Alain Poirier welcomes the participants at the conference. Over 365 participants from around the world from 42 countries and from health as well as environment and local and national government.
The Deputy Mayor Michelle Morin-Doyle welcomes delegates and hopes that we get a chance to see Quebec without missing any of the sessions.
Richard Masse, Chair of International Scientific Committee of the Conference and Professor at Montreal University thanks the international and local scientific committee members and all the person who contributed to setting up and supporting this conference.
Richard sets out the objectives and themes of the conference:
- HIA in the policy-making process
- Institutionalisation of HIA:addressing political and administrative issues...different ways not just a way
- Diversity of practices:developing a common framework, maintaining flexibility
- Evaluation, research and ethics: advancing HIA practice
Thanks to everyone who submitted proposals for oral presentations nd poster presentations.
What I'd like to see is discussion and dialogue within and across sectors - health and beyond health.
Carlos Dora, World Health Organization, he is responsible for HIA and intersectional action. Pleasure to be here in Quebec.
Carlos discusses future of HIA:
- Why is it essential to scale up action on HIA and Health in All Policies (HiAP)
- Why do we think HIA is a key part of the response to global health issues
- Elements for a strategy to increase the application of HIA for HiAP
- How this conference can be a turning point for tackling these global health issues
- Economic crisis has made the need for making more with less even more urgent.
- Crisis in non-communicable disease which can be solved with preventative measures taken by non-health sectors, trillions of dollars worldwide.
- Renewed debate on sustainable development - post 2015 goals
- HIA offers a framework for: sustainable development indicators, identifying inter-sectoral policies to tackle non-communicable diseases
- HIA can be used at a strategic level which multiplies the reach and impact of HIA. HIA can be way for private sector and public sector to manage investment risk. Sets a standard for industry. Enhance participation...WHO guide on Health and Community Finance...work with extractive industries...Inteersting and unique issues such as mobile men with money...provides a 'bird eye view'
- No reference to health in Rio+20 had health in it. A guide was developed Measuring Health Gains from Sustainable Development
- Health in a 'Green Economy'...focus on mitigation of climate change, co-benefits from green and climate friendly policies...transport, construction, energy, housing...health cobenefits part of next IPCC recommendations
- While health is in EIA and while it's not perfect it has a greater visibility than HiAP.
- A lot of discussions have happened around methodology and doing it and now we need to do it.
How can we increase the global implementation of HIA for HiAP?
- Wide dissemination of info on health risks and benefits of sector policies
- Tracking system to monitor and report on sector policies health performance
- Substantial health inputs made using existing legislation e.g. Environmental...
Lobby private sector to undertake HIAs of strategies and policies...
Develop a functional global tracking system to monitor the health impacts of policies through HIA usage
Hope we can us ethics conference to act as a springboard to realise the full potential and health gain storm HIA...hope for a QUEBEC MANIFESTO on how we can see the changes in the future by bringing the brains in this audience to develop a work plan to take things forward.
Health sector needs to do more HIAs and take a wider social determinant of health e.g how can the hospital influence the health of the local population - non patients - around it.
Q: What actions should local regional and national governments take in the next 5 years?
A: I think the 3 tasks I mentioned previously are for governments particularly the global tracking system. Energy is an important are and WHO are looking at developing a global tracking system for energy policies globally. The other tasks is communicating widely and being bolder in getting the message out even where faced with litigation and other hurdles. Using EIA and SEAs as a vehicle for health, with each country incorporating it in their own way - they are natural allies and competitors, need to use all existing mechanisms to get health onto the agenda.
Q: should it be a targeted approach where we can make headway or to have a broad approach and cover all sectors?
A: I'm in favour of the targeted approach and taking up opportunities and focusing on key sectors for a country, region, locality so that there can be visible achievements.
Q: Should economic analysis be integrated into HIA and in HiAP? Do you think we should develop skills in this area?
A: Yes and no. Yes because we have to create interactions and in other sectors. It is useful to quantify but it is not enough. Health is more important than economics because it is an important policy and societal goal. People see health as the mor eimportant issue.
Q: why don't we do HIA in the health field and in the vertical programmes for HIV and malaria? Are we ready to ask for this to happen?
A: WHO is asking for this and we hope health agencies and governments and health systems will listen an stake it up. Health systems are difficult to change to shift from treatment to prevention because the power and incentives are in curative services. This is true even in WHO. Disease focused programmes outweigh social determinants focused programmes. Need to think about what smart strategies we can use to engage health care workers - nurses, student doctors/nurses - to start some sort of change from within.
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