Second Environmental Performance Review of Albania

Chapter 10: Human health and environment147The Law on Public Health requires all data collectedby the public health structures, along with data oninfectious diseases, to be channelled to IPH, whichprepares analytical reports on the health status of thepopulation, exposures to environmental risks andrelated health effects, for MoH. The Ministry is tosubmit biannual reports to the Council of Ministerswhich will then present them to the NationalAssembly. The public health structures have toperiodically report to the local governments in theareas they cover.The quality of services, equipment and personnelvaries among the 36 public health structures; inaddition, data collection and reporting is, in manycases, outdated, and covering the entire breadth ofenvironmental public health services throughout thecountry in depth poses a significant challenge withlimited resources. MoH is currently undertaking aconsolidation of the health inspection regime as partof the initiative to pool together sectoral inspectionbodies with the aim of separating control andenforcement from the policy process. Optimization ofthe organizational structure and geographicalorganization of the public health system are alsounderway. As regards education, the Department ofPublic Health in the Medical Faculty of theUniversity of Tirana has since 2007 providedcapacity for public health professionals.Environmental health is a compulsory andfundamental course in the public health and medicalcurriculum, and is part of postgraduate education andmedical specialization and of the postgraduatequalification.The NFA – the newly created body following EUregulations, which is directly subordinated toMoAFCP through its General Directorate of FoodSafety Policies and Consumer Protection – has takenover food safety and related consumer protectionissues. The Authority has now increased operationalcapacity and is expanding across the 12 regions,while its risk assessment and communicationcapacity is still to be developed. The backbone of theAuthority is the inspectorates of food and foodbusiness establishments, and of animal health, whichoperate at central and regional levels.Responsibilities for plant health, and coordinationand support for laboratories, are also carried out atcentral and regional levels, and the Food Safety andVeterinary Institute (ISUV) provides the referencelaboratories for food safety analysis and officialcontrols. In addition, at regional level there is a uniton self-controls and control-points-basedinformation.INSTAT is coordinator of the national statisticalsystem and, in the fall of 2011, conducted thepopulation and housing census. It collects mortalitydata from the health sector and civil registrars butdata from those two sources do not match and areavailable in highly aggregated form only. TheInstitute will host registers on injuries andtraumatism in occupational and transport settings.Intersectoral collaborationSeveral working groups involving both experts andpolicy-makers from different sectors are beinginvolved in the development of policy programmesand legislation, which demonstrates intersectoralcollaboration in the policy preparation phase. Theestablishment of long-term partnerships among thedifferent sectors for the implementation of policy andlegislation in the field of environment and health isvery limited. The ECS envisions some policymeasures for intersectoral collaboration, but there isno report on what has been implemented and whatworked. The national transport, environment andhealth intersectoral committee set up in the context ofthe UNECE/WHO Transport, Health andEnvironment Pan-European Programme (THE PEP)is still not functioning. The intersectoral workinggroup following up on the Fifth MinisterialConference on Environment and Health in Parma is,equally, not operational. In some rather particularcases – such as monitoring of urban air quality and ofbathing waters when there is capacity and resources,mechanisms of inter-institutional communication,and clear definition of the tasks, includinginformation activities, data and reporting channels –intersectoral collaboration has been successful.The lack of policy-oriented monitoring andinformation support tools hinders intersectoralcollaboration during the entire policy process.Current monitoring and information systems focuseither on the state of the environment or on healthfrom a health-care perspective. Integratedassessments on the population’s health, involving theenvironmental and other economic sectors and usinga common language in the form of policy-relevantindicators such as those of the WHO/ENHIS system,are lacking. Furthermore, there are no periodicassessments of the health impacts of environmentalrisks which could provide strong argument forinvestment in “win-win” solutions benefiting bothpublic health and the environment.10.4 Conclusions and recommendationsIPH gathers data on key environmental healthexposures, such as air pollution and contaminateddrinking water, and on the health effects of degraded