Taking health into account in all policies – Author's reply
Authors: Francisco Becerra-Posada
Journal: The Lancet Global Health (2015)

The singularity of the opportunity presented by the UN Sustainable Development Goals (SDGs) lies in their explicit aim to support economic, social, and environmental development that promotes human rights, sustainability, and equity. And there is no better way to achieve this goal than promoting health. Within the complexity of the proposed goals and targets lies a key strength: the stakeholders responsible for promoting the broader sustainable development agenda agree to define development not in the reductive terms of gross domestic product, but framed by central considerations of equity, health, and sustainability. Under this agenda, the wider social determinants of health are being highlighted globally as never before. Many instances exist of the public health community's engagement with the challenging political processes called for in Lauri Kokkinen's letter. In past years, the Pan American Health Organization (PAHO) has actively worked hand-in-hand with Health Ministries in the Region of the Americas to support controversial legislation and regulation on several issues that directly or indirectly affect health such as water, air, and food, just to mention a few. It is the position of PAHO that global and national leaders in public health should be empowered to bolster, in unequivocal terms, the importance of health in policy making. To make this argument compelling, however, the public health community must recognise that the relevance of health to wider national and international development goals might not be immediately obvious to other sectors. That is the challenge that we now face, and furthermore that we wish to highlight to advocates, researchers, and practitioners alike: from promoting universal access to health and universal health coverage to ensuring that the effect of urbanisation on health is considered in city planning, and the social and economic development agendas. If those impacts are to be taken into account, they must be measured and described in ways that are persuasive, making direct reference to the numerous respects in which ill health and disease are disruptive, costly, and avoidable. It is valid to note that speaking broadly of health equity counts for little in the face of competing interests, when those interests might influence or pressure authorities defining the political agenda. However, because of the intersectoral nature of the work needed to achieve the SDGs, this observation supports, rather than undermines, the credibility of the post-2015 agenda to realise equitable health gains using a Health in All Policies approach. I am the Assistant Director of the Pan American Health Organization, Regional Office for the Americas of the World Health Organization. Health in all policies: a strategy to support the Sustainable Development GoalsRegarding the Comment by Jeff Waage and colleagues (May, 2015)1 about governing the UN Sustainable Development Goals (SDGs), we appreciate the authors' perspectives on the process of finalising the SDGs and agree with their recommendations to develop new and more accountable governance structures that work across sectors. As a result, the Pan American Health Organization (PAHO) has begun to incorporate the Health in All Policies framework,2 putting it into practice across the region of the Americas. Full-Text PDF Open AccessTaking health into account in all policiesFrancisco Becerra-Posada (July, 2015)1 writes about the efforts of the Pan American Health Organization to take up the challenge of addressing the social determinants of health through action across sectors and on becoming the first in the world to adopt a Regional Plan of Action on Health in All Policies. I fully agree with his comment that “the public health community now has a unique opportunity to use a Health in All Policies approach in informing policies and practices”.1 Full-Text PDF Open Access