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.
2013
Forging Partnerships for a Tobacco Free Suriname
A law that seeks a tobacco-free country, was the result of a hard negotiation process that mobilized the health sector in Suriname. From the beginning this sector knew it could not act alone . It is based on a collaborative effort with contributions from different sectors. It included lobbying with political leaders and the private sector, as well as a creating awareness and mobilizing citizens. The law was passed in 2013 with an absolute majority.
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.
2010
Cencinai: Education Centers, Nutrition and Holistic Care
A family living in poverty and vulnerability faces the risk of nurturing its children inadequately. A wide inter-sectoral response led by Health and Education was successful in providing this children in Costa Rica with holistic care as well as nutrition and education services. Working mothers are also given the support they need to succeed. This is an example of inter-sectoral coordination in the presence of a social determinant of health.
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
Social prevention of violence and crime
The law of Social Prevention of Violence and Crime was issued by the State of Chihuahua, Mexico in 2010. It is an example of intersectoral cooperation implemented at a regional level. The most important aspect of this case is that the State System of Public Safety took leadership and handles criminal situations from a public health perspective, going beyond the criminal approach.
2010
Strategy to Combat Overweight and Obesity
In Mexico, the numbers of overweight and obese people are increasing every year, as well as the diseases associated to these conditions . To meet this challenge, a National Agreement for Healthy Nutrition was proposed. Different sectors promote food regulation, changing the family diet and creating awareness of eating habits, and increasing physical activity. Each sector has a specific agenda that is coordinated with the rest.