Terveyskysymykset on pidettävä mukana myös vuoden 2015 jälkeisellä kehitysagendalla. Yksittäisiä sairauksia painottava lähestymistapa ei riitä vaan tarvitaan kokonaisvaltaista ajattelua, joka huomioi terveysvaikutukset kaikilla aloilla, totesi ministeri Heidi Hautala Maailman terveysjärjestön WHOn konferenssissa Helsingissä 14.6.2013.
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Excellencies, colleagues, ladies & gentlemen,
You have been discussing the theme of this 8th Global Conference on Health Promotion ‘Health in all Policies’ from many different aspects during this week. So I will not go into the concept discussion anymore. Now it’s time to look forward. Words are valuable but as Dr. Chan said in her opening remarks what we need is action.
We are now faced with an opportunity – the world is in the process of formulating the Post-2015 agenda. Today is an opportunity to have a substantive discussion to increase our common understanding on how to best promote health in the new agenda.
I will speak from the donor perspective but I don’t want you to think that we have found the silver bullet here – we have not; but we do have some ideas based on our own experiences that might be useful to share.
The Post-2015 agenda should be built on the current MDGs and achieving them. But it’s also the time to take the lessons learned from the MDGs.
The MDGs brought about a lot of positive things to international development: they are specific and easy to understand, which is good. At the same time, a theme or problem specific approach has led to a certain lack of coherence and non-adherance to the priorities of the recipient countries.
It has also led to vertical disease-specific programmes and health systems that focus on treatment and care, at the cost of a more preventive and comprehensive approach to health.
The MDG framework, although enabling more international financing for health, has not sufficiently addressed the systemic aspects of health systems.
The focus of the MDGs on developing countries is also a good thing. But at the same time issues beyond developing countries and development assistance, such as economic policies, globalization of trade, of services and of finances, demographic changes, climate change and food insecurity have at times been a blind spot. We have also seen the growth of inequity. Gaps in income level within and between countries persist and widen and the MDGs don’t sufficiently address this issue.
The new Post-2015 agenda must address the root causes of poverty and have universal applicability. Health and reducing health inequities should remain an integral part of the agenda. Health should be recognized as a right in and of itself. It should also be clearly linked with other development sectors. Here we need to change our thinking of development. For instance, the disease specific approach has to be abandoned as it no longer addresses the needs.
This is where the Health in all Policies approach comes in. It can be a very good starting point for the Post-2015 agenda as it highlights the interdependence of policy sectors (nutrition, education, adequate income, environment and gender equality for example) and the need to assess the implications of policies on each other.
Health should therefore not only be highlighted on its own but also considered in other sectors and vice-versa. Health in all Policies is an approach 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.
I will give you some examples. Having a gender or a rights based lens on, when for instance an agricultural programme is designed can yield clear health benefits for women and girls affected by the programme. Research also shows that a child´s chances of survival increase by 20 per cent when the mother controls the household budget.
Another example of the interlinkage of sectors is that it has been shown adolescents girls school attendance increased when attention was given to their hygiene and sanitation needs, such as private latrines and provision of sanitary pads.
Health in all Policies focuses on the role that governments play in achieving population health and equity and provides a mechanism and practical tools to enable authorities and politicians to understand health impacts of their action and ensure accountability for the health and equity consequences of their public policy decisions.