To further develop scientific proceeding of works concerning environment and people's health, guarantee the goals set by the 11th Five-Year Plan to come true and promote the sustainable development of economy and society, 18 ministries, committee, and other authorities jointly worked out China's Action Plan on Environment and Health (2007-2015), which was released on the website of the Ministry of Public Health on Nov. 12. Local authorities are required to implement the action plan based on regional circumstances.

1. Foreword

China is currently undergoing an important strategic period of economic and social development. To build an energy saving and environmentally friendly society, solve pressing environmental problems that harm human health and promote the sustainable economic and social development, are important tasks. They are also basic requirements needed to carry out China's scientific outlook on development and build a harmonious society.

China has always paid great attention to environment and health problems. Right after the founding of New China, the government set 'Prevention First' as a guideline for national sanitation work. Patriotic public health campaigns were enacted all over the country to improve environment and sanitation. The campaign was successful in preventing epidemic outbreaks and lowering the prevalence of disease, thus protecting people's health. The campaign played an irreplaceable role in national construction and paved the way for smooth economic development. In the early 1980's, China made 'environmental protection' one of the country's basic national policies. The government advocates the rational development and utilization of natural resources, controls on environmental pollution and ecological destruction, and prevention work to minimize environmental degradation.

For years China has constantly strengthened both management and research on environment and heath and the country has achieved great progress in this field. As the economy grew after the reform and opening-up, the general public expected better living conditions and the state of public health has consistently risen. Environmental degradation, ecological destruction and potential risks to public health have all become key restraining factors toward sustainable economic growth and harmonious societal development. To improve positive work strategies for environment and health, and to solve the pressing contradictions between development, environment and health are the major problems that China faces today.

In recent years, the World Health Organization, the United Nations Environment Program (UNEP) and its partners and member states, have worked together to promote the formulation of a comprehensive strategy and policy for environment and health. A long-term institutional cooperation mechanism between environmental and public health departments was proposed. National action plans on environment and health were also suggested.

In order to promote environment and health work in China and respond positively to the call from international society, China published this National Action Plan on Environment and Health (2007-2015). The Plan is the first of its kind in this field, and it is expected to guide environmental and health work in a scientific way. Positive public health is mandatory for sustainable social and economic development

2. Guidelines and basic principles

2.1 Guidelines

The government should improve the management and research regarding environment and health, try to reduce environmental related diseases to safeguard the public health, improve their ability to response to and offer quality service and promote harmonious development between the two.

2.2 Basic Principles

The government at all levels should play a leading role in mobilizing social forces and advocating the general public to participate.

Try to improve cooperation and increase interaction between government departments, and make effective use of present resources.

Prevention should be put first and supervision is crucial. Bear in the mind the policy of "prevention first," while attempting to improve the ability to guard against risks and to control pollution from every source.

Implement related policies in a scientific way. Try to promote equalization of public services.

3. Targets

3.1 Overall Targets

The government will enact and improve rules and regulations regarding environment and health; control environmental hazards and reduce environmental related disease to safeguard the public health. Authorities will try to reach emission control targets set in the 11th Five-year Plan and help achieve the Millennium Development Goals, while promoting the continuous and coordinated growth of the economy and society.

3.2 Staged Targets

2007-2010: Establish all-round cooperative mechanism between environment and health departments and improve the assessment system designed for environmental hazards. Make a comprehensive assessment of current rules and regulations on the environment and public health and find out which ones need to be improved and which are still out of range. Complete the survey on the current situation of China's environment and health. Finish the research study for measures on the environment and health supervision network. Strengthen and improve the scientific study on the environment and health safety assessment.

2010-2015: Start the work of researching, enacting and amending environment and health related rules and regulations. Establish a standard system for environment and health work. Build an effective management team and improve technical ability. A supervision network on environment and health and a platform for sharing information should be basically completed. Try to perfect an assessment of environmental hazards and risk prevention and early-warning system. Ensure that several departments can cope with public emergencies and mobilize all sections of society to participate in the work of environment and health.

4. Action Plans

4.1 Setting up a standard system for environment and health related laws and regulations

The environment and health work should be in line with the Party's people-oriented governing conception and aim to protect public health rights and improve the people's quality of life. Improved laws, regulations and a standardized system will provide a sound legal backing for government supervision and standardization of social activities.

Enacting and improving environment and health laws and regulations

Assess the effectiveness of current law enforcement, identify problems and design an overall plan to improve the system. Conduct research work on environmental damages compensation law, to hold polluters accountable for their environmental pollution. Research and work out measures to appraise the degree of the environmental damages, compensation items, procedures and legal aid for victims. Improve the laws on environmental impact assessment and make the impact on health a necessary part of the assessment. Strengthen the prevention and control work of health risks. Begin drafting regulations on drinking water safety and formulate assessment rules covering the environmental impact on health, indoor air quality management, and emergency response on public environmental pollution incidents.

Enacting and improving environment and health related standards.

Based on environment and health work needs and in line with China's national conditions, we should improve the standard system and work out the basic standards on environment and health and solve the problem of linking with current standards. Following are standards need to be worked out soon:

---Standard on appraisal and determining of environmental damages on health
---Standard on supervision of environmental pollution impact on health
---Standard on appraisal and risk assessment of environmental impact on health
---Standard on hygienic appraisal of drinking water, indoor air and Electromagnetic radiation
---Standard on biological pollution on earth
---Standard on detection of pollutant and health impact index
---Standard on emergency response on public environmental pollution incidents.

4.2 Build a supervision network on environment and health

Build a real-time and systematic supervision network on environmental pollution impact on health, and analyze the reasons and results, to provide scientific foundation for the government to work out effective coping measures and policies.

Formulate a unified national supervision plans and standards, improve the supervision equipment and build a qualified supervision team. A national environment and health supervision network should consist of environment quality supervision and supervision of the impact of pollution on health. Improve research on supervision and ascertain China's major pollutant levels, the status of pollution's impact on health and the developmental trends. Provide technical support to protect the environment and human health in a scientific way.

Establish a monitoring network of drinking water safety and health: consider the tasks and monitoring contents of the national drinking water safety scheme, set up a pollution index in water sources that can be monitored, create an irrigation water quality index & drinking water quality index, monitor sphere of water-caused diseases and other information related with health; draw up a state monitoring scheme, and reasonably distribute monitoring stations.

Establish a monitor network for air pollution and human health: recognize major pollutants in the air that harm people's health and those that indirectly harm people's health via agricultural, husbandry, fishery products, set up a human health monitor index, and set up a state scheme of air pollution and health monitoring; set up monitoring stations in communities to collect information about residents' health; increase the frequency of air quality monitoring and increase their numbers to improve the monitoring of major pollutants.

Establish a monitor network for soil and human health: set up monitoring stations in areas having typical soil environment, draw up state and regional monitoring schemes, combine and strengthen the current resources and forces concerned with monitoring soil and human health.

Establish monitor networks for extreme weather and human health: under provincial levels of supervision, set up monitoring stations in cities and counties to conduct real time monitoring, analysis and evaluation of physical harm happening to people due to extreme weather, enhance their ability during extreme weather to make forecasts and enlarge monitoring regions.

Establish monitor networks for hygiene and biological safety in public places and special places: targeting the risk of biological pollution and health damage pre-existing in public places, hospitals, biological labs, and breeding farms, draw up relevant monitoring programs and set up monitoring stations in those places.

4.3 Strengthen the risk warning systems concerning environment and health and the emergency disposal work systems

Effectively carry out risk evaluation, risk warning and emergency disposal, raise the ability of risk prediction and emergency disposal to get rid of or minimize environment and health damages.

Carry out environment and health risk evaluation: set up health and environment risk administrative mechanisms, improve the risk evaluation methods and procedures, improve the prediction and administrative forces of controllable damages on environment and health, and gradually control the cost of environment and health risks.

Enforce environment and health risk warning systems: based on environment and health risk evaluations, predict serious environmental pollution and health threats they may impose, put forward administrative and technical measures to deal with these issues. Set up environment and health risk warning, reporting and publishing mechanisms.

Strengthen the capability to cope with emergencies concerning environment and health: in the light of related laws and regulations, set up relevant accidents reporting mechanisms. Clarify the controlling status of environmental and public health departments when dealing with public emergencies caused by environmental pollution, and other departments that would participate in the efforts if needed. Carry out monitoring and evaluation of dangerous factors so as to raise the ability to predict an emergency; improve on-the-spot controlling abilities; carry out after-the-fact environmental investigations, trace healthful impacts and conduct treatment evaluations.

4.4 Set up state environment and health information share and service system.

Information is a fundamental factor for work regarding environment and health. Completely playing the role of information to offer support for decision making, management and research is guaranteed by sound information sharing and administration mechanisms.

Set up information share service systems: utilize the Internet and governmental network resources, and the state monitoring database for environment and health; rely on the e-government platform; consult the standards of the World Health Organization and the United Nations Environment Program. Learn from domestic and overseas advanced experience to set up a state environment and health index system, reflecting the circumstances, trends and requirements of the country's environment and people's health.

Set up an environment and health monitor database: respectively set up state and local monitor database for environmental pollution and a database for impact on health; set up a statistics management and operation mechanism; standardize the environment and health statistics codes and follow relevant international practices; make clear the source of statistics and guarantee their quality and strengthen their audit.

Improve information sharing and reporting systems: guarantee all-round and immediate provisions of relevant statistics and guarantee that they are available within certain limits; clarify the authority for releasing certain categories of information from related departments and guarantee the information's authoritativeness, timelessness and accurateness.

4.5 Improve technological support construction for environment and health

According to country's current circumstances, carry out research in key areas, strengthen technological innovations and resulting transformations in order to provide effective technological support for work concerning environment and health.

Investigate the current circumstances regarding environment and health: carry out a nationwide investigation on health damage caused by environmental problems to get to know the damage's variety, degree and distribution, thus providing scientific grounds for an environment and health action plan.

---National pollution source investigation: carry out investigations on pollution sources, pollutants and degrees of pollution in severely-polluted areas; combine the investigation results on health impacts from environmental pollution to set national and local lists of pollutants which then are given a priority to be controlled, providing references for the control and monitoring of key pollutants.

---Investigate the health impact caused by environmental pollution: investigate the content of major environmental pollutants in human bodies and carry out investigations in epidemiology of diseases caused by environmental pollution to provide technological grounds for drawing standards when evaluating health damage caused by pollution, carrying out related preventive research and monitoring and improving related laws and regulations.

Efforts should be made to conduct research on how to assess environment and health safety and how to conduct research on corresponding reaction plans. In view of national and international progress in environment and health work, the following fundamental and applied research should be started promptly.

— Research on the impact of climate change on human health: We should conduct the research on the impact of climate change on health state for rural and urban residents, especially the impact of extreme climate conditions and unexpected climate accidents, such as high temperatures, storms, floods, high winds, sandstorms, drought and mist, on the occurrence of diseases caused by climate change. We should also establish an early warning system, draw up emergency reaction plans and develop technologies to deal with climate change and ensuing health problems. We should keep assessing the early warning systems and all the other intervention measures.

—Fundamental research on environment and health, and research on how to use traditional Chinese medicine to prevent public health from being further affected by environmental pollution: Efforts should be made to strengthen fundamental research in environment and health fields; develop criteria for early signs of diseases caused by heavy metals, persistent organic pollutants and other major pollutants; work out how these major pollutants harm human health; conduct epidemic disease investigations and animal experiments so as to record early health damages caused by particular pollutants; and, based on the results of the investigations and experiments, identify pollutants to be controlled in the first place. Efforts should also be made to learn from traditional Chinese medical theory on health maintenance, rehabilitation and dialectic treatment; exploit traditional Chinese medicine's advantages in simple diagnosis, easy therapy, great curative effect, and cheap treatment cost; conduct research on traditional Chinese medicine's curative effects on diseases and sub-healthy states caused by pollution; and ascertain therapy methods in accordance with research results. Traditional Chinese medical theory on health maintenance should be spread to the public, thus building up people's resistance to pollution, and to cure and prevent diseases caused by pollution.

— Research on the methods to assess environmental pollution's damage to human health: This includes research on methods to assess physical endurance to major chemical pollutions and electromagnetic radiation. It also includes the research on methods to assess the special impact of such pollutions on human health. Efforts should be made to specify physical endurance to major pollutions and to identify early physical reactions to such pollutions, thus to find out the relation between physical endurance and disease occurrence in a polluted environment. Efforts should also be made to work out methods to identify pollution's early impact on human health, and to solidify the theoretical foundation for further developing research on environment protection and health maintenance.

— Research on how to assess the financial burden aroused by treating diseases caused by environmental pollution, and analysis of the capital requirement of launching environmental protection and health maintenance drive: It includes the research on how to use various indexes, such as patient's willingness to pay, disease treatment costs and human capital, to assess the financial costs incurred directly and indirectly by curing health damages caused by pollution. It also includes an analysis of the financial burden aroused by treating diseases caused by pollution, and the accurate calculation of the financial cost incurred by curing major diseases caused by pollution. We should conduct a preliminary analysis on the capital requirement of launching environment protection and health maintenance drive, thus achieving a diversified capital investment. We should also work out methods to assess and calculate the financial costs incurred by curing health damages caused by pollution, and to incorporate the assessment into green GDP accounting system.

Measures should be taken to promote technological development and reinforce construction of professional work teams. In view of the functions of the network to monitor environment and health conditions, the localities to be monitored, and the investigations and researches to be conducted, we should further improve laboratory facilities, better on-site monitoring methods, enhance abilities to monitor pollutants under key control, enhance abilities to monitor major indexes of health states, ensure smooth development of major investigations and researches; adjust and replenish professional work teams, stimulate development of relevant sciences and technologies, improve higher education, promote personnel training, prepare more qualified personnel and advanced technologies for environment and health works, and comprehensively enhance abilities to provide technological supports to environmental and health work.

4.6 Strengthening publicity and the exchange of environment and health knowledge

We should make every attempt to utilize public publicity, promote wider exchanges, and raise public awareness of our environment and health work. We should also work hard to seek support from all social circles and ensure the effective implementation of environment and health policies.

Strengthening public publicity and education: Taking advantage of television, radio, newspaper, network and other medias, we should widely publicize laws and regulations on environment and health work; make the public understand the current situation and challenges of our environment and health work; raise public awareness toward environmental protection and health maintenance; urge social organizations, non-government organizations, scientific research institutions, academic institutions, enterprises and mass medias to fulfill their responsibilities of environment protection and health maintenance on a voluntary basis, and urge them to enthusiastically contribute to our environment and health work. We should make every effort to provide public publicity and education of environment and health knowledge, raise public awareness of environmental protection and health maintenance, cultivate good habits in individuals and the whole society, and foster a social environment favorable to environmental protection and health maintenance drive.

Actively promoting national and international exchange: We should make full play of national environment and health forums, identify major scopes for national environment and health work, study necessary measures and actions, develop solutions to current problems, foster cooperation between different departments, and boost the scientific development of environment and health work. We should conduct wide academic exchanges and discussions about the environment and health technologies, promptly introduce foreign academic and technological achievements, offer training to academic leaders and chief technicians, foster technological innovations, and offer strong technological supports to environment and health work. We should actively participate in international and regional cooperative programs in environment and health fields, closely follow international progress, adopt the advanced practices of other countries, promote various cooperative programs, absorb new technologies and new working methods, and constantly improve our environment and health work.

5. Safeguard system

As a systematic program, environment and health work requires wide participation among various departments, enthusiastic support from different academic fields and good coordination among all social circles. To ensure the smooth progress of the environmental protection and health maintenance drive, we should adopt effective laws, make useful policies and ensure a strict enforcement of the laws and policies.

5.1 Putting environment and health work high on government work agenda

Addressing environment and health work is the basic requirement for sustainable development. It is of great importance in building a well-off society and realizing the fundamental interests of the overwhelming majority of Chinese people. All localities and departments should deepen their understanding of this field, strengthen their management, incorporate environment and health work into major work agendas, ensure that this work is always the priority in the economic and social development plans, strengthen their enforcement of environment and health laws, improve supervision and management teams, and ensure their fulfillment of administrative responsibilities. Governments at all levels should give strong supports to environment and health work, open more channels to introduce investment, and foster a situation where governments at all levels, social organizations, enterprises, individuals and all other social circles work together to promote rapid progress of environment and health work. All appropriate departments should reinforce their organization of environment and health work, carefully carry out their tasks, make their works known to the public, guarantee the strict appraisal of the fulfillment of various job responsibilities, receive supervision from all social circles, and ensure a smooth progress of environment and health work.

5.2 Setting up national environment and health organizations

Initiated by the Ministry of Health and the State Environment Protection Administration, a national environment and health work leading group should be set up among staff members also coming from the National Development and Reform Commission, the Ministry of Education, the Ministry of Science and Technology, the Ministry of Finance, the Ministry of Land Resources, the Ministry of Construction, the Ministry of Communications, the Ministry of Water Resources, the Ministry of Agriculture, the Ministry of Commerce, the State Administration of Radio, Film and Television, the National Bureau of Statistics, the State Administration of Work Safety, the Legislative Office of the State Council, the China Meteorological Administration and the State Administration of Traditional Chinese Medicine. This group will be responsible for formulating administrative policies on environment and health work, and guiding a scientific development of the environment protection and health maintenance drive. A secretarial institution to serve the leading group should be set up with staff members from the Ministry of Health and the State Environment Protection Administration. It will be responsible for conducting and coordinating relevant works designated by the leading group. A national environment and health consultancy committee should also be set up to provide professional suggestions and technological support to our environment and health work.

5.3 Establishing a coordinated system for environment and health work

Efforts should be made to establish a regular meeting system for the national environment and health work leading group, to establish a sound operation system for the secretarial institution to serve the leading group, and to establish a coordinated work system for various departments and localities, thus guaranteeing the effective implementation of our environment and health work. We should establish a coordinated system for environment and health work, clarify work divisions based on the strengths of each department, draw up scientific work plans, tap full potentials of the departments, and make full play of various resources.

As the initiator of the environmental protection and health maintenance drive, the Ministry of Health and the State Environment Protection Administration are both responsible for organizing and coordinating our environment and health work, formulating regulations and criteria in this field, supervising environment and public health condition, conducting information management, appraising work risks, and preparing for emergency reactions to major pollution accidents. The National Development and Reform Commission is responsible for coordinating and organizing the formulation of administrative policies favorable for the coordinated development of environment and health. The Ministry of Education is responsible for incorporating environment and health work into school curriculums and special education programs, and promoting environment and health education campaigns in schools. The Ministry of Science and Technology is responsible for incorporating major environment and health technologies into national technological development programs. The Ministry of Finance is responsible for preparing capital necessary for launching environment and health work, and is responsible for strengthening capital management and supervision. The Ministry of Land Resources is responsible for conducting geological environment protection, curbing groundwater pollution, and supervising excessive exploitation. The Ministry of Construction is responsible for formulating urban and rural development plans favorable for environment and health work, ensuring the water quality supplied for urban areas, monitoring urban environment sanitation, reinforcing guidance and supervision of urban wastewater treatment, and formulating criteria for relevant projects. The Ministry of Communications is responsible for formulating transport development programs and policies to boost environmental protection and health maintenance drive. The Ministry of Water Resources is responsible for formulating plans to protect water resources, defining demarcation of different water zones, controlling pollutant discharge in drinking water zones, conducting unified management and supervision of water resources (including precipitation, surface water and ground water), examining water zones' capacity to contain pollution, and making suggestions for curbing pollutant discharge. The Ministry of Agriculture is responsible for monitoring agricultural environment and agricultural bio-safety. The Ministry of Commerce is responsible for formulating trade plans and policies favorable for environment and health work. The State Administration of Radio, Film and Television is responsible for developing radio and television programs to promote environment protection and health maintenance. The National Bureau of Statistics is responsible for guiding construction of database and information-sharing platform for environment and health work. The State Administration of Work Safety is responsible for formulating and implementing plans to protect the environment and health condition in all work sites. The Legislative Office of the State Council will work with the others to do research, formulation and modification of laws and regulations on environment and health work. The China Meteorological Administration is responsible for weather monitoring, weather forecasts, organizing coordinated reactions to major disastrous weathers, conducting coordinative monitoring of air quality, doing meteorological researches, and providing meteorological information. The State Administration of Traditional Chinese Medicine is responsible for undertaking research on how to apply traditional Chinese medicine toward environment and health work.

(China.org.cn January 5, 2008)