Reproduced, with permission, from:Most of the WHO Commission's recommendations for research come under sectoral headings at the end of chapters 3-8. Here they will be briefly recapitulated. Some general considerations, principles, and recommendations about research on health in relations to the environment and development are also included.
1. The diversity of environmental health issues and differences in their importance in different parts of the world should be recognized.
For the majority of the world's population environment-related infectious diseases remain the most pressing health issue. For the developed world they play a lesser role, chronic diseases related to lifestyle (e.g., diet, smoking, and alcohol) and chemical pollution of the environment being more important. These diseases are also becoming increasingly important in developing countries.
2. Equal priority should be given to research aimed at preventing environmental health problems and to research aimed at their resolution or mitigation.
There is a tendency for research on environmental health to concentrate too much on "cleaning up" and too little on prevention. In many instances there is also a failure to apply existing knowledge because it is not available to those making decisions or is not fully understood by them. Inadequate coordination between research groups often leads to duplication of research. The various reasons for the underutilization of existing knowledge should be investigated using social sciences approaches.
Quantitative studies should be conducted to increase the precision with which it is possible to specify optimum levels of intervention and monitor environmental risk factors. Active exchange of relevant information and expertise should be organized at the international level, attention being paid to the need for international and regional databases.
Development is recognized as a key issue in the improvement of human health. However, the precise interaction between development and health remains poorly understood; most of the conventional indicators used to measure development have at best only an indirect relationship to health. There is a need for development indicators at all levels (from communitybased projects to national statistics) that ensure that the state of health of the people is included in development statistics and make easier the incorporation of health concerns in development plans.
An important subject of research should be exploration of significant and, as far as possible, causal relationships between development factors and health indicators, to quantify favourable links and detect possible adverse effects. In most circumstances the relationships are likely to be indirect and linked through environmental intermediaries.