Achievement of the aims of National Environmental Health Action Plans (NEHAPs) requires that the many different stakeholders within a country – principally the general public – be identified and involved in the drafting and implementation of the plan.
Because of its intersectoral and holistic nature, a NEHAP provides a mechanism for delivering the government's principal policy objectives. Many of the actions to be undertaken in pursuance of a NEHAP are beneficial to several interested parties and should be promoted in cooperation with them. A NEHAP is not separate from other policies but should be an integral part of them. Implementation then becomes a "win-win" situation reflecting the principle of partnership. When such mutually beneficial actions are implemented, what might have been a problem of competition for resources becomes a solution to meeting the aims of the interested parties.
Responsibility both for the burdens on environmental and health, and for taking remedial and preventive action lies with all the many different stakeholders involved: with policy-makers and planners, with industry and financial infrastructure, with education and the media, with NGOs and individual members of the public.
Although high-level government officials have issued many declarations and other resolutions endorsing the concept of sustainable development, in reality little progress has been made in improving collaboration between the environment, health and economic sectors. Despite being strongly endorsed by the Helsinki Conference and in Environmental Health Action Plan for Europe, collaboration with economic sectors has been one of the most difficult areas in the development of NEHAPs in most countries. The various sectors of the economy ought to see the environment and health sectors as the most important partners in attaining the objectives of sustainable development. Conversely, unless economic sectors are mobilized as key partners in implementing NEHAPs, the environment and health sectors will make little progress towards their objectives. What is needed is to demonstrate that sound environmental health policies complement and support overall socioeconomic development.
The concept of stakeholder involvement is an important cornerstone in Agenda 21 and the principle of sustainable development, as emphasized in the European Union's 5th Environmental Action Programme, yet the methods of achieving participation are as yet poorly developed. Although there is an increasing range of tools and resources available to support the process – including indicators, state of environment reports, on-line databases, Internet and geographic information systems – access to these is often limited and much of the experience of involving the public and other stakeholders in local decision-making (e.g. in local Agenda 21 programme), has remained isolated and fragmentary.
The various sectors of the economy are prime forces for the implementation of some aspects of NEHAPs. Whatever the size of an enterprise, concern for the environment and environmental health stimulates innovation that commonly leads to substantial savings and an improved competitive position. Moreover, the public is increasingly willing to withdraw support from undertakings which ignore such concerns. The ministries responsible for specific economic sectors can encourage the implementation of a NEHAP in those sectors by, for example, incorporating NEHAP actions into the programmes for sector development and reconstruction, including environmental health clauses in their contracts for goods and services, and linking environmental health performance to the issue of licences. Many environmental health initiatives would benefit if the private sector could be persuaded to endorse them. Chambers of commerce, trade organizations and trade unions are the natural bodies to bring about a modernization of attitudes in those undertakings which do not see the commercial logic of good practice in this area.
NEHAPs should be available and understandable to the public, and they should be as non-technical as is compatible with proper rigour. In this context, NGOs perform a useful function in interpreting the plan to the public and giving it local relevance. Educating and empowering people with regard to environment and health issues will encourage greater public participation.
The roles of both the private sector and practical, field-based nongovernmental organizations (NGOs) in implementing local projects is largely undefined. A key issue to address in future projects is how to achieve more complementarity between the different strengths and capabilities available in the public, NGO, community and private sectors.