Principle 1 of the Rio Declaration on Environment and Development in 1992 asserts that “Human beings are at the centre of concerns for sustainable development. They are entitled to a healthy and productive life in harmony with nature”. Twenty years later, Rio+20 offers an important opportunity to re-examine and re-establish the relationship between health and sustainable development.
For WHO, this relationship has three main components: (1) improvements in human health contribute to the achievement of sustainable development and to poverty reduction, particularly through universal health coverage; (2) health can be one of the principal beneficiaries of investment in sustainable development and the green economy; and (3) health indicators provide a powerful means of measuring progress across the social, economic and environmental pillars of sustainable development.
People who are healthy are better able to learn, to work and to contribute positively to the societies. The health of workers is an essential prerequisite for productivity and economic development, and, therefore, measures to protect workers’ health should be incorporated in national plans and programmes for sustainable development. Furthermore, a recent WHO global conference on occupational health and primary health concluded that good eemployment and working conditions have positive effects on health by providing income, social protection, personal development, social relations and self-esteem. By protecting and promoting the health of workers and their working capacity health services can contribute to sustainable development.
A healthy environment is also a prerequisite for good health. The reduction of several environmental and occupational health risks can prevent up to one quarter of the premature deaths from communicable and non-communicable diseases. Rio+20 is expected to stimulate major transformation of the global patterns of production and consumption towards a green economy with less pollution and use of natural resources. The development of new green technologies and clean production methods will change profoundly the world of work. For example, moving from coal to renewable energy sources would result in significant benefits for the health of workers, having in mind that working conditions in coal mining are one of the most hazardous resulting in a big burden of occupational diseases and injuries. Also, the introduction of integrated pest and weed management is expected to reduce substantially the use of pesticides and herbicides and the resulting intoxications and long-term effects among agricultural workers. The new green technologies and work processes and the green jobs associated with them need to be healthy and safe for workers. Occupational health control measures need to be incorporated into the design of the new technologies and processes, for example to prevent falls from wind turbines, or diseases from handling industrial and consumer waste. The full cost pricing of energy and products should reflect not only environmental externalities, but also social ones, such as occupational health.
Measurable progress towards sustainable development requires milestones that integrate its economic, environmental and social dimensions as well as a new generation of metrics to monitor achievements. Such measures should be integral to any new set of global goals developed to follow on from the Millennium Development Goals after 2015. Outcomes related to health can be measured and will generate both public and political interest. Indicators for measuring decent work, such as the incidence of fatal and serious work injuries and occupational diseases, should be included in the complex of indicators on sustainable development. It is also necessary to consider indicators to measure the health dimensions of green growth, for example the proportion of green jobs that comply with occupational safety and health standards, as well as occupational injuries and diseases in sectors that will be substantially affected by the greening of the economy, such as energy, construction, transport, waste management.
There are a number of lessons learned so far from the work of trade unions on addressing the health of workers in the policies for environmental protection and sustainable development. WHO is keen on utilizing these experiences for strengthening health governance and working across sectors to ensure that sustainable development and green economy are good for the health of all workers.
Maria Neira (MD, MPH) is the Director of the Department of Public Health and Environment, World Health Organization
 WHO Executive Board, 130th session, "United Nations Conference on Sustainable Development Rio+20 Document EB130/36, Geneva, 2012
 60th World Health Assembly, Resolution 60.26 "Workers' Health: Global Plan of Action", Geneva, 2007
 WHO, "Connecting Health and Labour: Bringing together occupational health and primary care to improve the health of working people" Executive summary of the Global Conference "Connecting Health and Labour: What Role for Occupational Health in Primary Health Care", The Hague, The Netherlands, 29.11-1.12.2011
 European Commission, Directorate-General XII Science, Research and Development, "ExternE: Externalities of Energy", Brussels
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