The International Lead Poisoning Prevention Week: A progress report on achievement of the Business Plan indicator, 2013–2017 1. Introduction The Global Alliance to Eliminate Lead Paint (Lead Paint Alliance) is a voluntary collaborative partnership working to focus and catalyse the efforts of a diverse range of stakeholders to achieve international goals to prevent children’s exposure to lead from paint and to minimize occupational exposures to lead paint. It was established in response to resolution II/4/B adopted by the second session of the International Conference on Chemicals Management in 2009. The Alliance is a joint undertaking of United Nations Environment Programme (UN Environment) and the World Health Organization (WHO). In 2012 the Lead Paint Alliance finalized its business plan1, which provides a road map describing the strategies, milestones and means of achieving the goals and overall objective of the Alliance. Section VII of the plan identifies a number of performance indicators for evaluating the achievements of the business plan. One of these indicators relates to awareness-raising about the risks of lead paint: • Performance indicator: Number of countries with national awareness activities about the risks of lead paint ▪ Milestone targets: o 2013 – 5 countries with national awareness days for prevention of lead poisoning with an emphasis on the risks of lead paint. o 2015 – 10 countries with national awareness days for prevention of lead poisoning with an emphasis on the risks of lead paint. o 2020 – 40 countries with national awareness days for prevention of lead poisoning with an emphasis on the risks of lead paint. 1.1 Establishing International Lead Poisoning Prevention Week Recognising the practical difficulty of synchronising national awareness-raising campaigns on a single day, the Lead Paint Alliance decided to establish an annual International Lead Poisoning Prevention Week (ILPPW), with the expectation that national days and activities would take place during this 1 Available at: http://www.unep.org/chemicalsandwaste/sites/unep.org.chemicalsandwaste/files/publications/GAELP_BusinessPlan.pdf 1 period. The purpose of ILPPW would be to raise awareness worldwide about lead poisoning and to strengthen actions to eliminate the use of lead additives in paint, in particular by: 1) highlighting the efforts of all countries and Alliance partners to prevent childhood lead poisoning; and 2) urging further action to eliminate lead paint. To facilitate the organization of local campaigns and the harmonization of campaign messages internationally, it was decided that customizable outreach materials should be provided each year and a register of events maintained by WHO. The already well-established annual Lead Poisoning Prevention Week in the USA provided a model for awareness-raising materials and activities. Each year a working group comprising representatives from WHO, UN Environment, the US Environmental Protection Agency (US EPA) and IPEN2 develop a range of hand-outs, posters, fact- sheets and other outreach materials on lead poisoning, and plan a social media communications strategy. Many of these materials are provided in the six UN official languages (Arabic, Chinese, English, French, Russian and Spanish) and can be downloaded from the WHO website, from dedicated webpages for each language3. Since 2016, a campaign resource pack has also been provided, which gives guidance on organizing campaigns, suggestions for key messages, as well as links to the campaign materials. In 2017, campaign materials were also made available from a Trello board4. WHO has set up an event registration page and organizations interested in arranging an event during the week are urged to register their plans on this page5. The campaign materials developed by Lead Paint Alliance partners can be customized with the logos and contact information of event organizers and translated into local languages. The purpose of developing campaign icons, key messages and customisable materials for adaptation by campaign organizers is to amplify the campaign at the global level. The success of this strategy is shown by the number of campaign posters, websites and events using the customisable ILPPW posters, the “Lead- Free Kids for a Healthy Future” icon and standardized messages in multiple languages, including in Albanian, Dutch, Georgian, Hindi, Nepali, Serbian, Sinhala and Thai. Many event organizers have created additional flyers and hand-outs to further raise awareness of lead exposure in their countries, sometimes drawing attention to other sources of exposure. The first International Lead Poisoning Prevention Week was held on 20–26 October 2013 and there has been an ILPPW in each subsequent year, in the last full week in October. The overarching theme for the ILPPW has been “Lead-Free Kids for a Healthy Future”, and the sub-theme has, thus far, been the elimination of lead paint. This report reviews the worldwide activities that have taken place during ILPPW over the past five years (2013–2017), and how these relate to the performance indicator and milestone targets established in the Alliance business plan of 2012. 2 An international network of environmental civil society organizations 3 http://www.who.int/ipcs/lead_campaign/en/ 4 https://trello.com/b/AmFq8zWK/international-lead-poisoning-prevention-week 5 http://www.who.int/ipcs/lead_campaign/event_registration/en/ 2 2. Analysis of participation in the ILPPW, 2013–2017 This analysis is based on events during ILPPW that were registered on the WHO website. It is recognised that there are an unknown number of events that were not registered and, therefore, not included in this analysis. 2.1 Number of awareness-raising events, by WHO region The number of events registered with WHO increased over the first four years, but decreased in 2017 (Table 1). The smaller number of events in 2017 was, to a large extent, because 33 fewer events were registered from the USA compared with 2016. This does not necessarily mean that fewer events took place but that fewer were registered from that country. Table 1. Number of ILPPW events and number of countries where events took place, 2013–2017 2013 2014 2015 2016 2017 No. events 57 74 95 106 67 No. countries 40 37 37 47 44 Figure 1 shows the number of events organized in each WHO region. The regions with the largest number of events are the Americas and Europe, while the smallest number of registered events has been in the Eastern Mediterranean and Western Pacific Regions. Figure 1. Number of registered events organized in each WHO region in the years 2013–2017 60 50 40 2013 30 2014 2015 No of No events 20 2016 10 2017 0 AFR AMR SEAR EUR EMR WPR WHO region Key. AFR: African Region; AMR: Region of the Americas; SEAR: South-East Asia Region; EUR: European Region; EMR: Eastern Mediterranean Region; WPR: Western Pacific Region. 3 2.2 Number of countries with awareness-raising events, by WHO region As shown in Table 1, the target of 40 countries having events was already achieved in the first ILPPW and this figure was exceeded in 2016 and 2017. Figure 2 shows the number of countries in each WHO region where an event was organized. There has been an increase in the number of countries in the regions for Africa and Western Pacific. In the region for the Americas there seems to be a downward trend, in South-East Asia and Europe the trend is more variable, while in the Eastern Mediterranean Region there has been little change. Figure 2. Number of countries in each WHO region where an event took place in 2013–2017 18 16 14 12 2013 10 2014 8 2015 6 2016 4 2017 No of No countries withevent an 2 0 AFR AMR SEAR EUR EMR WPR WHO Region Key. AFR: African Region; AMR: Region of the Americas; SEAR: South-East Asia Region; EUR: European Region; EMR: Eastern Mediterranean Region; WPR: Western Pacific Region. As the regions differ in the number of member countries, it is also helpful to look at the proportion of countries in each region where ILPPW events were held (Figure 3). This shows that there is again a consistent upward trend in the African region and a downward trend in the American region. The region with the highest proportion of countries having ILPPW events is South-East Asia where, in three of the five years that ILPPW has taken place, more than 50% of countries have had an event. In the other WHO regions, events were organized in at least 10% of countries, peaking at 30% in the European Region in 2016. 4 Figure 3. Proportion of countries in each WHO region where an event took place in 2013–2017 70% 60% 50% 2013 40% 2104 30% 2015 20% 2016 10% 2017 Percentage of countrieswithevent an 0% AFR AMR SEAR EUR EMR WPR WHO Region Key. AFR: African Region; AMR: Region of the Americas; SEAR: South-East Asia Region; EUR: European Region; EMR: Eastern Mediterranean Region; WPR: Western Pacific Region. 2.3 Types of organizations arranging awareness-raising events ILPPW events are organized by a range of organizations and institutions, with the most active being non-governmental organizations (NGOs), national governmental and local governmental authorities (Figure 4). Others include academic institutions, industry and poisons centres. NGOs are particularly active during ILPPW, organizing over 60% of the registered events in 2016 and 2017. While the number of events registered by the paint industry is small their engagement is important and is actively encouraged by the International Paint and Printing Ink Council (IPPIC). Industry activities include issuing statements of support for the goals of the Lead Paint Alliance and organizing workshops for manufacturers on the technical requirements for restricting lead use in paint. Note that the figures for intergovernmental organizations (IGOs) do not include WHO Headquarters and UN Environment, which are, of course, involved every year.