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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.
This experience of Florianopolis, Brazil, shows two core development sectors acting in a coordinated manner and with oa focus on Social Determinants of Health. On the one hand, the educational sector, modifying the school curricula to longitudinally address health issues such as drug abuse, violence, culture of peace, and healthy eating, among others. And on the other hand, the health sector, training educators and school communities as health promoters.
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.
A joint-effort between those responsible for preventing sexual and domestic violence and those caring for their victims was key for the work done in Campinas, in the state of Sao Paulo, Brazil . The coordination was made possible when domestic violence was considered a public health issue, not only a concern for the police force. Today the care for victims is quick and protective; education on this topic increases awareness by teaching people how to identify cases of violence, and to aid in the prevention and reporting of cases when they occur.
The Zero Hunger Pact in Guatemala and its implementation in the municipality of Tajamulco, is a good example of how a national policy can be adopted and implemented locally through intersectoral cooperation. The Pact intervenes in the social determinants that generate malnutrition and inequality, improving access to food and nutrition of children in the municipalities and most vulnerable populations .
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.