1. Laurence Carmichael PhD
Environment and Health for European Cities in the 21st century: making a difference Stakeholders consultation Utrecht, the Netherlands 13-14th December Towards the sixth Ministerial Conference on Environment and Health: which role for cities and sub-national level of government? 
Laurence Carmichael PhD
Head, WHO Collaborating Centre for Healthy Urban Environments
University of the West of England, Bristol

2. Environment and Health for European Cities in the 21st century: making a difference
Overall aim of the document:
To support delivery of the global “healthy planet healthy people” agenda and the Sustainable Development Goals (SDGs), by:
Exploring desirability and opportunities of developing new, strategic and mutually supportive partnerships with European cities and regional authorities in relation to environment and health challenges and the inequalities determined by them;
Identifying policy and technical areas for collaboration and partnership between international actors, national governments and sub-national and local levels of government within the context of the European Environment and Health Process (EHP)
Facilitating implementation of effective policies and interventions, including at the sub-national and local level, and fostering policy coherence and support across different levels of government

3. Environment and Health for European Cities in the 21st century: making a difference – the consultative process so far :
June 2016
First draft of the document
27-28th June 2016
Stakeholders consultation meeting at WHO Bonn offices (city and national representatives, UN Habitat, EEA, CoR, UNECE, city networks, NGOs) to inform next draft
July- October 2016
Redraft following stakeholders feedback
November 2016
Distribution of the document to broader stakeholder community
13-14 December 2016
Stakeholder consultation in Utrecht to inform final draft

4. Cities, key stakeholders of the global healthy people, healthy planet agenda
What policy-makers say about cities:
Cities today occupy approximatively only 2% of the total land, but make up 70% of global GDP, over 60% of global energy consumption, 70% of global greenhouse gas emissions and 70% of global waste (Habitat III, 2016)
And in response, academics say:
The future of the world’s climate will be decided in the cities.
(WBGU, 2015)

5. Drivers of change in European cities
European cities align with global trends:
Growing importance of cities for economic and social development
Increasing movement of people
Ageing population
Epidemic of non communicable disease
Impact of climate change

6. But European cities show specific demographic, cultural and political features
These offer specific challenges and opportunities to policy responses to economic, social or environmental drivers of changes
65% of urban European population live in cities with population less than 500,000
95% urban population live in cities with less than 5 millions
Economies of scale
Historic heritage
Adaptation/resilience to climate change
Many European cities have high old age dependency ratios
Organisation of services, accessibility of the urban environment
Devolution to sub-national and local authorities
Leadership. Vertical policy integration
Over 60% of decisions taken at the European level have a direct impact on municipalities, provinces and regions
70% to 80% of public investments in Europe are made by local and regional authorities: leadership, community engagement

7. Cities can make a difference to the Environment and Health Agenda in Europe
Cities and natural resources
Cities and the human habitat

8. Sectors where European cities make a difference to international policy
Resource management and climate action:
Waste management
Energy
Air pollution
Water management
Food systems
Ecological systems, biodiversity and green spaces
City living and health:
Urban planning and design
Equity
Housing
Transport planning

9. How can European cities make a difference in these fields? (1)
Local and sub-national responsibilities align with many SDGs
Many cities have developed their own initiatives to tackle climate change and promote healthy living, for example:
City planners licensing fast food outlets, providing spaces for allotments
Cities imposing Health Impact Assessment on new developments
Transport planners developing strategies for active travel and public transport
Green Capital Cities have promoted multi-sector partnerships
Cities have developed brownfield first and green belt policies
Some cities are exploring the smart city agenda
Local crowd funding of local projects
3. Over 60% of decisions taken at the European level have a direct impact on municipalities, provinces and regions. Cities integrate international policies in their services, for instance:
Energy Performance of buildings Directive part of local planning policies
Municipalities educate residents and invest in infrastructure/services to meet Waste Framework Directive

10. How can European cities make a difference in these fields? (2)
4. At the frontline of democracy, their leadership is best placed to ensure that settlements are inclusive, safe, resilient and sustainable
Examples of challenges that are best tackled at local level:
Social inclusion: integration of migrants
Infrastructure and service delivery based on needs assessments and hard priorities (housing, schools, healthcare)
Development of integrated operations for resource management
Making policy within context of multi-actor interests and negotiations
Obtaining consensus on local spatial and transport plans and strategies
City assets/opportunities:
Opportunities for policy integration adapted to local needs and priorities
Proximity helps building public/private/academic sector collaborations: creativity and innovation, green technologies, urban design, skill base
Leadership and community engagement support knowledge synergies and respond to local needs
Knowledge of what works and what does not work on their territories

11. How can European cities make a difference in these fields? (3)
5. Cities have organised themselves in thematic networks NB: This is encouraged by the EU urban agenda
Purpose and benefits:
Cohesive local approach to challenges
Knowledge exchange, good practice
Fostering multi-sector partnerships
Informing international policy processes
WHO Healthy Cities and Regions for Health networks
EU Committee of the Regions
Council of European Municipalities and Regions (CEMR)
Covenant of Mayors
ICLEI
EUROCITIES
POLIS

12. Placing urban policies at the heart of the EHP and SDG delivery – proposed guiding principles
Respect subsidiarity and legitimacy
Use of evidence-base to inform policy-making
Pursue the reduction of inequalities and build social and physical resilience
Abide by the Aarhus convention (public participation, transparency)
Consider cross border issues
Commitment to health in all policies, “whole-of-government” and “whole-of-society” approach

13. Placing urban policies at the heart of the EHP and SDG delivery – Possible topics and approaches
air pollution, water and sanitation, energy, waste, housing, urban spaces and mobility, climate change and resilience
In practice:
Develop cross sectoral collaboration, in particular between public health and urban and transport planning, with
Establish a new platform to channel sub-national representation in the EHP and promote vertical policy coherence and collaboration across international, national and local levels of governance
Develop a strong knowledge sharing ethos
Maximise use of tools already available to cities to evaluate the impact of policies, plans and projects – Health Impact Assessment

14. Next steps
Review the draft document in line of:
Feedback and discussion at this consultation;
Political discussion on the outcomes of the Sixth Ministerial Conference on Environment and Health;
Launch the document at the Sixth Ministerial Conference.

15. Thank you Laurence Carmichael WHO Collaborating Centre for Healthy Urban Environments University of the West of England, Bristol