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Integrity in Africa ENVIRONMENTAL DETERMINANTS AND MANAGEMENT SYSTEMS FOR HUMAN HEALTH AND ECOSYSTEMS INTEGRITY IN AFRICA Synthesis Report on the evaluation of implementation of The Libreville Declaration SYNTHESIS REPORT ON THE EVALUATION OF IMPLEMENTATION OF THE LIBREVILLE DECLARATION | i ACKNOWLEDGEMENTS ENVIRONMENTAL DETERMINANTS AND MANAGEMENT SYSTEMS FOR HUMAN HEALTH AND ECOSYSTEMS INTEGRITY IN AFRICA Synthesis Report on the evaluation of implementation of The Libreville Declaration ACRONYMS ACKNOWLEDGEMENTS This report was prepared by the following members of AEO3 Third Africa Environment Outlook NDP National Development Plan the WHO-UNEP Joint Task Team (JTT) for the Health and AfDB African Development Bank NPJA National Plans for Joint Action Environment Strategic Alliance: Lucien Manga, Tim Meredith, CEMAC Central African Economic NHPSP National Health Policies, Strategies Magaran Bagayoko, Waltaji Terfa, Solomon Nzioka, Bernadette and Monetary Community and Plans Ramirez, Hawa Senkoro, Inoua Boubacar, and Pierre Quiblier. CTT Country Task Team PPHACC PanAfrican Programme for Adaptation EA Environmental Audit to Climate Change Plans The report was further reviewed, finalised and adapted EAP Environmental Action Plan PRSP Poverty Reduction Strategy Paper by the Technical and Scientific Committee of the Second EIA Environmental Impact Assessment SADC Southern African Development Community Inter-ministerial Conference on Health and the Environment EMA Environment Management Act which met in September 2013 in Libreville, Gabon. EPA Environment Protection Act SAICM Strategic Approach to International Chemicals Management HESA Health and Environment Strategic Alliance Secretariat: SANA Situation Analysis and Needs Analysis IDSR Integrated Disease Surveillance World Health Organisation: Lucien Manga, Magaran and Response SOE State of the Environment UNDP United Nations Development Programme Bagayoko and Tim Meredith. IMCHE Inter- Ministerial Conference United Nations Environment Programme: Pierre Quiblier, on Health and Environment UNEP United Nations Environment Programme JTT Joint Task Team UNESCO United Nations Education Scientific David Ombisi and Angel Luh. and Cultural Organisation MDG Millennium Development Goals The report was reviewed technically, proof read and edited MoHSW Ministry of Health and Social Welfare UNFCC United Nations Framework Convention on Climate Change by Cheryl Goldstone and design and layout by Patricia Carey. MOP Meeting of Partners WHO World Health Organisation Photography IRIN Irinnews.org; Cover: Shutterstock NAP National Adaptation Plan ii | SYNTHESIS REPORT ON THE EVALUATION OF IMPLEMENTATION OF THE LIBREVILLE DECLARATION SYNTHESIS REPORT ON THE EVALUATION OF IMPLEMENTATION OF THE LIBREVILLE DECLARATION | iii TABLE OF CONTENTS EXECUTIVE SUMMARY ACKNOWLEDGEMENTS ii ACRONYMS iii EXECUTIVE SUMMARY 1 1 INTRODUCTION 2 2 EVALUATION APPROACH 6 2.1 Country-self assessment report 6 2.2 Assessment of intersectoral programmes and projects 6 2.3 External evaluation 6 2.4 Evaluation of the HESA secretariat (JTT) 6 3 GENERAL FINDINGS 7 3.1 Number of priority Libreville Declaration activities being implemented at country level 7 3.2 Number of countries implementing each of the 11 priority Libreville Declaration activities 7 3.3 Issues addressed by the intersectoral projects (n=18) assessed 7 3.4 Coordination and funding of intersectoral projects 8 3.5 Health and programme outcomes 8 3.6 Contribution of the JTT 8 3.7 Summary of country profiles against 11 Libreville Declaration priority actions 10 4 ACHIEVEMENTS AND CHALLENGES 11 4.1 Establishing a health and environment strategic alliance, as the basis for plans of joint action 11 4.2 Integration of health and environment linkages in policies, strategies, regulations and national The Libreville Declaration on Health and UNEP Joint Task Team (JTT) The evaluations also showed and Environment in Africa, adopted established in 2009 as the Secretariat that progress is being made by development plans 11 in 2008, represents the umbrella for the Health and Environment countries in addressing the identified 4.3 Implementing priority intersectoral programmes at all levels, aimed at accelerating achievement framework upon which African Strategic Alliance (HESA). challenges. The outcomes of the of MDGs 12 countries and their development The evaluations confirm that the implementation of the Declaration 4.4 Establishing or strengthening health and environment institutions 13 partners address the environmental key health and environment range from country ownership of the 4.5 Supporting knowledge acquisition and management to identify knowledge gaps and research priorities determinants of human health and challenges in the African region process, enhanced awareness and and to support education and training at all levels 13 ecosystems integrity in a coherent continue to be provision of safe increased dialogue between the two 4.6 Establishing or strengthening systems for health and environment surveillance to identify emerging fashion. In 2013 the Secretariat of the drinking water, sanitation and sectors, to identification of national risks, in order to manage them better 13 Health and Environment Strategic hygiene services; management priorities. However, much still needs 4.7 Enforcing compliance with international conventions 14 Alliance (HESA) commissioned a set of water, soil and air pollution; to be undertaken in order to ensure 4.8 Setting up national monitoring and evaluation mechanisms to assess performance in implementing of four complementary evaluations vector control and management of that this political commitment is fully priority programmes 14 to assess national and regional chemicals and wastes; food safety; translated into action. level progress in the five years since 4.9 Instituting the practice of systematic assessment of health and environment risks 15 environmental health of children and This second synthesis report the adoption of the Declaration. women; and health in the workplace. highlights achievements in executing 4.10 Developing partnerships for targeted and specific advocacy on health and environment issues 16 The assessments consisted of: These risk factors are exacerbated the priority actions included in 4.11 Achieving a balance in the allocation of national budgetary resources for intersectoral health (1) Country-self-evaluations of by the negative impacts of climate the Libreville Declaration and and environment programmes 16 their efforts in implementation change, unplanned urbanization, Luanda Commitment, and identifies 5 LESSONS LEARNT 17 of the Declaration; (2) An in- uncontrolled rapid population implementation challenges, potential 6 RECOMMENDATIONS 18 depth assessment of intersectoral growth and urban migration. These for enhancing what is already 6.1 Scale up the implementation of multi sector projects in all countries: 18 projects and/or programmes being factors increase pressure on already working well as well as opportunities 6.1 Increase investment for the implementation of the libreville declaration 18 implemented in selected countries; overburdened health systems which for improvement. Recommendations 6.3 Intensify advocacy efforts that stress the promotion of the linkages in health and environment as (3) An external evaluation conducted function in the context of paucity are made to address these issues and by an independent consultant; and a contribution to sustainable development: 18 of qualified human resources and build on the lessons learnt. (4) An internal evaluation of the shortage of financial resources. 7 CONCLUSION 18 contribution made by the WHO iv | SYNTHESIS REPORT ON THE EVALUATION OF IMPLEMENTATION OF THE LIBREVILLE DECLARATION SYNTHESIS REPORT ON THE EVALUATION OF IMPLEMENTATION OF THE LIBREVILLE DECLARATION | 1 1 INTRODUCTION 1 INTRODUCTION continued The First Inter-Ministerial The Declaration further calls upon mandated to perform the functions in addressing the top ten health and countries experience in implementing country level achievements in Conference on Health and United Nations Environment listed in Box 2 to support countries in environment priorities agreed upon in the Libreville Declaration. These six selected countries (IMCH/3/ Environment in Africa was held from Programme (UNEP) and World Health the implementation of the Libreville Luanda; (2) portraying initial outcomes evaluations were conducted in 2013 INH4). It included assessing the 26 to 28 August 2008 in Libreville, Organization (WHO) to “support, Declaration. and co-benefits of intersectoral action and consisted of four separate, but entire implementation process at Gabon. The conference was attended along with other partners and donors, on local communities and in relation complementary exercises covering the national and regional levels. by Ministers of Health and Ministers including the African Development Biennial roadmaps and workplans to the MDGs; and (3) strengthening years (2009-2012) since its adoption of the Environment from 52 African Bank (AfDB) and the African sub- spell out the milestones and key the HESA. in 2008. Collectively they provide o An internal evaluation to assess countries and culminated in the regional economic communities, the activities to be undertaken by the a comprehensive account of the the contribution of the Joint adoption of the Libreville Declaration implementation of this Declaration, and JTT at national and international The Second Inter-Ministerial progress made towards achieving Task Team (JTT) established
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