Building an ASEAN community in accordance with the ASEAN Charter is a challenge of all Member States. How can we ensure that the ASEAN community will comply with rule of law, good governance, human rights and fundamental freedom, human security, and sustainable development as described and aspired to in the Charter?
In the midst of increasing ASEAN economic integration which is likely to make faster progress than the other two pillars (political-security and socio-cultural), Member States have started looking for a tool to ensure sustainable development and add value to a policy-making process.
Health Impact Assessment (HIA) is one of these tools. HIA is a structured method for assessing and improving the health consequences of projects and policies in the non-health sector. It is a multidisciplinary process that incorporates qualitative and quantitative evidence to evaluate and estimate the health consequences of public policies, programmes, and projects; and, it can mitigate the negative impacts that affect the health of populations. Health in this context is not limited to physical well-being, but also mental and social dimensions of well-being according to the World Health Organization (WHO) definition of health – “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Countries’ development projects, programs and policies should consider and address health impacts that may result. This is consistent with sustainable and inclusive development as set out in Agenda 21 and the Millennium Development Goals.
Many countries in ASEAN are starting to develop HIAs to inform policy-making. Vietnam already has an HIA framework and now in the process of developing the National Environment and Health Action Plan which incorporates the HIA framework. Lao PDR, Cambodia and Malaysia integrate HIA as part of Environmental Impact Assessment (EIA) processes (proposed projects typically undergo an EIA, a standard evaluation of possible positive or negative impacts they may have on the environment). Thailand has made excellent progress as well, having institutionalized HIA – it is stipulated in the Constitution of Kingdom of Thailand, B.E 20550 (2007) as well as in the 2007 National Health Act. In addition, the National HIA Commission launched HIA Rules and Procedures in 2009.
Advancing HIA in ASEAN was initiated at the Asia Pacific Health Impact Assessment Conference in Chiang Mai, Thailand in 2009. The 2009 Chiang Mai Declaration on HIA for the Development of Healthy Societies in Asia Pacific Region calls for all stakeholders to bring attention of HIA to ASEAN and to establish a regional mechanism to implement HIA under the ASEAN framework. The Chiang Mai Declaration on HIA was presented to the Senior Officials Meeting on Health Development (SOMHD) in 2009.
In October 2012, ASEAN HIA focal points and academia made practical recommendations to set up an HIA control system to ensure that HIA is consistently standardized, assessors are accredited, and the evaluation of assessments is promoted. They also recommended that a regional network of HIA experts be established in parallel with capacity building/professional development of HIA as well as establishment of a training centre and information clearinghouse.
In spite of having a mechanism in place and available human resources, there is a need to increase awareness among policy makers and other stakeholders of the importance of HIA; and, to mainstream HIA into the process of decision-making and the implementation of policies, programmes and projects. HIA focal points of each country realize that the mainstreaming HIA in ASEAN still has a long way to go. However, there is a blueprint, and good case study examples, to advance HIA step by step in ASEAN Member States. For more information about HIA in ASEAN, please visit http://www.hiainasean.org/ and http://eng.anamai.moph.go.th
About the Author: Nusaraporn Kessomboon, PhD, is Associate Professor at Khon Kaen University,
Faculty of Pharmaceutical Sciences, Social and Administrative Pharmacy Division, in Bangkok, Thailand.