- Email: [email protected]
Governance for a sustainable future
Public Health (2006) 120, 604–608
MINI-SYMPOSIUM
Governance for a sustainable future Jack Jeffery Royal Institute of Public Health, 28 Portland Place, London W1B 1DE, UK
KEYWORDS Sustainability; Water; Cryptosporidiosis
Summary The paper discusses the concepts of governance and sustainability in the context of public health, drawing on the report of the World Humanity Action Trust on governance. It emphasises the importance of poverty reduction, economic valuation of the environment and natural resources and horizontal and vertical integration in policy and decision-making. Examples of water quality regulation are used as illustrations and the outcomes of the Johannesburg Earth Summit are discussed. The paper recognises some progress but concludes that sustainable development must become more than just words. Q 2006 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.
Introduction and definitions It has become fashionable in recent years to use ‘governance’ as a synonym for ‘management’ in many kinds of situations and organisations. It is also often used to mean ‘government’. Few people define precisely what they mean by the word so the meaning has to be inferred from the context, creating scope for misunderstanding. The World Humanity Action Trust, WHAT (an independent UK think-tank founded by Sir Austin Bide and Sir Maurice Laing), launched a report entitled ‘Governance for a Sustainable Future1’ in September 2000. That report defined ‘governance’ as “The framework of social and economic systems and legal and political structures through which humanity manages itself” That will be the definition used in this paper. It defines the integrated nature of governance, E-mail address: [email protected].
suggesting that ‘governance systems’ would reflect the multi-disciplinary approach to sustainability that is necessary. The need for a ‘joined-up’ approach to policy and decision-making was one of the main themes of the WHAT report. ‘Sustainability’ is like the word ‘governance’, in the sense that it is widely used and often misused. It is generally seen as being desirable, so (not surprisingly) it has been taken up by advertisers and is frequently used to sell products that do not spring naturally to mind as being associated with a sustainable future. The commonly used definition of sustainable development is that put forward in 1987 by the World Commission on Environment and Development (the Brundtland Commission), “Development which meets the needs of the present without compromising the ability of future generations to meet their own needs” The general thrust of this is clear but it begs the question of what is meant by ‘needs’. Our perceptions of human needs depend to some extent on the society in which we live. Some would define
0033-3506/$ - see front matter Q 2006 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2006.04.004
Governance for a sustainable future ‘needs’ as the basic essentials of food, water and shelter. Others might include health provision and social security, while ultimately, there are the socalled ‘needs’ of many in the developed world for cars, washing machines, television, etc. In debating sustainability, how do we take into account the proper aspirations of the developing world as well as recognising the changes taking place in countries such as China and India, let alone nuclear developments in Iran? There are no easy answers to these questions but it is important at least to appreciate them.
Public health and sustainable development Key factors in sustainable development include availability of energy and natural resources and the ways in which their use impacts on the environment and public health. Population growth and economic pressures have combined to increase demand for ever-more efficient use of these resources. But the fact that first order increases in efficiency may lead to second order consequences more harmful in a wider sense than the first order benefits is rarely considered. In the developed world, there have been tremendous improvements in public health in the past 150 years. Reasons include: † † † † † †
Availability of safe drinking water Improved sanitation Improved nutrition Chemotherapeutics and antibiotics Vaccination and immunisation Improved healthcare, including earlier diagnosis.
However, new public health risks are still arising in areas ranging from antibiotic resistant strains of bacteria (exacerbated by use of antibiotics to improve farming efficiency) to hazardous chemicals, not forgetting the ever-present threats to food safety. For example, a 1999 estimate from the US Centers for Disease Control and Prevention (CDC)2 attributed an annual rate of 76 million illnesses, 325,000 hospitalisations and 5000 deaths in the US to food-borne pathogens. Although water quality is generally high in the developed world, examples of water-borne illness continue to appear from time to time. For example, the water-borne outbreak of cryptosporidiosis in Milwaukee in the US in the spring of 1993 made over 400,000 people ill, including 4400 who were hospitalised. But it is in the developing world that the situation is really serious. The report of the WHAT Water
605 Commission3 noted that in 1996, the World Health Organisation, WHO, estimated that more than one billion people worldwide lack access to safe drinking water and that annually up to four million people die prematurely from water-borne diseases. A further one to two million people die each year from malaria, the incidence of which quadrupled in the 1990s compared with the 1980s. Many of these problems are associated with poverty and the scale of the resources required to apply remedies is enormous. Yet if those resources are not made available, increasing intercontinental travel means that there is a growing risk of transmission of disease between widely separated parts of the world. If altruism will not drive governments in the developed world to help, perhaps self-interest will?
Water—some examples of joined-up thinking? Water is essential to life but population growth is often highest in dry parts of the world or where rainfall patterns are uneven. Therefore, solutions require an integrated approach bringing together technical, environmental, social, economic and legal factors. It is no longer good enough, having identified a need for more water, to go ahead with building another dam, ignoring the potential environmental consequences. The risks and benefits of every option should be analysed. That is not the same as the absolute opposition of some singleissue lobbying groups to any proposal to build another dam. Such opposition in the UK has sometimes contributed to delays of several years in the implementation of essential, well-planned water resources schemes, leading occasionally to severe water shortages. In 1973, the water industry in England and Wales was reorganised into 10 Regional Water Authorities, based largely on river basins. The principle of bringing together management of water use, abstractions and discharges across river basins was good and the concept of integrated river basin management was praised widely. However, it gradually became apparent that the system had been inadequately thought through. In addition to their regulatory responsibilities, the Regional Water Authorities were given the task of managing the operational functions of water supply and sewage treatment. Their regulatory responsibilities included monitoring compliance with all discharge consents, including their own discharges from sewage works. It gradually became clear that one of the major sources of pollution of watercourses
606 was sewage works effluent. Under the governance system set-up, the Authorities combined the roles of poacher and gamekeeper, never a good idea. When the industry was privatised in 1989, the government recognised this. It privatised the operational functions of the Regional Water Authorities but eventually set-up the Environment Agency to undertake the environmental regulatory duties, apart from drinking water quality compliance, which was made the responsibility of another new body, the Drinking Water Inspectorate. Regulations adopting the requirements of the European Drinking Water Directive were already in place in the UK in the 1980s and subsequent changes in the Directive have been adopted in the same way. The European Union has done much good work in raising environmental standards but the process by which some changes to the Directive were agreed leaves questions about whether sustainability figured in the discussions. The changed limits for lead seem to provide a good example. The toxic properties of lead (especially to children) have been known for many years, although lead was widely used in domestic plumbing from Roman times until the 20th century. The original limit for lead in the EC Drinking Water Directive was 50 mg/l. New Regulations came into force in England and Wales in December 2003 transposing the requirements of the EC Drinking Water Directive (98/83/EC). They set an immediate interim lead standard of 25 mg/l and a final standard of 10 mg/l to be achieved by December 2013. The reduction from 50 to 25 mg/l is well supported by the clear correlation between lead concentrations in drinking water and blood lead levels in infants under the age of 6 months. The evidence supporting a further reduction in the lead limit to 10 mg/l is much less strong and its adoption seems to have been decided largely on the singleissue basis that as lead is bad for us we should set a limit that is effectively almost a surrogate for zero. Was any consideration given to whether the resources used to achieve the new limit could produce more significant improvements in public health if applied elsewhere? Further, as an obvious way to meet the limit will be the expensive replacement of lead plumbing with plastic pipes, was the possibility that these materials might themselves cause problems in years to come taken into account? The serious outbreak of water-borne cryptosporidiosis in Milwaukee in 1993, mentioned above, illustrates the range of factors associated with public health and the different ways in which different individuals respond to the same threat. In humans, the main cause of the disease is a protozoan parasite,
J. Jeffery Cryptosporidium parvum, spread via water or food. The oocysts of the parasite are often found in the excreta of farm animals and intensive farming seems likely to be a factor in their spread. Among those with intact immune systems, cryptosporidiosis is usually a self-limiting disease associated with severe diarrhoea lasting for a few days. Cryptosporidium species were thought to be harmless for many years but perceptions have changed rapidly in the last 30 years. In that period, techniques for their identification have much improved at a time when awareness of AIDS has been growing. These two factors came together when it was discovered that in people with a compromised immune system, as in AIDS patients, infection with Cryptosporidium can cause permanent diarrhoea and can be fatal. Cryptosporidium is now a major problem for water suppliers because of the high resistance of the oocysts to chlorine at the concentrations normally used for disinfection. The solution to the problem lies in a combination of better water treatment and water quality monitoring with a multi-disciplinary epidemiological approach and improved liaison, including with farmers. Disinfection of drinking water with chorine was a major reason for the improvements in public health in the UK in the 20th century when water-borne diseases like cholera disappeared. Then chemists developed more and more sensitive techniques for measurement of chloroform and other trihalomethanes. When these compounds began to be found in drinking water and this information was combined with their known carcinogenic properties, the use of chlorine for disinfection began to be questioned. If an equally reliable substitute existed, it ought to be considered, but while there is a small risk to health from trihalomethanes in water, there is a certainty of disaster if lower standards of disinfection were to allow cholera and typhoid to return. Again, several different but related issues need to be balanced.
Governance and the WHAT report The WHAT report discussed governance in terms of the inter-relationships between the systems and structures of governance, emphasising the need to find solutions that take into account all relevant aspects of problems in an integrated way rather than as a series of single-issues. Therefore, climate change, future energy sources, poverty, water supply and sanitation and public health should all be seen as related and considered in a broad context that includes the vast differences between
Governance for a sustainable future per capita use of resources between the developed world and the under-developed world. After much discussion, the trustees of WHAT recognised that a key element of the subject was the way in which the world treats global commons, that is resources generally seen as being freely available for use by mankind. Three international commissions were set-up to study the three examples of global commons chosen for detailed study by the trustees of WHAT, who hoped that it would be possible to identify some common governance factors from the reports of the commissions. The examples of global commons chosen were fish stocks, agricultural genetic diversity and water. Members of the commissions were drawn from various professions and came from countries in both the developing and the developed world. They included technical experts in each field, but the majority were not technical specialists and they included lawyers, journalists, economists, etc. At the first meetings of the commissions, some of the experts in the three fields of study assumed that they had joined a committee organised on typically narrow technical lines. They were told that the brief to the commissions was to consider why it was that although groups of experts usually broadly agreed on what should be done, only rarely were their ideas applied. The reasons were likely to include social, economic, legal and political factors, so the commissions were being asked to define the governance roadblocks to action. The completed reports of the three commissions were given to Michael Carley, an academic from Heriot-Watt University in Edinburgh, and Ian Christie, well known in the field for his work with DEMOS, the UK ‘think-tank for everyday democracy’. They were asked to produce an integrative report identifying common governance themes emerging from the three reports. This report was published alongside the reports of the three commissions under the overall title of ‘Governance for a Sustainable Future’.1 The report noted that ‘In the case of a common resource, whether it be fish in the high seas or upriver sources of freshwater, it is seldom in the shortterm self-interest of any harvester or consumer (or firm or country in the modern world) voluntarily to limit their consumption’. The main conclusions of the report included the need to: † Reduce the poverty gap between the rich world and the rest † Improve horizontal and vertical integration in policy and decision-making at all levels of society from local to international
607 † Find a proper method of economic valuation of natural resources and the environment through which scarce resources may be properly priced † Move away from perverse subsidies (defined as subsidies that encourage unsustainable harvesting), estimated by Norman Myers4 to cost around US$2 trillion per year † Identify independent sources of information, particularly good science, beyond the control of States, businesses, harvesters and consumers † Promote public education and understanding, North and South, underpinned by development of a common resource conservation philosophy. Although the report recognised the value of input from NGOs into the governance debate, it noted that many NGOs are set-up to campaign on single issues and in that sense may become part of the problem of a genuinely integrated, joined-up system of policy and decision-making. The example of lead given earlier helps to illustrate this. The report said that failure to achieve integrated resource management can stem from organisations that themselves lack co-ordination. It commented that in the United Nations there were 20 international bodies dealing with water-related issues but they lack an effective co-ordinating mechanism to bring this work together. Another example may be seen in the work of the European Union. In a proposal to a meeting of the European Council in Gothenburg in 2001,5 the European Commission said ‘Too often, action in one policy area hinders progress in another.’ It added, ‘policymakers must identify likely spillovers—good and bad—onto other policy areas and take them into account. Careful assessment of the full effects of a policy proposal must include estimates of its economic, environmental and social impacts inside and outside the EU’. Excellent advice, but is it being followed? The WHAT report also identified the administrative trap that undermines co-ordination. Institutional administration is typically organised vertically within sectors, for example, education, healthcare and agriculture. Horizontal communication is therefore difficult. Too many good international dialogues on sustainable development have failed to result in positive action. One explanation is the absence from the talks of government ministries such as finance and trade. Political, professional and academic systems can reinforce this ‘silo’ mentality, inhibiting coherent policy-making. Many problems that spring from existing governance systems were highlighted by the WHAT report. The World Summit on Sustainable Development in
608 Johannesburg in 2002 made some progress towards tackling them. It agreed the ‘WEHAB’ agenda of water, energy, health, food and agriculture and biodiversity, the five issues identified by the UN Secretary General, Kofi Annan, in 2001. It also agreed time-bound targets for a number of issues including poverty eradication, water and sanitation, sustainable production and consumption, energy, oceans and fisheries, atmosphere, biodiversity and health. However, are the targets sufficiently demanding and does the will exist in member states to reach even the targets agreed? Ayre and Callway have commented,6 ‘There are some major fault lines running through current governance systems that may make it very difficult to carry out strategic follow-up and implementation of sustainable development’. More hopefully, they add, ‘The shift at Johannesburg to a more balanced and joined-up view of environmental, social and economic arenas is significant’. But how much time do we have? UK Prime Minister Tony Blair said in his statement to the Johannesburg summit, ‘We know the problems and we know the solution is sustainable development’. Ayre and Callway remark that ‘without the real political will to face up to some of these more challenging and fundamental underlying issues sustainable development is likely to remain a distant dream’. All this at a time when, as we have seen, more than one billion people worldwide lack access to safe drinking water and annually up to four million die prematurely from water-borne and other poverty-associated diseases while in the developed world, there is pressure for ever-higher standards for drinking water, with little evidence of risk analysis. Some in the developing world might look at the scale of the resources, especially energy, needed to meet these higher standards, often with little evidence of public health benefits and they might decide that the expression of concern of the developed world about sustainability are supported in only limited areas by the actions of that developed world. They may well be right.
J. Jeffery
Conclusion There is unarguable evidence to support the need for urgent joined-up action to meet the massive challenges that the world is facing on so many fronts. These include the global imbalance between rich and poor nations; pressure on natural resources and the environment; threats to public health; population growth and climate change. The United Nations remains the best hope of finding solutions but it suffers internally from the ‘silo’ mentality that afflicts so many organisations. This is exacerbated by the failure of nations themselves to develop in the words of the WHAT report, ‘a new ethical, consensual philosophy of global stewardship and citizenship, in the face of the rapid expansion of worldwide consumerist society’. Sustainable development must become more than words and the world must make much more rapid progress towards recognising and implementing the changes to our governance systems that are required if the peoples of the world are to have a truly sustainable future.
References 1. WHAT (World Humanity Action Trust). Governance for a Sustainable Future. Report by the World Humanity Action Trust, Stakeholder Forum publication; 2000. [Accessed online February 2006 at http://www.stakeholderforum.org/policy/ governance/future.pdf]. 2. Mead, Slutsker, Dietz McCaig, Bresee, Shapiro, Griffin and Tauxe. Food-Related Illness and Death in the United States, CDC 1999. [Accessed online February 2006 at http://www. cdc.gov/ncidod/eid/vol5no5/mead.htm]. 3. WHAT (World Humanity Action Trust). Governance for a Sustainable Future. Report by the World Humanity Action Trust, Stakeholder Forum publication; 2000. p. 158. 4. Kent J, Myers N. Perverse subsidies. International Institute for Sustainable Development, Winnipeg, Canada. Island Press; 2001. 5. Commission of the European Communities proposal to the Gothenburg European Council, COM(2001)264 final. Brussels, 15.5.2001. 6. Ayre G, Callway R. Governance for sustainable development. Earthscan; 2005. p. 41.
MINI-SYMPOSIUM
Governance for a sustainable future Jack Jeffery Royal Institute of Public Health, 28 Portland Place, London W1B 1DE, UK
KEYWORDS Sustainability; Water; Cryptosporidiosis
Summary The paper discusses the concepts of governance and sustainability in the context of public health, drawing on the report of the World Humanity Action Trust on governance. It emphasises the importance of poverty reduction, economic valuation of the environment and natural resources and horizontal and vertical integration in policy and decision-making. Examples of water quality regulation are used as illustrations and the outcomes of the Johannesburg Earth Summit are discussed. The paper recognises some progress but concludes that sustainable development must become more than just words. Q 2006 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.
Introduction and definitions It has become fashionable in recent years to use ‘governance’ as a synonym for ‘management’ in many kinds of situations and organisations. It is also often used to mean ‘government’. Few people define precisely what they mean by the word so the meaning has to be inferred from the context, creating scope for misunderstanding. The World Humanity Action Trust, WHAT (an independent UK think-tank founded by Sir Austin Bide and Sir Maurice Laing), launched a report entitled ‘Governance for a Sustainable Future1’ in September 2000. That report defined ‘governance’ as “The framework of social and economic systems and legal and political structures through which humanity manages itself” That will be the definition used in this paper. It defines the integrated nature of governance, E-mail address: [email protected].
suggesting that ‘governance systems’ would reflect the multi-disciplinary approach to sustainability that is necessary. The need for a ‘joined-up’ approach to policy and decision-making was one of the main themes of the WHAT report. ‘Sustainability’ is like the word ‘governance’, in the sense that it is widely used and often misused. It is generally seen as being desirable, so (not surprisingly) it has been taken up by advertisers and is frequently used to sell products that do not spring naturally to mind as being associated with a sustainable future. The commonly used definition of sustainable development is that put forward in 1987 by the World Commission on Environment and Development (the Brundtland Commission), “Development which meets the needs of the present without compromising the ability of future generations to meet their own needs” The general thrust of this is clear but it begs the question of what is meant by ‘needs’. Our perceptions of human needs depend to some extent on the society in which we live. Some would define
0033-3506/$ - see front matter Q 2006 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2006.04.004
Governance for a sustainable future ‘needs’ as the basic essentials of food, water and shelter. Others might include health provision and social security, while ultimately, there are the socalled ‘needs’ of many in the developed world for cars, washing machines, television, etc. In debating sustainability, how do we take into account the proper aspirations of the developing world as well as recognising the changes taking place in countries such as China and India, let alone nuclear developments in Iran? There are no easy answers to these questions but it is important at least to appreciate them.
Public health and sustainable development Key factors in sustainable development include availability of energy and natural resources and the ways in which their use impacts on the environment and public health. Population growth and economic pressures have combined to increase demand for ever-more efficient use of these resources. But the fact that first order increases in efficiency may lead to second order consequences more harmful in a wider sense than the first order benefits is rarely considered. In the developed world, there have been tremendous improvements in public health in the past 150 years. Reasons include: † † † † † †
Availability of safe drinking water Improved sanitation Improved nutrition Chemotherapeutics and antibiotics Vaccination and immunisation Improved healthcare, including earlier diagnosis.
However, new public health risks are still arising in areas ranging from antibiotic resistant strains of bacteria (exacerbated by use of antibiotics to improve farming efficiency) to hazardous chemicals, not forgetting the ever-present threats to food safety. For example, a 1999 estimate from the US Centers for Disease Control and Prevention (CDC)2 attributed an annual rate of 76 million illnesses, 325,000 hospitalisations and 5000 deaths in the US to food-borne pathogens. Although water quality is generally high in the developed world, examples of water-borne illness continue to appear from time to time. For example, the water-borne outbreak of cryptosporidiosis in Milwaukee in the US in the spring of 1993 made over 400,000 people ill, including 4400 who were hospitalised. But it is in the developing world that the situation is really serious. The report of the WHAT Water
605 Commission3 noted that in 1996, the World Health Organisation, WHO, estimated that more than one billion people worldwide lack access to safe drinking water and that annually up to four million people die prematurely from water-borne diseases. A further one to two million people die each year from malaria, the incidence of which quadrupled in the 1990s compared with the 1980s. Many of these problems are associated with poverty and the scale of the resources required to apply remedies is enormous. Yet if those resources are not made available, increasing intercontinental travel means that there is a growing risk of transmission of disease between widely separated parts of the world. If altruism will not drive governments in the developed world to help, perhaps self-interest will?
Water—some examples of joined-up thinking? Water is essential to life but population growth is often highest in dry parts of the world or where rainfall patterns are uneven. Therefore, solutions require an integrated approach bringing together technical, environmental, social, economic and legal factors. It is no longer good enough, having identified a need for more water, to go ahead with building another dam, ignoring the potential environmental consequences. The risks and benefits of every option should be analysed. That is not the same as the absolute opposition of some singleissue lobbying groups to any proposal to build another dam. Such opposition in the UK has sometimes contributed to delays of several years in the implementation of essential, well-planned water resources schemes, leading occasionally to severe water shortages. In 1973, the water industry in England and Wales was reorganised into 10 Regional Water Authorities, based largely on river basins. The principle of bringing together management of water use, abstractions and discharges across river basins was good and the concept of integrated river basin management was praised widely. However, it gradually became apparent that the system had been inadequately thought through. In addition to their regulatory responsibilities, the Regional Water Authorities were given the task of managing the operational functions of water supply and sewage treatment. Their regulatory responsibilities included monitoring compliance with all discharge consents, including their own discharges from sewage works. It gradually became clear that one of the major sources of pollution of watercourses
606 was sewage works effluent. Under the governance system set-up, the Authorities combined the roles of poacher and gamekeeper, never a good idea. When the industry was privatised in 1989, the government recognised this. It privatised the operational functions of the Regional Water Authorities but eventually set-up the Environment Agency to undertake the environmental regulatory duties, apart from drinking water quality compliance, which was made the responsibility of another new body, the Drinking Water Inspectorate. Regulations adopting the requirements of the European Drinking Water Directive were already in place in the UK in the 1980s and subsequent changes in the Directive have been adopted in the same way. The European Union has done much good work in raising environmental standards but the process by which some changes to the Directive were agreed leaves questions about whether sustainability figured in the discussions. The changed limits for lead seem to provide a good example. The toxic properties of lead (especially to children) have been known for many years, although lead was widely used in domestic plumbing from Roman times until the 20th century. The original limit for lead in the EC Drinking Water Directive was 50 mg/l. New Regulations came into force in England and Wales in December 2003 transposing the requirements of the EC Drinking Water Directive (98/83/EC). They set an immediate interim lead standard of 25 mg/l and a final standard of 10 mg/l to be achieved by December 2013. The reduction from 50 to 25 mg/l is well supported by the clear correlation between lead concentrations in drinking water and blood lead levels in infants under the age of 6 months. The evidence supporting a further reduction in the lead limit to 10 mg/l is much less strong and its adoption seems to have been decided largely on the singleissue basis that as lead is bad for us we should set a limit that is effectively almost a surrogate for zero. Was any consideration given to whether the resources used to achieve the new limit could produce more significant improvements in public health if applied elsewhere? Further, as an obvious way to meet the limit will be the expensive replacement of lead plumbing with plastic pipes, was the possibility that these materials might themselves cause problems in years to come taken into account? The serious outbreak of water-borne cryptosporidiosis in Milwaukee in 1993, mentioned above, illustrates the range of factors associated with public health and the different ways in which different individuals respond to the same threat. In humans, the main cause of the disease is a protozoan parasite,
J. Jeffery Cryptosporidium parvum, spread via water or food. The oocysts of the parasite are often found in the excreta of farm animals and intensive farming seems likely to be a factor in their spread. Among those with intact immune systems, cryptosporidiosis is usually a self-limiting disease associated with severe diarrhoea lasting for a few days. Cryptosporidium species were thought to be harmless for many years but perceptions have changed rapidly in the last 30 years. In that period, techniques for their identification have much improved at a time when awareness of AIDS has been growing. These two factors came together when it was discovered that in people with a compromised immune system, as in AIDS patients, infection with Cryptosporidium can cause permanent diarrhoea and can be fatal. Cryptosporidium is now a major problem for water suppliers because of the high resistance of the oocysts to chlorine at the concentrations normally used for disinfection. The solution to the problem lies in a combination of better water treatment and water quality monitoring with a multi-disciplinary epidemiological approach and improved liaison, including with farmers. Disinfection of drinking water with chorine was a major reason for the improvements in public health in the UK in the 20th century when water-borne diseases like cholera disappeared. Then chemists developed more and more sensitive techniques for measurement of chloroform and other trihalomethanes. When these compounds began to be found in drinking water and this information was combined with their known carcinogenic properties, the use of chlorine for disinfection began to be questioned. If an equally reliable substitute existed, it ought to be considered, but while there is a small risk to health from trihalomethanes in water, there is a certainty of disaster if lower standards of disinfection were to allow cholera and typhoid to return. Again, several different but related issues need to be balanced.
Governance and the WHAT report The WHAT report discussed governance in terms of the inter-relationships between the systems and structures of governance, emphasising the need to find solutions that take into account all relevant aspects of problems in an integrated way rather than as a series of single-issues. Therefore, climate change, future energy sources, poverty, water supply and sanitation and public health should all be seen as related and considered in a broad context that includes the vast differences between
Governance for a sustainable future per capita use of resources between the developed world and the under-developed world. After much discussion, the trustees of WHAT recognised that a key element of the subject was the way in which the world treats global commons, that is resources generally seen as being freely available for use by mankind. Three international commissions were set-up to study the three examples of global commons chosen for detailed study by the trustees of WHAT, who hoped that it would be possible to identify some common governance factors from the reports of the commissions. The examples of global commons chosen were fish stocks, agricultural genetic diversity and water. Members of the commissions were drawn from various professions and came from countries in both the developing and the developed world. They included technical experts in each field, but the majority were not technical specialists and they included lawyers, journalists, economists, etc. At the first meetings of the commissions, some of the experts in the three fields of study assumed that they had joined a committee organised on typically narrow technical lines. They were told that the brief to the commissions was to consider why it was that although groups of experts usually broadly agreed on what should be done, only rarely were their ideas applied. The reasons were likely to include social, economic, legal and political factors, so the commissions were being asked to define the governance roadblocks to action. The completed reports of the three commissions were given to Michael Carley, an academic from Heriot-Watt University in Edinburgh, and Ian Christie, well known in the field for his work with DEMOS, the UK ‘think-tank for everyday democracy’. They were asked to produce an integrative report identifying common governance themes emerging from the three reports. This report was published alongside the reports of the three commissions under the overall title of ‘Governance for a Sustainable Future’.1 The report noted that ‘In the case of a common resource, whether it be fish in the high seas or upriver sources of freshwater, it is seldom in the shortterm self-interest of any harvester or consumer (or firm or country in the modern world) voluntarily to limit their consumption’. The main conclusions of the report included the need to: † Reduce the poverty gap between the rich world and the rest † Improve horizontal and vertical integration in policy and decision-making at all levels of society from local to international
607 † Find a proper method of economic valuation of natural resources and the environment through which scarce resources may be properly priced † Move away from perverse subsidies (defined as subsidies that encourage unsustainable harvesting), estimated by Norman Myers4 to cost around US$2 trillion per year † Identify independent sources of information, particularly good science, beyond the control of States, businesses, harvesters and consumers † Promote public education and understanding, North and South, underpinned by development of a common resource conservation philosophy. Although the report recognised the value of input from NGOs into the governance debate, it noted that many NGOs are set-up to campaign on single issues and in that sense may become part of the problem of a genuinely integrated, joined-up system of policy and decision-making. The example of lead given earlier helps to illustrate this. The report said that failure to achieve integrated resource management can stem from organisations that themselves lack co-ordination. It commented that in the United Nations there were 20 international bodies dealing with water-related issues but they lack an effective co-ordinating mechanism to bring this work together. Another example may be seen in the work of the European Union. In a proposal to a meeting of the European Council in Gothenburg in 2001,5 the European Commission said ‘Too often, action in one policy area hinders progress in another.’ It added, ‘policymakers must identify likely spillovers—good and bad—onto other policy areas and take them into account. Careful assessment of the full effects of a policy proposal must include estimates of its economic, environmental and social impacts inside and outside the EU’. Excellent advice, but is it being followed? The WHAT report also identified the administrative trap that undermines co-ordination. Institutional administration is typically organised vertically within sectors, for example, education, healthcare and agriculture. Horizontal communication is therefore difficult. Too many good international dialogues on sustainable development have failed to result in positive action. One explanation is the absence from the talks of government ministries such as finance and trade. Political, professional and academic systems can reinforce this ‘silo’ mentality, inhibiting coherent policy-making. Many problems that spring from existing governance systems were highlighted by the WHAT report. The World Summit on Sustainable Development in
608 Johannesburg in 2002 made some progress towards tackling them. It agreed the ‘WEHAB’ agenda of water, energy, health, food and agriculture and biodiversity, the five issues identified by the UN Secretary General, Kofi Annan, in 2001. It also agreed time-bound targets for a number of issues including poverty eradication, water and sanitation, sustainable production and consumption, energy, oceans and fisheries, atmosphere, biodiversity and health. However, are the targets sufficiently demanding and does the will exist in member states to reach even the targets agreed? Ayre and Callway have commented,6 ‘There are some major fault lines running through current governance systems that may make it very difficult to carry out strategic follow-up and implementation of sustainable development’. More hopefully, they add, ‘The shift at Johannesburg to a more balanced and joined-up view of environmental, social and economic arenas is significant’. But how much time do we have? UK Prime Minister Tony Blair said in his statement to the Johannesburg summit, ‘We know the problems and we know the solution is sustainable development’. Ayre and Callway remark that ‘without the real political will to face up to some of these more challenging and fundamental underlying issues sustainable development is likely to remain a distant dream’. All this at a time when, as we have seen, more than one billion people worldwide lack access to safe drinking water and annually up to four million die prematurely from water-borne and other poverty-associated diseases while in the developed world, there is pressure for ever-higher standards for drinking water, with little evidence of risk analysis. Some in the developing world might look at the scale of the resources, especially energy, needed to meet these higher standards, often with little evidence of public health benefits and they might decide that the expression of concern of the developed world about sustainability are supported in only limited areas by the actions of that developed world. They may well be right.
J. Jeffery
Conclusion There is unarguable evidence to support the need for urgent joined-up action to meet the massive challenges that the world is facing on so many fronts. These include the global imbalance between rich and poor nations; pressure on natural resources and the environment; threats to public health; population growth and climate change. The United Nations remains the best hope of finding solutions but it suffers internally from the ‘silo’ mentality that afflicts so many organisations. This is exacerbated by the failure of nations themselves to develop in the words of the WHAT report, ‘a new ethical, consensual philosophy of global stewardship and citizenship, in the face of the rapid expansion of worldwide consumerist society’. Sustainable development must become more than words and the world must make much more rapid progress towards recognising and implementing the changes to our governance systems that are required if the peoples of the world are to have a truly sustainable future.
References 1. WHAT (World Humanity Action Trust). Governance for a Sustainable Future. Report by the World Humanity Action Trust, Stakeholder Forum publication; 2000. [Accessed online February 2006 at http://www.stakeholderforum.org/policy/ governance/future.pdf]. 2. Mead, Slutsker, Dietz McCaig, Bresee, Shapiro, Griffin and Tauxe. Food-Related Illness and Death in the United States, CDC 1999. [Accessed online February 2006 at http://www. cdc.gov/ncidod/eid/vol5no5/mead.htm]. 3. WHAT (World Humanity Action Trust). Governance for a Sustainable Future. Report by the World Humanity Action Trust, Stakeholder Forum publication; 2000. p. 158. 4. Kent J, Myers N. Perverse subsidies. International Institute for Sustainable Development, Winnipeg, Canada. Island Press; 2001. 5. Commission of the European Communities proposal to the Gothenburg European Council, COM(2001)264 final. Brussels, 15.5.2001. 6. Ayre G, Callway R. Governance for sustainable development. Earthscan; 2005. p. 41.