HIA For ASEAN Community is touching its reality



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ASEAN has committed to intensify community building through enhanced regional cooperation and integration, in particular by establishing an ASEAN Community comprising the ASEAN Political-Security Community, the ASEAN Economic Community and the ASEAN Socio-Cultural Community, as provided for in the Bali Declaration of ASEAN Concord II.
ASEAN Socio-Cultural Community (ASCC) has the primary goal of contributing to realizing an ASEAN Community that is people-centred and socially responsible, with a view to achieving solidarity and unity among the nations and peoples of ASEAN by forging a common identity and building a caring and sharing society which is inclusive and harmonious where the well-being, livelihood, and welfare of the peoples are enhanced.
Today HIA is being implemented in a number of ASEAN member states. In Cambodia, Lao PDR, and Malaysia, HIA is anchored within environmental frameworks relying on government decisions to integrate HIA within Environmental Impact Assessment (EIA) programmes. Thailand’s approach uses a public policy process to advocate HIA at the policy level as well as in EIA and at the community level. Grassroots communities and local government authorities are able to initiate and conduct their own Health Impact Assessments. Currently, Thailand and Vietnam are applying HIA in case studies on various topics.
These vary in scope and size, from national policy on transportation, agriculture and energy to public health and disease control programs. These case studies are providing experience to be learnt from in order to further develop HIA. Many HIA case studies, such as in Lao PDR, apart from being a good learning process, have proven to be very useful in providing supportive information for EIA reports.
The 6th SOMHD on 25-27 July 2011, Naypyitaw, the Republic of the Union of Myanmar, the Meeting agreed on the following HIA matters;
a. Thailand to lead the initiative as well as implementation of HIA and report it to SOMHD;
b. Member States will nominate focal point for HIA and submit it to ASEAN Secretariat within 25 August 2011;
c. Thailand will develop the TOR and framework of HIA and further share and discuss it to the HIA focal point;
d. Convene the 1st Capacity Building Workshop on HIA for ASEAN on February 2012, as proposed by Thailand.

WHY HIA?
. The ongoing processes of economic development and integration, intensified with modern globalization, are creating new challenges for the ASEAN Community and have the potential

to create both positive and negative impacts on the well-being and quality of life of both individuals and communities. Negative impacts which have arisen have included development-induced disasters, pollution of soil, air and water supplies, natural resource depletion, climate change and global warming, population displacement and the deterioration of the social determinants of health. Achieving well-being in this context requires progress on gender equity and the empowerment of women, food security, access to education, management of the impacts of cross-border migration, maintaining the environment and the promotion and protection of human rights. ASEAN as a community needs to have an enhanced awareness and commitment to improving the multitude of factors impacting on the well-being of ASEAN peoples.
States in the ASEAN region are facing challenges in ensuring sustainable development in the dynamic context of regional integration and economic growth. Trans-boarder diseases, vulnerability to disasters, cross country trade, investment and large development programmes inevitably cause impacts on the environment, natural resources, socio-economic fabric, and most importantly, on the well-being, including the life style, of local communities which may extend beyond national boundaries.

WHAT is HIA?
. HIA as defined by the World Health Organisation, is a combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population . HIA is an important process for the protection and promotion of human health from possible impacts/effects of the processes of regional economic integration and environmental change.
. HIA is also a structured method for assessing and improving the health consequences of projects and policies in the non-health sector. It is a multidisciplinary process combining a range of qualitative and quantitative evidence in a decision making framework. HIA is based on key principles and values ; Democracy, Equity, Sustainable development and Ethical use of evidence.
The implementation of HIA requires good governance and true participation of all stakeholders throughout the process. HIA brings together different stakeholders including government authorities, academics, the private sector, civil society and grassroots communities to determine how policy or programme implementation would affect the population’s health and its determinants of health.

. HIA is comprised of three conceptual elements.
a. Health.
Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity. The determinants of health include social, cultural, economic and environments, the physical environment, and the person’s individual characteristics and behaviours.
b. Impact
HIA examines for both positive and negative consequences of developments to enhance the positive ones and mitigate the negative ones. HIA is often undertaken prospectively, it offers the unique advantage of preventing damage from occurring. Furthermore, HIA often needs to assess a broader set of public health factors than has traditionally been considered in environmental impact assessment.
c. Assessment
HIA goes beyond the anticipation of traditional local risks e.g. sanitation conditions, communicable diseases, malnutrition and other physical health risks but also focuses on the foresight of modern risks which are the result of increasingly globalised physical, biological and social environment changes. HIA also covers the assessment of significant Social Determinants of Health (SDH) which include life skills, access to health services, social safety net, gender, age, income, social status and environment. HIA is a form of assessment aimed at mitigating negative impacts on health by focusing on “the causes of the causes” of a lack of wellbeing.
HIA is a tool that supports the decision making process. The expected result of HIA is a set of “evidence-based recommendations” reflecting the ultimate aim of a move towards healthier societies. HIA should provide possible strategies to support and promote the potential positive impacts of a programme or policy and mitigate the potential negative impacts of a programme or policy. It is essential that HIAs are designed to stimulate all sectors in ASEAN community to think, analyse, discuss, argue and learn throughout the process to create healthy public policy.

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