies.


            C.  Implementing integrated environment and development
                programmes at the local level, taking into account
                demographic trends and factors

Basis for action

5.42.  Population programmes are more effective when implemented together with
appropriate cross-sectoral policies.  To attain sustainability at the local
level, a new framework is needed that integrates demographic trends and
factors with such factors as ecosystem health, technology and human
settlements, and with socio-economic structures and access to resources.
Population programmes should be consistent with socio-economic and
environmental planning.  Integrated sustainable development programmes should
closely correlate action on demographic trends and factors with resource
management activities and development goals that meet the needs of the people
concerned.

Objective

5.43.  Population programmes should be implemented along with natural resource
management and development programmes at the local level that will ensure
sustainable use of natural resources, improve the quality of life of the
people and enhance environmental quality.

Activities

5.44.  Governments and local communities, including community-based women's
organizations and national non-governmental organizations, consistent with
national plans, objectives, strategies and priorities, could, inter alia,
undertake the activities set out below with the assistance and cooperation of
international organizations, as appropriate.  Governments could share their
experience in the implementation of Agenda 21 at the International Conference
on Population and Development, to be held in 1994, especially its committee
on population and environment.

(a)  Developing a framework for action

5.45.  An effective consultative process should be established and implemented
with concerned groups of society where the formulation and decision-making of
all components of the programmes are based on a nationwide consultative
process drawing on community meetings, regional workshops and national
seminars, as appropriate.  This process should ensure that views of women and
men on needs, perspective and constraints are equally well reflected in the
design of programmes, and that solutions are rooted in specific experience.
The poor and underprivileged should be priority groups in this process.

5.46.  Nationally determined policies for integrated and multifaceted
programmes, with special attention to women, to the poorest people living in
critical areas and to other vulnerable groups should be implemented, ensuring
the involvement of groups with a special potential to act as agents for change
and sustainable development.  Special emphasis should be placed on those
programmes that achieve multiple objectives, encouraging sustainable economic
development, and mitigating adverse impacts of demographic trends and factors,
and avoiding long-term environmental damage.  Food security, access to secure
tenure, basic shelter, and essential infrastructure, education, family
welfare, women's reproductive health, family credit schemes, reforestation
programmes, primary environmental care, women's employment should, as
appropriate, be included among other factors.

5.47.  An analytical framework should be developed to identify complementary
elements of sustainable development policies as well as the national
mechanisms to monitor and evaluate their effects on population dynamics.

5.48.  Special attention should be given to the critical role of women in
population/environment programmes and in achieving sustainable development.
Projects should take advantage of opportunities to link social, economic and
environmental gains for women and their families.  Empowerment of women is
essential and should be assured through education, training and policies to
accord and improve women's right and access to assets, human and civil rights,
labour-saving measures, job opportunities and participation in
decision-making.  Population/environment programmes must enable women to
mobilize themselves to alleviate their burden and improve their capacity to
participate in and benefit from socio-economic development.  Specific measures
should be undertaken to close the gap between female and male illiteracy
rates.

(b)  Supporting programmes that promote changes in demographic trends and
     factors towards sustainability

5.49.  Reproductive health programmes and services, should, as appropriate,
be developed and enhanced to reduce maternal and infant mortality from all
causes and enable women and men to fulfil their personal aspirations in terms
of family size, in a way in keeping with their freedom and dignity and
personally held values.

5.50.  Governments should take active steps to implement, as a matter of
urgency, in accordance with country-specific conditions and legal systems,
measures to ensure that women and men have the same right to decide freely and
responsibly on the number and spacing of their children, to have access to the
information, education and means, as appropriate, to enable them to exercise
this right in keeping with their freedom, dignity and personally held values
taking into account ethical and cultural considerations.

cont'd

[Soldier4Christ]

5.51.  Governments should take active steps to implement programmes to
establish and strengthen preventive and curative health facilities that
include women-centred, women-managed, safe and effective reproductive health
care and affordable, accessible services, as appropriate, for the responsible
planning of family size, in keeping with freedom, dignity and personally held
values and taking into account ethical and cultural considerations.
Programmes should focus on providing comprehensive health care, including
pre-natal care, education and information on health and responsible parenthood
and should provide the opportunity for all women to breast-feed fully, at
least during the first four months post-partum.  Programmes should fully
support women's productive and reproductive roles and well being, with special
attention to the need for providing equal and improved health care for all
children and the need to reduce the risk of maternal and child mortality and
sickness.

5.52.  Consistent with national priorities, culturally based information and
education programmes that transmit reproductive health messages to men and
women that are easily understood should be developed.

(c)  Creating appropriate institutional conditions

5.53.  Constituencies and institutional conditions to facilitate the
implementation of demographic activities should, as appropriate, be fostered.
This requires support and commitment from political, indigenous, religious and
traditional authorities, the private sector and the national scientific
community.  In developing these appropriate institutional conditions,
countries should closely involve established national machinery for women.

5.54.  Population assistance should be coordinated with bilateral and
multilateral donors to ensure that population needs and requirements of all
developing countries are addressed, fully respecting the overall coordinating
responsibility and the choice and strategies of the recipient countries.

5.55.  Coordination should be improved at local and international levels.
Working practices should be enhanced in order to make optimum use of
resources, draw on collective experience and improve the implementation of
programmes.  UNFPA and other relevant agencies should strengthen the
coordination of international cooperation activities with recipient and donor
countries in order to ensure that adequate funding is available to respond to
growing needs.

5.56.  Proposals should be developed for local, national and international
population/environment programmes in line with specific needs for achieving
sustainability.  Where appropriate, institutional changes must be implemented
so that old-age security does not entirely depend on input from family
members.

Means of implementation

(a)  Financing and cost evaluation

5.57.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$7 billion, including about $3.5 billion from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b)  Research

5.58.  Research should be undertaken with a view to developing specific action
programmes; it will be necessary to establish priorities between proposed
areas of research.

5.59.  Socio-demographic research should be conducted on how populations
respond to a changing environment.

5.60.  Understanding of socio-cultural and political factors that can
positively influence acceptance of appropriate population policy instruments
should be improved.

5.61.  Surveys of changes in needs for appropriate services relating to
responsible planning of family size, reflecting variations among different
socio-economic groups and variations in different geographical regions should
be undertaken.

(c)  Human resource development and capacity-building

5.62.  The areas of human resource development and capacity-building, with
particular attention to the education and training of women, are areas of
critical importance and are a very high priority in the implementation of
population programmes.

5.63.  Workshops to help programme and projects managers to link population
programmes to other development and environmental goals should be conducted.

5.64.  Educational materials, including guides/workbooks for planners and
decision makers and other actors of population/environment/development
programmes, should be developed.

5.65.  Cooperation should be developed between Governments, scientific
institutions and non-governmental organizations within the region, and similar
institutions outside the region.  Cooperation with local organizations should
be fostered in ordered to raise awareness, engage in demonstration projects
and report on the experience gained.

5.66.  The recommendations contained in this chapter should in no way
prejudice discussions at the International Conference on Population and
Development in 1994, which will be the appropriate forum for dealing with
population and development issues, taking into account the recommendations of
the International Conference on Population, held in Mexico City in 1984, 1/
and the Forward-looking Strategies for the Advancement of Women, 2/ adopted
by the World Conference to Review and Appraise the Achievements of the United
Decade for Women:  Equality, Development and Peace, held in Nairobi in 1985.


                                  Notes

     1/    Report of the International Conference on Population, Mexico City,
6-14 August 1984 (United Nations publication, Sales No. E.84.XIII.,
chap. I.

     2/    Report of the World Conference to Review and Appraise the
Achievements of the United Nations Decade for Women:  Equality, Development
and Peace, Nairobi, 15-26 July 1985 (United Nations publication, Sales
No. E.84.IV.10), chap. I, sect. A.


END OF CHAPTER 5
.

[nChrist]

            WOW!

It appears there are a few good things sprinkled in to hide the overall - maybe something close to international communism and one-world government. I didn't study this carefully, but that was the impression that I got. Did I miss something?

[Soldier4Christ]

I think that you got the overall gist of it as that is the intention of this whole thing. There are many governments that are buying into this. too.

[Shammu]

Chapter 6

PROTECTING AND PROMOTING HUMAN HEALTH


INTRODUCTION

6.1.  Health and development are intimately interconnected.  Both insufficient
development leading to poverty and inappropriate development resulting in
overconsumption, coupled with an expanding world population, can result in
severe environmental health problems in both developing and developed nations.
Action items under Agenda 21 must address the primary health needs of the
world's population, since they are integral to the achievement of the goals
of sustainable development and primary environmental care.  The linkage of
health, environmental and socio-economic improvements requires intersectoral
efforts.  Such efforts, involving education, housing, public works and
community groups, including businesses, schools and universities and
religious, civic and cultural organizations, are aimed at enabling people in
their communities to ensure sustainable development.  Particularly relevant
is the inclusion of prevention programmes rather than relying solely on
remediation and treatment.  Countries ought to develop plans for priority
actions, drawing on the programme areas in this chapter, which are based on
cooperative planning by the various levels of government, non-governmental
organizations and local communities.  An appropriate international
organization, such as WHO, should coordinate these activities.

6.2.  The following programme areas are contained in this chapter:

     (a)   Meeting primary health care needs, particularly in rural areas;

     (b)   Control of communicable diseases;

     (c)   Protecting vulnerable groups;

     (d)   Meeting the urban health challenge;

     (e)   Reducing health risks from environmental pollution and hazards.


                             PROGRAMME AREAS

   A.  Meeting primary health care needs, particularly in rural areas

Basis for action
6.3.  Health ultimately depends on the ability to manage successfully the
interaction between the physical, spiritual, biological and economic/social
environment.  Sound development is not possible without a healthy population;
yet most developmental activities affect the environment to some degree, which
in turn causes or exacerbates many health problems.  Conversely, it is the
very lack of development that adversely affects the health condition of many
people, which can be alleviated only through development.  The health sector
cannot meet basic needs and objectives on its own; it is dependent on social,
economic and spiritual development, while directly contributing to such
development.  It is also dependent on a healthy environment, including the
provision of a safe water supply and sanitation and the promotion of a safe
food supply and proper nutrition.  Particular attention should be directed
towards food safety, with priority placed on the elimination of food
contamination; comprehensive and sustainable water policies to ensure safe
drinking water and sanitation to preclude both microbial and chemical
contamination; and promotion of health education, immunization and provision
of essential drugs.  Education and appropriate services regarding responsible
planning of family size, with respect for cultural, religious and social
aspects, in keeping with freedom, dignity and personally held values and
taking into account ethical and cultural considerations, also contribute to
these intersectoral activities.

Objectives

6.4.  Within the overall strategy to achieve health for all by the year 2000,
the objectives are to meet the basic health needs of rural peri-urban and
urban populations; to provide the necessary specialized environmental health
services; and to coordinate the involvement of citizens, the health sector,
the health-related sectors and relevant non-health sectors (business, social,
educational and religious institutions) in solutions to health problems.  As
a matter of priority, health service coverage should be achieved for
population groups in greatest need, particularly those living in rural areas.

Activities

6.5.  National Governments and local authorities, with the support of relevant
non-governmental organizations and international organizations, in the light
of countries' specific conditions and needs, should strengthen their health
sector programmes, with special attention to rural needs, to:

     (a)   Build basic health infrastructures, monitoring and planning
systems:

     (i)   Develop and strengthen primary health care systems that are
           practical, community-based, scientifically sound, socially
           acceptable and appropriate to their needs and that meet basic
           health needs for clean water, safe food and sanitation;

    (ii)   Support the use and strengthening of mechanisms that improve
           coordination between health and related sectors at all
           appropriate levels of government, and in communities and relevant
           organizations;

   (iii)   Develop and implement rational and affordable approaches to the
           establishment and maintenance of health facilities;

    (iv)   Ensure and, where appropriate, increase provision of social
           services support;

     (v)   Develop strategies, including reliable health indicators, to
           monitor the progress and evaluate the effectiveness of health
           programmes;

    (vi)   Explore ways to finance the health system based on the assessment
           of the resources needed and identify the various financing
           alternatives;

   (vii)   Promote health education in schools, information exchange,
           technical support and training;
  (viii)               Support initiatives for self-management of services by vulnerable
           groups;

    (ix)   Integrate traditional knowledge and experience into national
           health systems, as appropriate;

     (x)   Promote the provisions for necessary logistics for outreach
           activities, particularly in rural areas;

    (xi)   Promote and strengthen community-based rehabilitation activities
           for the rural handicapped.

     (b)   Support research and methodology development:

     (i)   Establish mechanisms for sustained community involvement in
           environmental health activities, including optimization of the
           appropriate use of community financial and human resources;

    (ii)   Conduct environmental health research, including behaviour
           research and research on ways to increase coverage and ensure
           greater utilization of services by peripheral, underserved and
           vulnerable populations, as appropriate to good prevention
           services and health care;

   (iii)   Conduct research into traditional knowledge of prevention and
           curative health practices.

[Shammu]

Means of implementation

(a)  Financing and cost evaluation

6.6.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$40 billion, including about $5 billion from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b)  Scientific and technological means

6.7.  New approaches to planning and managing health care systems and
facilities should be tested, and research on ways of integrating appropriate
technologies into health infrastructures supported.  The development of
scientifically sound health technology should enhance adaptability to local
needs and maintainability by community resources, including the maintenance
and repair of equipment used in health care.  Programmes to facilitate the
transfer and sharing of information and expertise should be developed,
including communication methods and educational materials.

(c)  Human resource development

6.8.  Intersectoral approaches to the reform of health personnel development
should be strengthened to ensure its relevance to the "Health for All"
strategies.  Efforts to enhance managerial skills at the district level should
be supported, with the aim of ensuring the systematic development and
efficient operation of the basic health system.  Intensive, short, practical
training programmes with emphasis on skills in effective communication,
community organization and facilitation of behaviour change should be
developed in order to prepare the local personnel of all sectors involved in
social development for carrying out their respective roles.  In cooperation
with the education sector, special health education programmes should be
developed focusing on the role of women in the health-care system.

(d)  Capacity-building

6.9.  Governments should consider adopting enabling and facilitating
strategies to promote the participation of communities in meeting their own
needs, in addition to providing direct support to the provision of health-care
services.  A major focus should be the preparation of community-based health
and health-related workers to assume an active role in community health
education, with emphasis on team work, social mobilization and the support of
other development workers.  National programmes should cover district health
systems in urban, peri-urban and rural areas, the delivery of health
programmes at the district level, and the development and support of referral
services.


                  B.  Control of communicable diseases

Basis for action

6.10.  Advances in the development of vaccines and chemotherapeutic agents
have brought many communicable diseases under control.  However, there remain
many important communicable diseases for which environmental control measures
are indispensable, especially in the field of water supply and sanitation.
Such diseases include cholera, diarrhoeal diseases, leishmaniasis, malaria and
schistosomiasis.  In all such instances, the environmental measures, either
as an integral part of primary health care or undertaken outside the health
sector, form an indispensable component of overall disease control strategies,
together with health and hygiene education, and in some cases, are the only
component.

6.11.  With HIV infection levels estimated to increase to 30-40 million by the
year 2000, the socio-economic impact of the pandemic is expected to be
devastating for all countries, and increasingly for women and children.  While
direct health costs will be substantial, they will be dwarfed by the indirect
costs of the pandemic - mainly costs associated with the loss of income and
decreased productivity of the workforce.  The pandemic will inhibit growth of
the service and industrial sectors and significantly increase the costs of
human capacity-building and retraining.  The agricultural sector is
particularly affected where production is labour-intensive.

Objectives

6.12.  A number of goals have been formulated through extensive consultations
in various international forums attended by virtually all Governments,
relevant United Nations organizations (including WHO, UNICEF, UNFPA, UNESCO,
UNDP and the World Bank) and a number of non-governmental organizations.
Goals (including but not limited to those listed below) are recommended for
implementation by all countries where they are applicable, with appropriate
adaptation to the specific situation of each country in terms of phasing,
standards, priorities and availability of resources, with respect for
cultural, religious and social aspects, in keeping with freedom, dignity and
personally held values and taking into account ethical considerations.
Additional goals that are particularly relevant to a country's specific
situation should be added in the country's national plan of action (Plan of
Action for Implementing the World Declaration on the Survival, Protection and
Development of Children in the 1990s). 1/  Such national level action plans
should be coordinated and monitored from within the public health sector.
Some major goals are:

[Shammu]

(a)   By the year 2000, to eliminate guinea worm disease
(dracunculiasis);

(b)   By the year 2000, eradicate polio;

(c)   By the year 2000, to effectively control onchocerciasis (river
blindness) and leprosy;

(d)   By 1995, to reduce measles deaths by 95 per cent and reduce
measles cases by 90 per cent compared with pre-immunization levels;

(e)   By continued efforts, to provide health and hygiene education and
to ensure universal access to safe drinking water and universal access to
sanitary measures of excreta disposal, thereby markedly reducing waterborne
diseases such as cholera and schistosomiasis and reducing:
(i)   By the year 2000, the number of deaths from childhood diarrhoea in developing countries by 50 to 70 per cent;

(ii)   By the year 2000, the incidence of childhood diarrhoea in developing countries by at least 25 to 50 per cent;

(f)   By the year 2000, to initiate comprehensive programmes to reduce
mortality from acute respiratory infections in children under five years by
at least one third, particularly in countries with high infant mortality;

(g)   By the year 2000, to provide 95 per cent of the world's child
population with access to appropriate care for acute respiratory infections
within the community and at first referral level;

(h)   By the year 2000, to institute anti-malaria programmes in all
countries where malaria presents a significant health problem and maintain the
transmission-free status of areas freed from endemic malaria;

(i)   By the year 2000, to implement control programmes in countries
where major human parasitic infections are endemic and achieve an overall
reduction in the prevalence of schistosomiasis and of other trematode
infections by 40 per cent and 25 per cent, respectively, from a 1984 baseline,
as well as a marked reduction in incidence, prevalence and intensity of
filarial infections;

(j)   To mobilize and unify national and international efforts against
AIDS to prevent infection and to reduce the personal and social impact of HIV
infection;

(k)   To contain the resurgence of tuberculosis, with particular
emphasis on multiple antibiotic resistant forms;

(l)   To accelerate research on improved vaccines and implement to the
fullest extent possible the use of vaccines in the prevention of disease.

Activities

6.13.  Each national Government, in accordance with national plans for public
health, priorities and objectives, should consider developing a national
health action plan with appropriate international assistance and support,
including, at a minimum, the following components:

     (a)   National public health systems:

    (i)  Programmes to identify environmental hazards in the causation of
         communicable diseases;

    (ii) Monitoring systems of epidemiological data to ensure adequate
         forecasting of the introduction, spread or aggravation of
         communicable diseases;

   (iii) Intervention programmes, including measures consistent with the
         principles of the global AIDS strategy;

    (iv) Vaccines for the prevention of communicable diseases;

    (b)  Public information and health education:

         Provide education and disseminate information on the risks of
         endemic communicable diseases and build awareness on environmental
         methods for control of communicable diseases to enable communities
         to play a role in the control of communicable diseases;

    (c)  Intersectoral cooperation and coordination:

    (i)  Second experienced health professionals to relevant sectors, such
         as planning, housing and agriculture; 

    (ii) Develop guidelines for effective coordination in the areas of
         professional training, assessment of risks and development of
         control technology;

    (d)  Control of environmental factors that influence the spread of
         communicable diseases:

         Apply methods for the prevention and control of communicable
         diseases, including water supply and sanitation control, water
         pollution control, food quality control, integrated vector control,
         garbage collection and disposal and environmentally sound
         irrigation practices;

    (e)  Primary health care system:

    (i)  Strengthen prevention programmes, with particular emphasis on
         adequate and balanced nutrition;

    (ii) Strengthen early diagnostic programmes and improve capacities for
         early preventative/treatment action;

   (iii) Reduce the vulnerability to HIV infection of women and their
         offspring;

    (f)  Support for research and methodology development:

    (i)  Intensify and expand multidisciplinary research, including focused
         efforts on the mitigation and environmental control of tropical
         diseases;

    (ii) Carry out intervention studies to provide a solid epidemiological
         basis for control policies and to evaluate the efficiency of
         alternative approaches;

   (iii) Undertake studies in the population and among health workers to
         determine the influence of cultural, behavioural and social factors
         on control policies;

    (g)  Development and dissemination of technology:

    (i)  Develop new technologies for the effective control of communicable
         diseases;

    (ii) Promote studies to determine how to optimally disseminate results
         from research;

   (iii) Ensure technical assistance, including the sharing of knowledge and
         know-how.

Means of implementation

(a) Financing and cost evaluation

6.14.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$4 billion, including about $900 million from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Scientific and technological means

6.15.  Efforts to prevent and control diseases should include investigations
of the epidemiological, social and economic bases for the development of more
effective national strategies for the integrated control of communicable
diseases.  Cost-effective methods of environmental control should be adapted
to local developmental conditions.

(c)             Human resource development

6.16.  National and regional training institutions should promote broad
intersectoral approaches to prevention and control of communicable diseases,
including training in epidemiology and community prevention and control,
immunology, molecular biology and the application of new vaccines.  Health
education materials should be developed for use by community workers and for
the education of mothers for the prevention and treatment of diarrhoeal
diseases in the home.

(d) Capacity-building

6.17.  The health sector should develop adequate data on the distribution of
communicable diseases, as well as the institutional capacity to respond and
collaborate with other sectors for prevention, mitigation and correction of
communicable disease hazards through environmental protection.  The advocacy
at policy- and decision-making levels should be gained, professional and
societal support mobilized, and communities organized in developing
self-reliance.

[Shammu]

C.  Protecting vulnerable groups

Basis for action

6.18.  In addition to meeting basic health needs, specific emphasis has to be
given to protecting and educating vulnerable groups, particularly infants,
youth, women, indigenous people and the very poor as a prerequisite for
sustainable development.  Special attention should also be paid to the health
needs of the elderly and disabled population.

6.19.  Infants and children.  Approximately one third of the world's
population are children under 15 years old.  At least 15 million of these
children die annually from such preventable causes as birth trauma, birth
asphyxia, acute respiratory infections, malnutrition, communicable diseases
and diarrhoea.  The health of children is affected more severely than other
population groups by malnutrition and adverse environmental factors, and many
children risk exploitation as cheap labour or in prostitution.

6.20.  Youth.  As has been the historical experience of all countries, youth
are particularly vulnerable to the problems associated with economic
development, which often weakens traditional forms of social support essential
for the healthy development, of young people.  Urbanization and changes in
social mores have increased substance abuse, unwanted pregnancy and sexually
transmitted diseases, including AIDS.  Currently more than half of all people
alive are under the age of 25, and four of every five live in developing
countries.  Therefore it is important to ensure that historical experience is
not replicated.

6.21.  Women.  In developing countries, the health status of women remains
relatively low, and during the 1980s poverty, malnutrition and general
ill-health in women were even rising.  Most women in developing countries
still do not have adequate basic educational opportunities and they lack the
means of promoting their health, responsibly controlling their reproductive
life and improving their socio-economic status.  Particular attention should
be given to the provision of pre-natal care to ensure healthy babies.

6.22.  Indigenous people and their communities.  Indigenous people had their
communities make up a significant percentage of global population.  The
outcomes of their experience have tended to be very similar in that the basis
of their relationship with traditional lands has been fundamentally changed.
They tend to feature disproportionately in unemployment, lack of housing,
poverty and poor health.  In many countries the number of indigenous people
is growing faster than the general population.  Therefore it is important to
target health initiatives for indigenous people.

Objectives

6.23.  The general objectives of protecting vulnerable groups are to ensure
that all such individuals should be allowed to develop to their full potential
(including healthy physical, mental and spiritual development); to ensure that
young people can develop, establish and maintain healthy lives; to allow women
to perform their key role in society; and to support indigenous people through
educational, economic and technical opportunities.

6.24.  Specific major goals for child survival, development and protection
were agreed upon at the World Summit for Children and remain valid also for
Agenda 21.  Supporting and sectoral goals cover women's health and education,
nutrition, child health, water and sanitation, basic education and children
in difficult circumstances.

6.25.  Governments should take active steps to implement, as a matter of
urgency, in accordance with country specific conditions and legal systems,
measures to ensure that women and men have the same right to decide freely and
responsibly on the number and spacing of their children, to have access to the
information, education and means, as appropriate, to enable them to exercise
this right in keeping with their freedom, dignity and personally held values,
taking into account ethical and cultural considerations.

6.26.  Governments should take active steps to implement programmes to
establish and strengthen preventive and curative health facilities which
include women-centred, women-managed, safe and effective reproductive health
care and affordable, accessible services, as appropriate, for the responsible
planning of family size, in keeping with freedom, dignity and personally held
values and taking into account ethical and cultural considerations.
Programmes should focus on providing comprehensive health care, including
pre-natal care, education and information on health and responsible parenthood
and should provide the opportunity for all women to breast-feed fully, at
least during the first four months post-partum.  Programmes should fully
support women's productive and reproductive roles and well being, with special
attention to the need for providing equal and improved health care for all
children and the need to reduce the risk of maternal and child mortality and
sickness.

Activities

6.27.  National Governments, in cooperation with local and non-governmental
organizations, should initiate or enhance programmes in the following areas:

    (a)  Infants and children:

    (i)  Strengthen basic health-care services for children in the context
         of primary health-care delivery, including prenatal care,
         breast-feeding, immunization and nutrition programmes;

    (ii) Undertake widespread adult education on the use of oral rehydration
         therapy for diarrhoea, treatment of respiratory infections and
         prevention of communicable diseases;

   (iii) Promote the creation, amendment and enforcement of a legal
         framework protecting children from sexual and workplace
         exploitation;

    (iv) Protect children from the effects of environmental and occupational
         toxic compounds;

    (b)  Youth:

         Strengthen services for youth in health, education and social
         sectors in order to provide better information, education,
         counselling and treatment for specific health problems, including
         drug abuse;

    (c)  Women:

    (i)  Involve women's groups in decision-making at the national and
         community levels to identify health risks and incorporate health
         issues in national action programmes on women and development;
    (ii)             Provide concrete incentives to encourage and maintain attendance of
         women of all ages at school and adult education courses, including
         health education and training in primary, home and maternal health
         care;

   (iii) Carry out baseline surveys and knowledge, attitude and practice
         studies on the health and nutrition of women throughout their life
         cycle, especially as related to the impact of environmental
         degradation and adequate resources;

    (d)  Indigenous people and their communities:

    (i)  Strengthen, through resources and self-management, preventative and
         curative health services;

    (ii) Integrate traditional knowledge and experience into health systems.

[Shammu]

Means of implementation

(a) Financing and cost evaluation

6.28.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$3.7 billion, including about $400 billion from the international community
on grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Scientific and technological means

6.29.  Educational, health and research institutions should be strengthened
to provide support to improve the health of vulnerable groups.  Social
research on the specific problems of these groups should be expanded and
methods for implementing flexible pragmatic solutions explored, with emphasis
on preventive measures.  Technical support should be provided to Governments,
institutions and non-governmental organizations for youth, women and
indigenous people in the health sector.

(c) Human resources development

6.30.  The development of human resources for the health of children, youth
and women should include reinforcement of educational institutions, promotion
of interactive methods of education for health and increased use of mass media
in disseminating information to the target groups.  This requires the training
of more community health workers, nurses, midwives, physicians, social
scientists and educators, the education of mothers, families and communities
and the strengthening of ministries of education, health, population etc.

(d) Capacity-building

6.31.  Governments should promote, where necessary:  (i) the organization of
national, intercountry and interregional symposia and other meetings for the
exchange of information among agencies and groups concerned with the health
of children, youth, women and indigenous people, and (ii) women's
organizations, youth groups and indigenous people's organizations to
facilitate health and consult them on the creation, amendment and enforcement
of legal frameworks to ensure a healthy environment for children, youth, women
and indigenous peoples.


                 D.  Meeting the urban health challenge

Basis for action

6.32.  For hundreds of millions of people, the poor living conditions in urban
and peri-urban areas are destroying lives, health, and social and moral
values.  Urban growth has outstripped society's capacity to meet human needs,
leaving hundreds of millions of people with inadequate incomes, diets, housing
and services.  Urban growth exposes populations to serious environmental
hazards and has outstripped the capacity of municipal and local governments
to provide the environmental health services that the people need.  All too
often, urban development is associated with destructive effects on the
physical environment and the resource base needed for sustainable development.
Environmental pollution in urban areas is associated with excess morbidity and
mortality. Overcrowding and inadequate housing contribute to respiratory
diseases, tuberculosis, meningitis and other diseases.  In urban environments,
many factors that affect human health are outside the health sector.
Improvements in urban health therefore will depend on coordinated action by
all levels of government, health care providers, businesses, religious groups,
social and educational institutions and citizens.


Objectives

6.33.  The health and well-being of all urban dwellers must be improved so
that they can contribute to economic and social development.  The global
objective is to achieve a 10 to 40 per cent improvement in health indicators
by the year 2000.  The same rate of improvement should be achieved for
environmental, housing and health service indicators.  These include the
development of quantitative objectives for infant mortality, maternal
mortality, percentage of low birth weight newborns and specific indicators
(e.g. tuberculosis as an indicator of crowded housing, diarrhoeal diseases as
indicators of inadequate water and sanitation, rates of industrial and
transportation accidents that indicate possible opportunities for prevention
of injury, and social problems such as drug abuse, violence and crime that
indicate underlying social disorders).

Activities

6.34.  Local authorities, with the appropriate support of national Governments
and international organizations should be encouraged to take effective
measures to initiate or strengthen the following activities:

    (a)  Develop and implement municipal and local health plans:

    (i)  Establish or strengthen intersectoral committees at both the
         political and technical level, including active collaboration on
         linkages with scientific, cultural, religious, medical, business,
         social and other city institutions, using networking arrangements;

    (ii) Adopt or strengthen municipal or local "enabling strategies" that
         emphasize "doing with" rather than "doing for" and create
         supportive environments for health;

   (iii) Ensure that public health education in schools, workplace, mass
         media etc. is provided or strengthened;

    (iv) Encourage communities to develop personal skills and awareness of
         primary health care;

    (v)  Promote and strengthen community-based rehabilitation activities
         for the urban and peri-urban disabled and the elderly;

    (b)  Survey, where necessary, the existing health, social and
         environmental conditions in cities, including documentation of
         intra-urban differences;

    (c)  Strengthen environmental health services:

    (i)  Adopt health impact and environmental impact assessment procedures;

    (ii) Provide basic and in-service training for new and existing
         personnel;

    (d)  Establish and maintain city networks for collaboration and exchange
         of models of good practice.

Means of implementation

(a) Financing and cost evaluation

6.35.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$222 million, including about $22 million from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Scientific and technological means

6.36.  Decision-making models should be further developed and more widely used
to assess the costs and the health and environment impacts of alternative
technologies and strategies.  Improvement in urban development and management
requires better national and municipal statistics based on practical,
standardized indicators.  Development of methods is a priority for the
measurement of intra-urban and intra-district variations in health status and
environmental conditions, and for the application of this information in
planning and management.

(c) Human resources development

6.37.  Programmes must supply the orientation and basic training of municipal
staff required for the healthy city processes.  Basic and in-service training
of environmental health personnel will also be needed.

(d) Capacity-building

6.38.  The programme is aimed towards improved planning and management
capabilities in the municipal and local government and its partners in central
Government, the private sector and universities.  Capacity development should
be focused on obtaining sufficient information, improving coordination
mechanisms linking all the key actors, and making better use of available
instruments and resources for implementation.


             E.  Reducing health risks from environmental pollution
                 and hazards

Basis for action

6.39.  In many locations around the world the general environment (air, water
and land), workplaces and even individual dwellings are so badly polluted that
the health of hundreds of millions of people is adversely affected.  This is,
inter alia, due to past and present developments in consumption and production
patterns and lifestyles, in energy production and use, in industry, in
transportation etc., with little or no regard for environmental protection.
There have been notable improvements in some countries, but deterioration of
the environment continues.  The ability of countries to tackle pollution and
health problems is greatly restrained because of lack of resources.  Pollution
control and health protection measures have often not kept pace with economic
development.  Considerable development-related environmental health hazards
exist in the newly industrializing countries.  Furthermore, the recent
analysis of WHO has clearly established the interdependence among the factors
of health, environment and development and has revealed that most countries
are lacking such integration as would lead to an effective pollution control
mechanism. 2/  Without prejudice to such criteria as may be agreed upon by the
international community, or to standards which will have to be determined
nationally, it will be essential in all cases to consider the systems of
values prevailing in each country and the extent of the applicability of
standards that are valid for the most advanced countries but may be
inappropriate and of unwarranted social cost for the developing countries.

[Shammu]

Objectives

6.40.  The overall objective is to minimize hazards and maintain the
environment to a degree that human health and safety is not impaired or
endangered and yet encourage development to proceed.  Specific programme
objectives are:

    (a)  By the year 2000, to incorporate appropriate environmental and
health safeguards as part of national development programmes in all countries;


    (b)  By the year 2000, to establish, as appropriate, adequate national
infrastructure and programmes for providing environmental injury, hazard
surveillance and the basis for abatement in all countries;

    (c)  By the year 2000, to establish, as appropriate, integrated
programmes for tackling pollution at the source and at the disposal site, with
a focus on abatement actions in all countries;

    (d)  To identify and compile, as appropriate, the necessary statistical
information on health effects to support cost/benefit analysis, including
environmental health impact assessment for pollution control, prevention and
abatement measures.

Activities

6.41.  Nationally determined action programmes, with international assistance,
support and coordination, where necessary, in this area should include:

    (a)  Urban air pollution:

    (i)  Develop appropriate pollution control technology on the basis of
         risk assessment and epidemiological research for the introduction
         of environmentally sound production processes and suitable safe
         mass transport;

    (ii) Develop air pollution control capacities in large cities,
         emphasizing enforcement programmes and using monitoring networks,
         as appropriate;

    (b)  Indoor air pollution:

    (i)  Support research and develop programmes for applying prevention and
         control methods to reducing indoor air pollution, including the
         provision of economic incentives for the installation of
         appropriate technology;

    (ii) Develop and implement health education campaigns, particularly in
         developing countries, to reduce the health impact of domestic use
         of biomass and coal;

    (c)  Water pollution:

    (i)  Develop appropriate water pollution control technologies on the
         basis of health risk assessment;

    (ii) Develop water pollution control capacities in large cities;

    (d)  Pesticides:

         Develop mechanisms to control the distribution and use of
         pesticides in order to minimize the risks to human health by
         transportation, storage, application and residual effects of
         pesticides used in agriculture and preservation of wood;

    (e)  Solid waste:

    (i)  Develop appropriate solid waste disposal technologies on the basis
         of health risk assessment;
    (ii)             Develop appropriate solid waste disposal capacities in large
         cities;

    (f)  Human settlements:

         Develop programmes for improving health conditions in human
         settlements, in particular within slums and non-tenured
         settlements, on the basis of health risk assessment;

    (g)  Noise:

         Develop criteria for maximum permitted safe noise exposure levels
         and promote noise assessment and control as part of environmental
         health programmes;

    (h)  Ionizing and non-ionizing radiation:

         Develop and implement appropriate national legislation, standards
         and enforcement procedures on the basis of existing international
         guidelines;

    (i)  Effects of ultraviolet radiation:

         Undertake, as a matter of urgency, research on the effects on human
         health of the increasing ultraviolet radiation reaching the earth's
         surface as a consequence of depletion of the stratospheric ozone
         layer;

    (ii) On the basis of the outcome of this research, consider taking
         appropriate remedial measures to mitigate the above-mentioned
         effects on human beings;

    (j)  Industry and energy production:

    (i)  Establish environmental health impact assessment procedures for the
         planning and development of new industries and energy facilities;

    (ii) Incorporate appropriate health risk analysis in all national
         programmes for pollution control and management, with particular
         emphasis on toxic compounds such as lead;

   (iii) Establish industrial hygiene programmes in all major industries for
         the surveillance of workers' exposure to health hazards;

    (iv) Promote the introduction of environmentally sound technologies
         within the industry and energy sectors;

    (k)  Monitoring and assessment:

         Establish, as appropriate, adequate environmental monitoring
         capacities for the surveillance of environmental quality and the
         health status of populations;

    (l)  Injury monitoring and reduction:

    (i)  Support, as appropriate, the development of systems to monitor the
         incidence and cause of injury to allow well-targeted
         intervention/prevention strategies;

    (ii) Develop, in accordance with national plans, strategies in all
         sectors (industry, traffic and others) consistent with the WHO safe
         cities and safe communities programmes, to reduce the frequency and
         severity of injury;

   (iii) Emphasize preventive strategies to reduce occupationally derived
         diseases and diseases caused by environmental and occupational
         toxins to enhance worker safety;

    (m)  Research promotion and methodology development:
                (i)  Support the development of new methods for the quantitative
         assessment of health benefits and cost associated with different
         pollution control strategies;

    (ii) Develop and carry out interdisciplinary research on the combined
         health effects of exposure to multiple environmental hazards,
         including epidemiological investigations of long-term exposures to
         low levels of pollutants and the use of biological markers capable
         of estimating human exposures, adverse effects and susceptibility
         to environmental agents.

Means of implementation

(a) Financing and cost evaluation

6.42.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$3 billion, including about $115 million from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Scientific and technological means

6.43.  Although technology to prevent or abate pollution is readily available
for a large number of problems, for programme and policy development countries
should undertake research within an intersectoral framework.  Such efforts
should include collaboration with the business sector.  Cost/effect analysis
and environmental impact assessment methods should be developed through
cooperative international programmes and applied to the setting of priorities
and strategies in relation to health and development.

6.44.  In the activities listed in paragraph 6.41 (a) to (m) above, developing
country efforts should be facilitated by access to and transfer of technology,
know-how and information, from the repositories of such knowledge and
technologies, in conformity with chapter 34.

(c) Human resource development

6.45.  Comprehensive national strategies should be designed to overcome the
lack of qualified human resources, which is a major impediment to progress in
dealing with environmental health hazards.  Training should include
environmental and health officials at all levels from managers to inspectors.
More emphasis needs to be placed on including the subject of environmental
health in the curricula of secondary schools and universities and on educating
the public.

(d) Capacity-building

6.46.  Each country should develop the knowledge and practical skills to
foresee and identify environmental health hazards, and the capacity to reduce
the risks.  Basic capacity requirements must include knowledge about
environmental health problems and awareness on the part of leaders, citizens
and specialists; operational mechanisms for intersectoral and
intergovernmental cooperation in development planning and management and in
combating pollution; arrangements for involving private and community
interests in dealing with social issues; delegation of authority and
distribution of resources to intermediate and local levels of government to
provide front-line capabilities to meet environmental health needs.


                                  Notes

    1/   A/45/625, annex.

    2/   Report of the WHO Commission on Health and Environment (Geneva,
forthcoming).

END OF CHAPTER 6

[Soldier4Christ]

Chapter 7

           PROMOTING SUSTAINABLE HUMAN SETTLEMENT DEVELOPMENT


                              INTRODUCTION

7.1. In industrialized countries, the consumption patterns of cities are
severely stressing the global ecosystem, while settlements in the developing
world need more raw material, energy, and economic development simply to
overcome basic economic and social problems.  Human settlement conditions in
many parts of the world, particularly the developing countries, are
deteriorating mainly as a result of the low levels of investment in the sector
attributable to the overall resource constraints in these countries.  In the
low-income countries for which recent data are available, an average of only
5.6 per cent of central government expenditure went to housing, amenities,
social security and welfare. 1/  Expenditure by international support and
finance organizations is equally low.  For example, only 1 per cent of the
United Nations system's total grant-financed expenditures in 1988 went to
human settlements, 2/ while in 1991, loans from the World Bank and the
International Development Association (IDA) for urban development and water
supply and sewerage amounted to 5.5 and 5.4 per cent, respectively, of their
total lending. 3/

7.2. On the other hand, available information indicates that technical
cooperation activities in the human settlement sector generate considerable
public and private sector investment.  For example, every dollar of UNDP
technical cooperation expenditure on human settlements in 1988 generated a
follow-up investment of $122, the highest of all UNDP sectors of
assistance. 4/

7.3. This is the foundation of the "enabling approach" advocated for the
human settlement sector.  External assistance will help to generate the
internal resources needed to improve the living and working environments of
all people by the year 2000 and beyond, including the growing number of
unemployed - the no-income group.  At the same time the environmental
implications of urban development should be recognized and addressed in an
integrated fashion by all countries, with high priority being given to the
needs of the urban and rural poor, the unemployed and the growing number of
people without any source of income.

Human settlement objective

cont'd

[Soldier4Christ]

7.4. The overall human settlement objective is to improve the social,
economic and environmental quality of human settlements and the living and
working environments of all people, in particular the urban and rural poor.
Such improvement should be based on technical cooperation activities,
partnerships among the public, private and community sectors and participation
in the decision-making process by community groups and special interest groups
such as women, indigenous people, the elderly and the disabled.  These
approaches should form the core principles of national settlement strategies.
In developing these strategies, countries will need to set priorities among
the eight programme areas in this chapter in accordance with their national
plans and objectives, taking fully into account their social and cultural
capabilities.  Furthermore, countries should make appropriate provision to
monitor the impact of their strategies on marginalized and disenfranchised
groups, with particular reference to the needs of women.

7.5. The programme areas included in this chapter are:

    (a)  Providing adequate shelter for all;

    (b)  Improving human settlement management;

    (c)  Promoting sustainable land-use planning and management;

    (d)  Promoting the integrated provision of environmental infrastructure:
water, sanitation, drainage and solid-waste management;

    (e)  Promoting sustainable energy and transport systems in human
settlements;

    (f)  Promoting human settlement planning and management in disaster-prone
areas;

    (g)  Promoting sustainable construction industry activities;

    (h)  Promoting human resource development and capacity-building for human
settlement development.


                             PROGRAMME AREAS

                 A.  Providing adequate shelter for all

Basis for action

7.6.  Access to safe and healthy shelter is essential to a person's physical,
psychological, social and economic well-being and should be a fundamental part
of national and international action.  The right to adequate housing as a
basic human right is enshrined in the Universal Declaration of Human Rights
and the International Covenant on Economic, Social and Cultural Rights.
Despite this, it is estimated that at the present time, at least 1 billion
people do not have access to safe and healthy shelter and that if appropriate
action is not taken, this number will increase dramatically by the end of the
century and beyond.

7.7.  A major global programme to address this problem is the Global Strategy
for Shelter to the Year 2000, adopted by the General Assembly in December 1988
(resolution 43/181, annex).  Despite its widespread endorsement, the Strategy
needs a much greater level of political and financial support to enable it to
reach its goal of facilitating adequate shelter for all by the end of the
century and beyond.

Objective

7.8.  The objective is to achieve adequate shelter for rapidly growing
populations and for the currently deprived urban and rural poor through an
enabling approach to shelter development and improvement that is
environmentally sound.

Activities

7.9.  The following activities should be undertaken:

    (a)  As a first step towards the goal of providing adequate shelter for
all, all countries should take immediate measures to provide shelter to their
homeless poor, while the international community and financial institutions
should undertake actions to support the efforts of the developing countries
to provide shelter to the poor;

    (b)  All countries should adopt and/or strengthen national shelter
strategies, with targets based, as appropriate, on the principles and
recommendations contained in the Global Strategy for Shelter to the Year 2000.
People should be protected by law against unfair eviction from their homes or
land;

    (c)  All countries should, as appropriate, support the shelter efforts
of the urban and rural poor, the unemployed and the no-income group by
adopting and/or adapting existing codes and regulations, to facilitate their
access to land, finance and low-cost building materials and by actively
promoting the regularization and upgrading of informal settlements and urban
slums as an expedient measure and pragmatic solution to the urban shelter
deficit;

    (d)  All countries should, as appropriate, facilitate access of urban and
rural poor to shelter by adopting and utilizing housing and finance schemes
and new innovative mechanisms adapted to their circumstances;

    (e)  All countries should support and develop environmentally compatible
shelter strategies at national, state/provincial and municipal levels through
partnerships among the private, public and community sectors and with the
support of community-based organizations;

    (f)  All countries, especially developing ones, should, as appropriate,
formulate and implement programmes to reduce the impact of the phenomenon of
rural to urban drift by improving rural living conditions;

    (g)  All countries, where appropriate, should develop and implement
resettlement programmes that address the specific problems of displaced
populations in their respective countries;

    (h)  All countries should, as appropriate, document and monitor the
implementation of their national shelter strategies by using, inter alia, the
monitoring guidelines adopted by the Commission on Human Settlements and the
shelter performance indicators being produced jointly by the United Nations
Centre for Human Settlements (Habitat) and the World Bank;

    (i)  Bilateral and multilateral cooperation should be strengthened in
order to support the implementation of the national shelter strategies of
developing countries;

    (j)  Global progress reports covering national action and the support
activities of international organizations and bilateral donors should be
produced and disseminated on a biennial basis, as requested in the Global
Strategy for Shelter to the Year 2000.

Means of implementation

(a) Financing and cost evaluation

7.10.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$75 billion, including about $10 billion from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Scientific and technological means

7.11.  The requirements under this heading are addressed in each of the other
programme areas included in the present chapter.

(c) Human resource development and capacity-building

7.12.  Developed countries and funding agencies should provide specific
assistance to developing countries in adopting an enabling approach to the
provision of shelter for all, including the no-income group, and covering
research institutions and training activities for government officials,
professionals, communities and non-governmental organizations and by
strengthening local capacity for the development of appropriate technologies.


                B.  Improving human settlement management

Basis for action

7.13.  By the turn of the century, the majority of the world's population will
be living in cities.  While urban settlements, particularly in developing
countries, are showing many of the symptoms of the global environment and
development crisis, they nevertheless generate 60 per cent of gross national
product and, if properly managed, can develop the capacity to sustain their
productivity, improve the living conditions of their residents and manage
natural resources in a sustainable way.

7.14.  Some metropolitan areas extend over the boundaries of several political
and/or administrative entities (counties and municipalities) even though they
conform to a continuous urban system.  In many cases this political
heterogeneity hinders the implementation of comprehensive environmental
management programmes.

Objective

7.15.  The objective is to ensure sustainable management of all urban
settlements, particularly in developing countries, in order to enhance their
ability to improve the living conditions of residents, especially the
marginalized and disenfranchised, thereby contributing to the achievement of
national economic development goals.

Activities

(a) Improving urban management



cont'd

[Soldier4Christ]

7.16.  One existing framework for strengthening management is in the United
Nations Development Programme/World Bank/United Nations Centre for Human
Settlements (Habitat) Urban Management Programme (UMP), a concerted global
effort to assist developing countries in addressing urban management issues.
Its coverage should be extended to all interested countries during the period
1993-2000.  All countries should, as appropriate and in accordance with
national plans, objectives and priorities and with the assistance of
non-governmental organizations and representatives of local authorities,
undertake the following activities at the national, state/provincial and local
levels, with the assistance of relevant programmes and support agencies:

    (a)  Adopting and applying urban management guidelines in the areas of
land management, urban environmental management, infrastructure management and
municipal finance and administration;

    (b)  Accelerating efforts to reduce urban poverty through a number of
actions, including:

    (i)  Generating employment for the urban poor, particularly women,
         through the provision, improvement and maintenance of urban
         infrastructure and services and the support of economic activities
         in the informal sector, such as repairs, recycling, services and
         small commerce;

    (ii) Providing specific assistance to the poorest of the urban poor
         through, inter alia, the creation of social infrastructure in order
         to reduce hunger and homelessness, and the provision of adequate
         community services;

   (iii) Encouraging the establishment of indigenous community-based
         organizations, private voluntary organizations and other forms of
         non-governmental entities that can contribute to the efforts to
         reduce poverty and improve the quality of life for low-income
         families;

    (c)  Adopting innovative city planning strategies to address
environmental and social issues by:

    (i)  Reducing subsidies on, and recovering the full costs of,
         environmental and other services of high standard (e.g. water
         supply, sanitation, waste collection, roads, telecommunications)
         provided to higher income neighbourhoods;

    (ii) Improving the level of infrastructure and service provision in
         poorer urban areas;

    (d)  Developing local strategies for improving the quality of life and
the environment, integrating decisions on land use and land management,
investing in the public and private sectors and mobilizing human and material
resources, thereby promoting employment generation that is environmentally
sound and protective of human health.

(b) Strengthening urban data systems

7.17.  During the period 1993-2000 all countries should undertake, with the
active participation of the business sector as appropriate, pilot projects in
selected cities for the collection, analysis and subsequent dissemination of
urban data, including environmental impact analysis, at the local,
state/provincial, national and international levels and the establishment of
city data management capabilities. 5/  United Nations organizations, such as
Habitat, UNEP and UNDP, could provide technical advice and model data
management systems.

(c) Encouraging intermediate city development

7.18.  In order to relieve pressure on large urban agglomerations of
developing countries, policies and strategies should be implemented towards
the development of intermediate cities that create employment opportunities
for unemployed labour in the rural areas and support rural-based economic
activities, although sound urban management is essential to ensure that urban
sprawl does not expand resource degradation over an ever wider land area and
increase pressures to convert open space and agricultural/buffer lands for
development.

7.19.  Therefore all countries should, as appropriate, conduct reviews of
urbanization processes and policies in order to assess the environmental
impacts of growth and apply urban planning and management approaches
specifically suited to the needs, resource capabilities and characteristics
of their growing intermediate-sized cities.  As appropriate, they should also
concentrate on activities aimed at facilitating the transition from rural to
urban lifestyles and settlement patterns and at promoting the development of
small-scale economic activities, particularly the production of food, to
support local income generation and the production of intermediate goods and
services for rural hinterlands.

7.20.  All cities, particularly those characterized by severe sustainable
development problems, should, in accordance with national laws, rules and
regulations, develop and strengthen programmes aimed at addressing such
problems and guiding their development along a sustainable path.  Some
international initiatives in support of such efforts, as in the Sustainable
Cities Programme of Habitat and the Healthy Cities Programme of WHO, should
be intensified.  Additional initiatives involving the World Bank, the regional
development banks and bilateral agencies, as well as other interested
stakeholders, particularly international and national representatives of local
authorities, should be strengthened and coordinated.  Individual cities
should, as appropriate:

    (a)  Institutionalize a participatory approach to sustainable urban
development, based on a continuous dialogue between the actors involved in
urban development (the public sector, private sector and communities),
especially women and indigenous people;

    (b)  Improve the urban environment by promoting social organization and
environmental awareness through the participation of local communities in the
identification of public services needs, the provision of urban
infrastructure, the enhancement of public amenities and the protection and/or
rehabilitation of older buildings, historic precincts and other cultural
artifacts.  In addition, "green works" programmes should be activated to
create self-sustaining human development activities and both formal and
informal employment opportunities for low-income urban residents;

    (c)  Strengthen the capacities of their local governing bodies to deal
more effectively with the broad range of developmental and environmental
challenges associated with rapid and sound urban growth through comprehensive
approaches to planning that recognize the individual needs of cities and are
based on ecologically sound urban design practices;

    (d)  Participate in international "sustainable city networks" to exchange
experiences and mobilize national and international technical and financial
support;

    (e)  Promote the formulation of environmentally sound and culturally
sensitive tourism programmes as a strategy for sustainable development of
urban and rural settlements and as a way of decentralizing urban development
and reducing discrepancies among regions;

    (f)  Establish mechanisms, with the assistance of relevant international
agencies, to mobilize resources for local initiatives to improve environmental
quality;

    (g)  Empower community groups, non-governmental organizations and
individuals to assume the authority and responsibility for managing and
enhancing their immediate environment through participatory tools, techniques
and approaches embodied in the concept of environmental care.

7.21.  Cities of all countries should reinforce cooperation among themselves
and cities of the developed countries, under the aegis of non-governmental
organizations active in this field, such as the International Union of Local
Authorities (IULA), the International Council for Local Environmental
Initiatives (ICLEI) and the World Federation of Twin Cities.

Means of implementation

(a) Financing and cost evaluation

7.22.  The Conference secretariat has estimated the average total annual cost
(1993-2000) of implementing the activities of this programme to be about
$100 billion, including about $15 billion from the international community on
grant or concessional terms.  These are indicative and order-of-magnitude
estimates only and have not been reviewed by Governments.  Actual costs and
financial terms, including any that are non-concessional, will depend upon,
inter alia, the specific strategies and programmes Governments decide upon for
implementation.

(b) Human resource development and capacity-building

7.23.  Developing countries should, with appropriate international assistance,
consider focusing on training and developing a cadre of urban managers,
technicians, administrators and other relevant stakeholders who can
successfully manage environmentally sound urban development and growth and are
equipped with the skills necessary to analyse and adapt the innovative
experiences of other cities.  For this purpose, the full range of training
methods - from formal education to the use of the mass media - should be
utilized, as well as the "learning by doing" option.
7.24.  Developing countries should also encourage technological training and
research through joint efforts by donors, non-governmental organizations and
private business in such areas as the reduction of waste, water quality,
saving of energy, safe production of chemicals and less polluting
transportation.



cont'd

[Soldier4Christ]

7.25.  Capacity-building activities carried out by all countries, assisted as
suggested above, should go beyond the training of individuals and functional
groups to include institutional arrangements, administrative routines,
inter-agency linkages, information flows and consultative processes.

7.26.  In addition, international efforts, such as the Urban Management
Programme, in cooperation with multilateral and bilateral agencies, should
continue to assist the developing countries in their efforts to develop a
participatory structure by mobilizing the human resources of the private
sector, non-governmental organizations and the poor, particularly women and
the disadvantaged.


       C.  Promoting sustainable land-use planning and management

Basis for action

7.27.  Access to land resources is an essential component of sustainable
low-impact lifestyles.  Land resources are the basis for (human) living
systems and provide soil, energy, water and the opportunity for all human
activity.  In rapidly growing urban areas, access to land is rendered
increasingly difficult by the conflicting demands of industry, housing,
commerce, agriculture, land tenure structures and the need for open spaces.
Furthermore, the rising costs of urban land prevent the poor from gaining
access to suitable land.  In rural areas, unsustainable practices, such as the
exploitation of marginal lands and the encroachment on forests and
ecologically fragile areas by commercial interests and landless rural
populations, result in environmental degradation, as well as in diminishing
returns for impoverished rural settlers.

Objective

7.28.  The objective is to provide for the land requirements of human
settlement development through environmentally sound physical planning and
land use so as to ensure access to land to all households and, where
appropriate, the encouragement of communally and collectively owned and
managed land. 6/  Particular attention should be paid to the needs of women
and indigenous people for economic and cultural reasons.

Activities

7.29.  All countries should consider, as appropriate, undertaking a
comprehensive national inventory of their land resources in order to establish
a land information system in which land resources will be classified according
to their most appropriate uses and environmentally fragile or disaster-prone
areas will be identified for special protection measures.

7.30.  Subsequently, all countries should consider developing national
land-resource management plans to guide land-resource development and
utilization and, to that end, should:

    (a)  Establish, as appropriate, national legislation to guide the
implementation of public policies for environmentally sound urban development,
land utilization, housing and for the improved management of urban expansion;

    (b)  Create, where appropriate, efficient and accessible land markets
that meet community development needs by, inter alia, improving land registry
systems and streamlining procedures in land transactions;

    (c)  Develop fiscal incentives and land-use control measures, including
land-use planning solutions for a more rational and environmentally sound use
of limited land resources;

                (d)  Encourage partnerships among the public, private and community
sectors in managing land resources for human settlements development;

    (e)  Strengthen community-based land-resource protection practices in
existing urban and rural settlements;

    (f)  Establish appropriate forms of land tenure that provide security of
tenure for all land-users, especially indigenous people, women, local
communities, the low-income urban dwellers and the rural poor;

    (g)  Accelerate efforts to promote access to land by the urban and rural
poor, including credit schemes for the purchase of land and for
building/acquiring or improving safe and healthy shelter and infrastructure
services;

    (h)  Develop and support the implementation of improved land-management
practices that deal comprehensively with potentially competing land
requirements for agriculture, industry, transport, urban development, green
spaces, preserves and other vital needs;

    (i)  Promote understanding among policy makers of the adverse
consequences of unplanned settlements in environmentally vulnerable areas and
of the appropriate national and local land-use and settlements policies
required for this purpose.

7.31.  At the international level, global coordination of land-resource
management activities should be strengthened by the various bilateral and
multilateral agencies and programmes, such as UNDP, FAO, the World Bank, the
regional development banks, other interested organizations and the UNDP/World
Bank/Habitat Urban Management Programme, and action should be taken to promote
the transfer of applicable experience on sustainable land-management practices
to and among developing countries.

Means of implementation

(a) Financing and cost evaluation

cont'd