Route of the Americas
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.
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.
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.
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.
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.
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 .