Keynote: Using HIA as a development planning tool to its full potential

Over the past two decades there have been significant developments in the formulation of HIA policies. Yet hurdles remain on the interface between policy and practice, which can be of a political, governance, institutional, professional, economic and human resource nature. In the application of HIA policies, tensions remain between the environment and health sector about who has the ultimate mandate with respect to HIA. In countries where HIAs are put to practice, hurdles remain as well in the operational phase. Having an HIA report on the shelf of a project manager is not enough to protect vulnerable communities. Public health management plans may lack the teeth to ensure that development partners comply with the actions required from them. Ministries of health may siphon of financial support for a public health management plan to focus on strengthening medical infrastructure. For lack of clear institutional arrangements there may be misconceptions about roles and responsibilities, and gaps in essential public health functions to be performed. With the health sector itself often ambivalent about the role of HIA in a health systems approach, what are the mechanisms to overcome these hurdles and to ensure HIA is used as a development planning tool to its full potential? This keynote presentation will be followed by a panel discussion with time for Q&A.

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KEYNOTE: Robert Bos is a Public Health Biologist from the Netherlands. He joined the World Health Organization in 1981 and spent two-and-a-half years in the national WHO/PAHO programme in Costa Rica. In 1983 he was transferred to the Vector Biology and Control Division of WHO in Geneva. He was assigned to the Secretariat of the Joint WHO/FAO/UNEP Panel of Experts on Environmental Management for Vector Control. One major spin-off of the Panel’s efforts became the focus of his work in the 1990s, after a move to the Organization’s Environmental Health Programme: the development and promotion of Health Impact Assessment (HIA). It included expanding the scope from vector-borne diseases associated with water resources development to the full range of health issues in relation to all types of development, and providing support to Member States through HIA policy formulation and human resources development to perform and appraise HIAs. In the 2000s Robert’s work on HIA continued with comprehensive capacity development efforts around the construction of dams in the Mekong River Basin, while also expanding into the WHO’s normative work related to the area of safe use of wastewater in agriculture and aquaculture.  From 2009 to 2013 he was the Coordinator of the WHO Water, Sanitation and Health programme, with responsibility for the WHO Drinking Water Quality Guidelines, the WHO/UNICEF Joint Monitoring Programme, the International Regulators Network, and water-related UN interagency cooperation. After retiring in 2013 Robert has done a range of consultancies, including for a large HIA project in the Greater Mekong Sub-region for the Asian Development Bank.

PANELIST: Dr. Martin Birley (HonMFPH) has over 35 years of Health Impact Assessment experience worldwide. He co-founded the HIA section of IAIA as well as the annual international HIA conference. He has written many books, research papers, and reports on HIA. He has acted as consultant/adviser to organizations such as WHO, DFID, World Bank, ADB, AfDB, FAO, as well as private companies and governments. He has advised on HIA and run training courses in many countries of the world. He was senior health adviser on HIA for Shell corporate from 2003-2005. He has written many HIA guidelines and been a reviewer of many others. He was instrumental in bringing the discipline to the UK and set up the Liverpool Health Impact Assessment Consortium (IMPACT) with Alex Scott-Samuel in 1997. His latest book "Health Impact Assessment: Principles and Practice" was published in 2011 by Earthscan/Routledge and was highly commended by the British Medical Association in 2012. It is also available as an ebook. It was published in Chinese in 2017. He was principal author of the Asian Development Bank’s Good Practice Sourcebook, published 2018. Recent HIA projects were in Nigeria and Scotland. Current projects are in Oman and Ecuador.

PANELIST: Francesca Viliani is the Director of Public Health and Sustainability at International SOS and a Chatham House fellow. She is a specialist in public health and sustainable development, with over 25 years of work experience across the globe. She has been working on pandemic preparedness and response with public and private organizations.

PANELIST: Gene Peralta has 40 years of experience working on environment and health with government, academic and international institutions.  She is a retired senior environmental safeguard specialist (2015) from the Asian Development Bank and currently a senior consultant on health and the environment at WHO Western Pacific Regional Office. For 27 years, she has been involved intermittently on Health Impact Assessment with ADB since 1991 with latest role as HIA adviser (2016-2018) and with WHO on various assignments including climate change and health. Gene has worked in more than 30 countries in Asia and the Pacific and collaborated with global and country experts on EIA and HIA. She would like to continue promoting capacity development and application of HIA in multilateral finance institutions and member countries as well as in nurturing networks.

Session 2: MANAGING DEVELOPMENT, IMPACT ASSESSMENT, AND EMERGING INFECTIOUS DISEASES

What can be done at the project level and the global level regarding the link between human activities, infrastructure and other development, and emerging infectious diseases? This session will start with an introduction to HIA, mega projects, and the pandemic, to be followed by the project perspective and the global perspective.

PRESENTATION #1: Introduction to HIA, mega projects, and pandemics. (Francesca Viliani; starts at 00:15) An introduction to HIA and experiences in addressing risk factors for emerging infectious diseases and pandemics.
 

PRESENTATION #2: Biodiversity aspects of impact assessment to limit risk of exposure to zoonoses following land use change. (Dr. Jo Treweek; starts at 11:10) Takeaways from this presentation: Land use change is the primary transmission pathway for emerging infectious diseases. Impact assessment can play an important role in guiding land use decisions to “build back better” in the face of climate change and the COVID-19 pandemic, especially where development proposals affect wildlife rich habitats such as intact tropical forest. Robust consideration of biodiversity aspects is key, as well as deliberate efforts to maintain ecosystem integrity and health. Mitigation is needed through specific actions related to illegal wildlife trade, agri-business, tourism, and transport infrastructure planning amongst others. Human rights aspects of ecosystem exploitation also need much stronger emphasis.
 

PRESENTATION #3: Health at a project vs. health of a project vs. health from a project: Compatible? (Dr. Philippe Guibert; starts at 26:39) Takeaways from this presentation: It is not enough to have a doctor on site to think health issues are all sorted out; a much broader agenda needs to be anticipated by projects to tackle workforce and community’s health prevention and protection intertwined agendas. The COVID-19 pandemic has epitomized the interconnectedness between all the determinants of health, and the criticality of assessing them holistically in the context of development projects. From evidence gathering to capacity building, they are some fundamentals mega projects shall systematically consider, to meet their duty of care obligations.
 

PRESENTATION #4: Social risks of emerging infectious diseases: Perspective from a public lender. (Mariana Ruiz Alvarado; starts at 42:20) The risk of emergence of an infectious disease can give rise to a series of additional social risks and impacts; ranging from challenges in the undertaking of stakeholder engagement to worsening of labour conditions, and violations to data protection rights. This presentation will highlight some of these social risks and discuss the importance of their due identification and management from a public lender perspective.
 

PRESENTATION #5: Conclusion. (Dr. Osman A. Dar; starts at 1:00:15) This presentation pulls together conclusions on linkages between project and global efforts in pandemic preparedness and response.

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Francesca Viliani is the Director of Public Health and Sustainability at International SOS and a Chatham House fellow. She is a specialist in public health and sustainable development, with over 25 years of work experience across the globe. She has been working on pandemic preparedness and response with public and private organizations.

Dr. Jo Treweek (MCIEEM; Director TEC ltd) is an experienced researcher, practitioner, and due diligence reviewer, specializing in biodiversity and ecosystem services aspects of projects in a variety of sectors. She has worked in many countries in diverse roles and project development stages, from inception and design through to implementation. Throughout her career she has actively promoted the incorporation of biodiversity in impact assessment and has pursued an increased emphasis on efforts to secure sustainable futures for the ecosystems on which we all depend for our livelihoods and wellbeing.

Dr. Philippe Guibert is a Regional Medical Director at International SOS offices. He is an international health consulting expert with more than 26 years’ experience in the private sector. His main areas of expertise are in pandemic planning, disease outbreaks, infectious diseases, risk and crisis management.

Mariana Ruiz Alvarado is a Senior Social Development Specialist at the European Investment Bank (EIB) where she is the lead expert on Labour Standards, Health and Safety and Human Rights. She is an economist and finance expert with over 15 years of international experience. Before joining the Bank, she was Advisor to the President of Spain and two Ministers of Housing.

Dr. Osman A. Dar is a medical consultant at Public Health England  where he works to support low and middle income countries build core capacities under the International Health Regulations and in the design and implementation of their broader Health System Strengthening initiatives. Osman is also the Chatham House director of the Global Health Programme's One Health project, an umbrella term referring to the programme's work on zoonotic diseases, emerging infections, antimicrobial resistance, and food security.

Session 3: LEVERAGING HEALTH IMPACT ASSESSMENT FOR SOCIETAL RESPONSES TO THE PANDEMIC

Societal responses to the pandemic have varied across the globe with both intended and unintended consequences. This panel-type session will present case studies on how HIA and HIA methods and tools have been used to inform private sector responses to the effects of the COVID-19 pandemic, assist Indigenous People in Canada navigate the response the pandemic, and assess the intended and unintended consequences of government policies in Wales.


PRESENTATION #1: The value of HIA processes and tools in preparing Indigenous communities for the COVID-19 pandemic: A Canadian case study. (Dr. Janis Shandro; starts at 05:15)

PRESENTATION #2: COVID-19 Framework for Community Response Planning - WeCare Programme. (Dr. Mark Divall; starts at 23:42)

PRESENTATION #3: HIA on the ‘Staying at Home and Social Distancing Policy in Wales’ in response to the COVID-19 pandemic. (Liz Green; starts at 37:37)

PANEL DISCUSSION: Chaired by Yina Xiao, featuring the session presenters Dr. Janis Shandro and Dr. Mark Divall, plus Laura Morgan. (Starts at 1:11:38)

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Dr. Janis Shandro has a co-disciplined PhD in mining engineering and population health. She is a mother, a community health and safety practitioner and researcher and a vocal advocate for the health and well-being of vulnerable populations. For over 15 years, she has worked extensively on community health and safety issues with international finance institutions, private sector clients, governments and communities. She has direct project experience in over 30 countries. In Canada, Janis has worked in partnership with over 40 Indigenous Nations on HIA related projects and co-leads a research program focused on Indigenous health surveillance systems as part of the HIA/EIA process. She has been the lead author on recent topic specific HIA guidance including HIA for industrial zones in Asia, HIA for Indigenous People in Canada, and community health and safety/emergency preparedness and response guidance for a major mining company. She was a lead contributor to recent COVID-19 guidance for infrastructure and agricultural projects supported by IDB Invest and the Terron Group for Latin America.

Dr. Mark Divall is a medical doctor with post-graduate qualifications in anaesthesia, occupational medicine, environmental medicine and tropical medicine and hygiene. He has been involved in various aspects of health consultancy for the past 19 years with a focus on low and middle income countries. He specialises in health impact assessment and has conducted over 95 assessments in over 29 countries across four continents in the energy, mining and infrastructure sector. He supports a number of large multinational mining organisations in general health risk management from an occupational health and community health perspective, including part time roles as the Group medical consultant to First Quantum Minerals and as a community health and safety specialist to Anglo American Group Social Performance. He is the immediate past co-chair of the health section for the International Association for Impact Assessment.

Liz Green is a Public Health Specialist, the Programme Director for Health Impact Assessment at Public Health Wales, and the Director of the Wales Health Impact Assessment Support Unit (WHIASU). She is also a Fellow of the Faculty of Public Health and Visiting Professor at the WHO Collaborating Centre for 'Healthy Urban Environments' at the University of West of England, UK. Liz has extensive knowledge, understanding, and practical application of HIA, ‘Health in All Policies’ (HiAP) and spatial planning and provides training, advice, and guidance about the HIA and other IA processes.  As part of a HiAP approach to policy making, much of the work Liz leads on takes place in non-heath sectors including spatial planning. Liz has published several journal papers and directed, and was the lead author for, influential HIAs such as the ‘The Public Health Implications of Brexit: A Health Impact Assessment (HIA) approach’ (PHW, 2019). Most recently, she directed and wrote the ‘Staying at Home and Social Distancing HIA in response to the COVID-19 pandemic in Wales’ which looked at impact of ‘Lockdown’ in Wales. She is also the lead author of the only broad critical appraisal review tool for HIA ‘A Quality Review Framework for HIA’ (WHIASU, 2018).

Yina Xiao is currently working as Eni regional global health reference in Central Asia and Far East region and Eni Foundation Myanmar project team leader, based in Milan, Italy. She is specialized in public health project management and HIA in developing country setting.

Laura Morgan works for Public Health Wales where she has participated in a number of Health Impact Assessments. She has over twenty years’ experience in research, policy and communications across the public, private and voluntary sectors. Her work has played a key role in influencing government policies and initiatives in areas including health, social justice, housing and education.

Session 4: BETTER METHODS AND TOOLS: EMERGING GUIDANCE ON HEALTH AND IMPACT ASSESSMENT

The societal value of impact assessments, from the strategic to the project level, is well established. While human health has been a key consideration since the inception of impact assessment in the 1970’s, its practical inclusion in impact assessment processes has not been optimal. This session will explore historical shortcoming and emerging guidance on the inclusion of Human Health in SEA and EIA via multiple presentations.

PRESENTATION #1: Better methods and tools guidance in health and impact assessment. (Ben Cave; starts at 00:15)

PRESENTATION #2: Addressing Health Impact in Strategic Environmental Assessment. (Thomas Fischer; starts at 25:29)

PRESENTATION #3: Addressing Human Health in EIA across the EU – the IAIA-EUPHA guidance on Human Health in EIA. (Odile Mekel and Ryngan Pyper; starts at 45:12)

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Ben Cave, Director, BCA Insight Ltd, Ireland and United Kingdom. Visitor, Environmental Assessment and Management Research Centre and WHO Collaborating Centre for Health in Impact Assessments, University of Liverpool, UK; and Centre for Health Equity Training, Research and Evaluation (CHETRE) and Health Equity Research Development Unit, University of New South Wales, Australia.

Thomas Fischer (PhD, Dipl-Geogr, FIEMA, FHEA) is Professor and Director at the Environmental Assessment and Management Research Centre and WHO Collaborating Centre for Health in Impact Assessments at the University of Liverpool, UK; and at the Research Unit for Environmental Science and Management, Faculty of Natural and Agricultural Sciences, North West University (Potchefstroom Campus), South Africa.

Odile Mekel, Dr., MPH, NRW Centre for Health (LZG.NRW), Head Division Healthy Settings, Germany; President European Public Health Association HIA Section

Ryngan Pyper, Director, BCA Insight Ltd, Ireland and United Kingdom.