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.
2004
PBF: Bolsa Familia Program
Bolsa Familia is a Brazilian government program that originated from the legislative and executive powers. It serves families in extreme poverty by increasing their human capital and improving their development opportunities through cash transfers and by increasing access to public services and food, among other actions. It assumes an intense inter-sectoral coordination and shows good results in child nutrition, lower fertility rates, improved maternal education and a higher purchasing power.
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.
2005
Anti-Dengue Campaign: Kill it with Thirst
The case study from Uruguay describes the actions taken to control and reduce the prevalence of dengue in the country. This is a case of intersectoral action at the level of information sharing. While it does not meet many of the criteria to be considered a Health in All Policies approach, it is an example of a successful partnership between government institutions and the National Movement of Public and Private Health Users (NMPPHU), a nongovernmental organization that addresses public health issues.
2008
Health Program in School
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.
2007
Planal: A National Sovereignty, Food Safety And Nutrition Plan
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.
2010
Health Promotion by Fighting Cholera
The Haitian Ministry of Health spearheaded the Strategy to Promote Health and Quality of Life in the Fight against Cholera in Haiti with support from the international community. This program grew out of the destruction and health challenges caused by the 2010 earthquake that devastated the island. An example of intersectoral action at the information sharing and cooperation levels, this strategy provides education and training to promote public awareness and community participation and empowerment to control the epidemic.