Inequalities in the environmental public health funding in the European region

Background and aim: Many societies in low- and middle-income (LMICs) countries face increasing environmental challenges, while also have minimal capacities to monitor and assess their impacts on population health, and therefore to inform decision making and policy. The European Union (EU) has supported the research in Environment and Health (EH) for more than 3 decades through its Framework Programmes of Research and Innovation, resulting in over 500 research projects, and investing close to €2 billion until 2020. The aim was to examine in detail the distribution of such funding across the European region and internationally, and in supporting EH capacities. Methods: An analysis of EU Horizon 2020 (2014-20) was carried out initially, assessing 269 funded projects linked to EH, totalling to €1.1 billion. The distribution of funding by country, institution, coordination, provisions for supporting research and policy capacities and capabilities, and how these have changed overtime were examined for EH domains (i.e. air pollution, urban health, climate change, EH Policy). Results: In all EH funding domains, the majority of the funding and coordination went to just a handful of countries (Spain, UK, Netherlands, Germany, France, Italy) and institutions. Societal Challenges 1 (SC1) and SC5, and Scientific Excellence received 77%, while the Spreading Excellence and Widening Participation projects aimed at building and strengthening capacities in EH only 3% of this funding. There was little indication that the majority of these projects contributed to EH capacity building in LMICs. Conclusions: Inequalities in the EU funding distribution for EH research and policy capacities remain stark and persistent overtime. It is difficult to understand how the EU informs strategies to addressing such inequalities, but potential lack of attention to addressing these can lead to environmental and health justice issues across the region and beyond. Key words: environment, health, funding, capacities, inequality, justice