Public Health, Environment and Sustainable Development
This domain combines the organisation of the health system, national public health programmes, the framework of environmental law and the meaning of sustainable development, usually through a project or policy scenario.
Public health: the system
Services form a pyramid: central level (referral and general hospitals such as the Yaounde Central and General Hospitals), intermediate level (regional hospitals), district level (district hospitals and district medical centres) and peripheral level (integrated health centres). The health district is the operational planning unit; the Ministry of Public Health sets policy while councils share competences in primary health care.
Public health priorities
Malaria remains the leading cause of consultation, fought with long-lasting insecticidal nets, intermittent preventive treatment in pregnancy and artemisinin-based therapy. The Expanded Programme on Immunisation provides BCG, polio, pentavalent, measles-rubella and yellow fever vaccines; HIV antiretroviral treatment and tuberculosis treatment under DOTS are free in public facilities. Maternal and neonatal health, nutrition, water and sanitation, and epidemic preparedness complete the picture.
Environmental law
The framework statute is Law No. 96/12 of 5 August 1996 on environmental management, supplemented by the forestry, wildlife and fisheries law of 1994 and the water law of 1998. Its cornerstones are the polluter-pays and precaution principles, public participation, and a compulsory environmental and social impact assessment for listed projects, with a management plan and monitoring under Decree No. 2013/0171/PM. MINEPDED is the lead ministry, working with MINFOF on forests and wildlife.
Sustainable development
Sustainable development rests on three pillars: economic, social and environmental. Cameroon frames policy in the National Development Strategy 2030 and the SDGs, and ratified the Paris Agreement. Pressure points: deforestation and illegal logging, desertification and the shrinking of Lake Chad in the Far North, poaching in protected areas such as Dja, Waza and Korup, plastic pollution, artisanal mining, coastal erosion and flooding in Douala.
Worked example
A company plans a cement plant near the Wouri estuary. Before works begin it must carry out an environmental and social impact assessment, obtain approval and implement the environmental management plan; a project begun without an assessment can be stopped and sanctioned. The Preamble also makes protection of the environment a duty for every person.
Traps
Saying the impact assessment is optional or comes after construction. Confusing MINEPDED with the health ministry or MINFOF. Treating sustainable development as purely ecological. Ignoring the role of councils in sanitation and waste.