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Authors: Françoise Barten1, Marco Akerman2, Daniel Becker3, Sharon Friel4, Trevor Hancock5, ... - page 40 / 47





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Box 3  Participatory budgeting : the case of Porto Alegre, Brazil –

In the 1980’s the municipal government in Porto Alegre held a referendum to identify priorities for urban public investment and guide the local government plan. The community of 1.4 million identified sanitation among the priorities. This consultation process was the beginning of the “participatory budgeting” initiative – an important strategy for governance. Community demand for improvements in sanitation led to a DMAE (Municipal Department of Water and Sewage) project to increase black water treatment coverage. To date the municipality has invested US$160 million on new sewage systems. The work, which concludes in 2012, will support the MDG to reduce by more than half the 1990 deficit in sewage treatment.  Piped drinking water is now universal, black water treatment is forecast to increase from 27% in 1990 to 83% by 2015, and universal black water collection and treatment services will be provided by 2030.  “Participatory budgeting” shifted local political power and decision-making structures towards resource reallocation for community-defined priorities.

Source: Marilyn Rice( personal communication), 2010.



Box  4Building new institutions and transforming environmental health practice in San Francisco  -

In the early 1990s, a set of overlapping forces combined to reframe San Francisco’s environmental health planning process from a focus on individual risk towards the social determinants of health. The residents of Bayview-Hunters Point (BVHP) - one of the most polluted, impoverished, and unhealthy neighbourhoods in San Francisco - organized for environmental justice and approached the San Francisco Department of Public Health (SFDPH). A survey by SFDPH in the predominately African-American neighborhood highlighted other priority concerns including crime, unemployment, and poor food and housing conditions. These findings were used to re-define the environmental health mandate of the agency to influence non-health policies including land use, housing quality and housing affordability. The activities later expanded into the city wide San Francisco Food Alliance to improve access to affordable and nutritious food. Community involvement including the

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