Route of the Americas
When PAHO’s Directing Council approved the first Regional Plan of Action in the world for Health in All Policies in September 2014, it took the lead in implementing an innovative and ambitious approach to the formulation of public policies. HiAP was first defined in the Adelaide Declaration of 2010 and then in the global framework for action by the countries in the Helsinki declaration. The prompt action of the Organization reveals the promise of this new approach to health promotion and the broad support of its goals and objectives.
At the same time, the HIAP incorporates many elements of health promotion and the formulation of health policies that have been developed and debated for decades. It is based on the widespread view of health and well-being defined by Alma Ata (1978) and addressing the public health policies established in the Ottawa Charter (1986). It also recognizes the important contributions of the movement in addressing the social determinants of health and health equities identified by the WHO Commission on the Social Determinants of Health (2008).
In the context of the 8th Global Conference on Health Promotion, Health in All Policies is defined as "an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity”. In the framework for country action, PAHO’s Action Plan on HiAP was based on six strategic areas identified in the Declaration of Helsinki as well as on elements from the Rio Political Declaration on Social Determinants of Health and the Rio + 20 Conference on Sustainable Development, which required dynamic approaches to policymakingacross sectors to address growing inequities, particularly in the area of health.
Due to its importance, a strategy to move the Plan of Action on HIAP into effective results was put into action. Given its innovative nature, expert guidance was sought and experiences have been studied both in the Region of the Americas and elsewhere. With these objectives in mind, the Special Program on Sustainable Development and Health Equity organized an Expert Consultation on HiAP in Washington, DC, from March 31 to April 1, 2015. This meeting provided an opportunity to gather world leaders in the field as well as experts from academia and politics of the Americas and other countries with relevant experience in HiAP, such as Finland and Australia. The purpose of this meeting was to translate the Plan of Action on HIAP into a roadmap, identifying concrete actions that would be crucial for the Region to implement HiAP.
1960
The Cuban Health System
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.
2010
Life in Traffic: An Intersectoral Strategy
Since the mid 1990s, Belo Horizonte, Brazil, presented a persistent increase in traffic accidents. In 2010, the Ministry of Health proposed " Life in Traffic ", an intersectoral strategy that developed a Local Action Plan. By having joint collaboration and coordination with other sectors, it coordinated actions in raising awareness through education, outreach, plans and policies. Strong evidence supports the effectiveness of this program.
2009
Rio 2016: Primary Health Care as a legacy
In 2008 Rio de Janeiro received two important and contrasting news: it was selected as the host of the Olympic Games in 2016 and it appeared as the Brazilian city with the worst health indicators. The Municipal Government decided to link the two facts and intends to organize the Olympics where the main legacy that is left for its citizenship is a reform of Primary Health Care (APS) that benefits the development of competition as well as improving and dignifying life for the citizens of Rio. They have gone from coverage in APS of 150 thousand people in 2008, to 2.5 million people in 2012 , nearly 40 % of its target population. An example of an international sports event that was used as a motivation to produce results in Health with an equity approach.
1998
National Commission of Health and Tourism CONSATUR
The CONSATUR experience in the Dominican Republic was born in 1998 motivated by the need to bring together two engines of national development: Tourism and Health of its inhabitants and of those who visit. They have gradually been shifting from specific coordination actions to consolidate a space of alliance seeking a common goal: to create favorable conditions for health of people and to foster tourism as an important economic activity. It is a good example of practices previous to the HiAP initiative, since back then it was incorporating already many of its criteria.
2009
Intersectoral Health Commision (CISALUD)
The Intersectoral Health Commission of El Salvador is a space for horizontal dialogue where different sectors define health priorities. The sectors make recommendations and each focuses its decisions and resources to develop actions that affect the Social Determinants of Health and promote health equity.
2012
The Zero Hunger Pact and its Implementation in Tajumulco
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 .