Strategic Lines of Action
Since 2003, by presidential decree, Brazil created the National Commission for Implementation of the Convention for Tobacco Control (CONICQ). The Commission comprises 18 areas of government acting together; for example: Finance develops tax policy, and combats the illegal tobacco market; Justice elaborates materials on illicit drugs; Agrarian Development, carries out a national program to promote crop area diversification, among other actions. Different sectors are working together for Health in All Policies (HiAP).
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.
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.
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.
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.