Putting Health in All Policies into Practice Dr Kira Fortune 1 To provide the context of the HiAP Regional Plan of Action 2 To illustrate how the HiAP Regional Plan of Action came into being and its contents 3 To address next steps implementing the HiAP Regional Plan of Action 4 To highlight how the outcomes of the expert consultation will feed into other regional and global events

Despite the fact that Latin America and the Caribbean is a middle income region, the Region is one of the most unequal region in the world with regards to income levels (PAHO, 2012) Recent evidence demonstrates that almost 1 in 5 residents of the Region lives on less than 2 US$ a day (World Bank, 2010) 70 million people in the Region still live in extreme poverty (ECLAC, 2012) Source: PAHO: Health in the Americas, 2012 poorer mid richer ,000 10,000 15,000 20,000 25,000 30,000 35,000 gross national income per capita ($ ppp) 40, ,000 30,000 gap 6,000 gap Income Growth by Income Terciles: Region of Americas [1] The Greatest Challenge in the 21 st Century; Poverty & Inequity

Key Challenges for the Region of the Americas: Non- Communicable Diseases, Urbanization and a Changing Epidemiological Profile Health Systems Family and Peer Influences Gender Norms Social Exclusion Ethnicity National Legal and Policy Environment Increased Urbanization [1] Key Regional Challenges Employment Cultural and Religious Values and Traditions

Through public consultation, Member States identified Five Key Pillars: A key outcome of the Global Conference was the Rio Political Declaration Governance to tackle the root causes of health inequities Promoting participation The role of the health sector Monitoring progress [1] Rio Political Declaration Adopted by Member States, Sept 2011 Global action on social determinants

HiAP a key tool to implement the Rio Political Declaration on the Social Determinants of Health HiAP focuses on the social and environmental determinants of health Often better addressed through policies, interventions and actions outside the health sector Building partnerships and finding common ground between the health sector and other sectors of government, civil society and the private sector is essential “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 ” 2013 Helsinki Statement on Health in All Polices [2] Health in All Policies

The central theme of 8 th Global Conference on Health Promotion called for Health in All Policies Regional Consultation on Health in All Policies held in February, 2013 A total of 26 case studies from 15 countries in the Americas developed to showcase HiAP Five case studies from the Americas developed to provide extensive analysis of successes and challenges addressing health in All Policies Regional Analysis of Intersectoral Action conducted by Chile University In June 2013 countries committed to Health in All Policies Conference Statement WHO Health in All Policies Framework for Country Action launched in January, 2014` Bolivia Brazil Costa Rica Cuba Canada Dominican Republic Ecuador El Salvador Guatemala Haiti Honduras Mexico Paraguay Suriname Uruguay [2] HiAP Process in the Americas

Line of Action 1: Establish the need and priorities for HiAP Number of countries and territories implementing the Health in All Policies Framework for Country Action Line of Action 2: Frame planned action Number of countries and territories producing equity profiles that address at least two priority determinants of health at the national and sub-national level Line of Action 4: Facilitate assessment and engagement Number of countries and territories with mechanisms to engage communities and civil society in the policy development process across sectors. Line of Action 6: Build capacity Number of countries and territories with recognized institutes such as national public health institutes, universities and collaborating centers offering training courses on the implementation and monitoring of HiAP. Line of Action 5: Ensure monitoring, evaluation, and reporting Number of countries and territories that monitor, evaluate and report on progress towards introducing health and health equity in the development and implementation of government policies Line of Action 3: Identify supportive structures and processes Number of countries and territories with a specific mechanism, such as intersectoral committees or HIA, by which the health sector can engage within and beyond the public sector. [2] First Regional Plan of Action on HiAP Adopted Sept 2014

White Paper highlighting state-of-the-art knowledge in the Region of the Americas Indicator Analysis to facilitate our work in developing a Roadmap including roles and responsibilities Roadmap to guide implementation of Plan of Action over the next five years Expert Consultation on HiAP with wide range of experts defining next steps and concrete actions in implementing the Regional Plan of Action: More than 65 experts involved in this Expert Consultation from the region of the Americas and beyond [3] Putting PAHO’s Regional HiAP Plan of Action into Practice

Image: National Institute for Health and Welfare; Finland Regional Forum on Urban Health in Medellin in September 2015 UIPES Conference in Curitiba, Brazil in June 2016 WHO Global Conference on Health Promotion in Shanghai, China, September 2016 Health in All Polices Expert Consultation Washington DC 2015 [4] Health in All Policies: from the Local to the Global