May own experience on how HIA has changed.
Pre-2009: 77% HIA done after ESIA, 50% retrospective
After 2009: 33% HIAs done after ESIA
Integration in management plans
No HIA performed because of legal framework before or after 2009.
Public domain reports 0% to 8% (4).
Mainly mining projects in Sub-Saharan Africa.
Barriers and opportunities
No frameworks in high and low income countries for mining, health and EA. So variation in company standards and no one to hold to account.
Significant health costs particularly TB and chronic lung disease. HIV also a big issue.
Too narrow a definition of health in guidelines.
Interaction health authorities locally is challenging.
Strong occupational health regulation none for community health.
Health in EA is an untapped potential to improve public health locally.
Weak monitoring and evaluation of health findings.
What is the gap between the projects that don't consider health at all?
Need for better health regulations.
Documents public and community aware and can read/understand findings.
Host governments leading not just lending institutions and companies.