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In 2012, Medellin set out to transform itself into a healthy city. It assessed its past, reevaluating the achievements and developments of previous administrations. It studied its present, joining efforts with the University of Antioquia, assessing the challenges and possibilities of a healthy model for the city. And the city began to build its vision by joining citizens, their organizations and the private sector. These efforts have allowed that in the recent four years the city has invested its resources and efforts to improve its surroundings where people can either gain or lose health by acting on key determinants such as the environment, employment, education, housing and poverty. Since then the Ministry of Health not only runs the programs it is responsible for, it also coordinates and supports all of the health generating structure of the city.
PLANAL is an experience in Paraguay where a government and its citizens work together to respond with holisticpolicies and actions to fight the main causes of food insecurity. It is a global governance strategy to improve the efficiency of State action. In this case a strong intersectoral coordination seeks to overcome the fragmented efforts and reverse the unequal distribution of resources.
Cuba exemplifies a process of incorporating the focus of health promotion in the national system that was initiated at the time of the Revolution, and adapted to the perspective of the social determinants of health over time. It is a case of inter-sectoral work that has been institutionalized and is reflected in the Constitution, where all relevant actor, including community representatives, are summoned to collaborate on the design, implementation and monitoring of policies and programs.
When classes end, the children in Costa Rica go to school stores to buy food. The Ministries of Health and Education saw the daily need for food and drinks as an opportunity to promote healthy eating habits and proposed regulating which products are sold in school stores. In the midst of a national debate led by the food industry, the decree was finally passed. The importance of health was proven to be more important than the economic interests of corporations.
The experience of Boca de Mao in the Dominican Republic is a local example that shows how the Health In All Policies (HiAP) approach may be present at a smaller scale. It showcases the level of coordination between a strong community organization that presents and manages its demands, and a holistic and coordinated response from various government sectors. The experience focuses its efforts on raising awareness through education and moving towards concrete actions on issues that concern the environment, food safety, health monitoring and nutrition.
Ecuador established the National Plan for Good Living as a way to plan and generate actions. The Plan permeated the entire state structure, integrating Health, Education, Labor and Social Inclusion sectors , among others. It created opportunities for citizen participation, from the national to the local level with a focus on rights. The plan has its own resources and it has Presidential and legislative support. It is a clear example of intersectoral action to build sustainable development.