Adelaide Statement ǁ
Outcome Statement from the 2017 International Conference Health in All Policies: Progressing the Sustainable Development Goals
One hundred and fifty experts and practitioners of Health in All Policies (HiAP) from 21 countries came together in Adelaide at the invitation of the Government of South Australia and the World Health Organization, to celebrate ten years of Health in All Policies in South Australia. This meeting, on the traditional lands of the Kaurna people, offered the first major opportunity to explore the recommendations of the Shanghai Declaration in greater depth. They commited to take forward the mandate of the Shanghai Declaration on Promoting Health in the 2030 Agenda for Sustainable Development and to advancing the equitable achievement of the Sustainable Development Goals (SDGs) through the mechanisms of good governance. In this, we draw on our practical experience of working at different levels of government and in diverse contexts in countries around the world.
Participant’s work has benefited from previous important policy documents such as the 2010 Adelaide and 2013 Helsinki Statements on Health in All Policies, the report of the Commission on the Social Determinants of Health (SDOH) and the Rio Political Declaration on SDOH.
Introduction
Action on the Sustainable Development Goals means acting on the determinants of health and wellbeing. These determinants are frequently shaped by political decisions and public policies – policies which can support health and wellbeing or can fail to take account of their impacts on health and equity.
Health is a political choice. Political decisions can impact on economic and social inequities, including through policies which shape unhealthy living and working environments, or which fail to address inequities of gender, race and ethnicity. Faced with the many complex existing and emerging challenges to health and wellbeing in countries and globally, including rapid urbanisation, climate change, pandemic threats and the proliferation of unhealthy commodities, practical responses are urgently needed.
The SDGs are indivisible and universal. They provide a road map for all countries to societal wellbeing by integrating actions across the social, economic and ecological domains. Within the SDG context good health is a precondition for, an outcome and indicator of, sustainable development. Health is core to the SDGs with their focus on people, planet, peace, prosperity and partnerships.
Transformative strategies for implementing the SDGs. A transformative approach requires joint action and policy coherence. Good governance for health and wellbeing will be a crucial strategy in achieving the SDGs, in line with the emphasis in the Shanghai Declaration.
The SDGs provide new impetus for our work in reaching out across different sectors of government and society. The SDGs require us to be systemic in our thinking; to recognise the commonalities between the health of people, ecosystems and the planet. Health is a societal investment that contributes to wellbeing beyond Gross Domestic Product (GDP).
Health in AII Policies offers us new ways to confront major 21st century challenges to health and wellbeing, including safety and security. We must accelerate and foster the wider adoption of this approach in order to: reduce inequities in health and wellbeing for people of all ages; embrace social innovation such as network models of governance; address the commercial determinants of health; and ensure no one is left behind in social and economic development.
The investment in, and lessons from, the successful experience of HiAP implementation in South Australia and internationally will support us in moving forward. The breadth of experience presented at the conference affirmed that the benefits of a HiAP based approach can be realised at all levels of government – city, regional, state, national – and in different contexts.
Action on determinants
The interconnectedness between the determinants of health will require strong and effective action by governments and societies. Our discussions have put a special focus on the commercial, political and environmental determinants. Our work aims to implement a mutual gain approach but we recognise that persistent marketing of proven unhealthy commodities, enduring inequalities and environmental degradation, can require strengthened Legislative, regulatory, and fiscal measures.
Many of the determinants we need to address are at the global Ievel. lt is essential that we build international alliances between countries, cities, civil society organisations and citizens to address these determinants.
Action on equity
ln acting on determinants we affirm the importance of pursuing equity, fairness and social justice. The mental, physical, and spiritual needs of First Nations peoples must feature strongly, including recognising the impact of colonization.
Participants acknowledged the contribution of social protection and equitable access to health care services as a determinant of health outcomes, and recognise that universal health coverage is the most effective mechanism to ensure this can be achieved.
Participants recognised that fiscal responses in the face of economic downturns can have a profound effect on citizens as well as institutional capacities to respond to the needs of the most disadvantaged, and we urge governments to consider the health and wellbeing impacts of such decisions.
Action on shared leadership with Citizens
HiAP requires active engagement of citizens and this can be achieved through mechanisms such as citizens’ juries, participatory budgeting, and societal dialogue. The Shanghai Declaration reminds us that health Iiteracy empowers individual citizens and enables their engagement in collective health action. Ensuring a strong civil society underpins this. Transparency in the provision of information fosters citizen engagement and strengthens accountability. Citizen engagement must respect the rights and needs of displaced persons, refugees, asylum seekers and other marginalized groups, and ensure opportunities for their participation.
Action on evidence
We need to generate an evidence base that can be used by all sectors and citizens. Accountability of HiAP approaches will be strengthened through interdisciplinary research. Learning from HiAP to implement the Sustainable Development Agenda HiAP is a practical strategy that can be used to achieve the SDGs. lt is implemented in different ways in a variety of contexts and systems but there are common values and aims. HiAP works best when a combination of factors are in place: good governance; development of strong and sound partnerships based on co-design, co-delivery and co-benefits; dedicated capacity and resources; and the use of evidence and evaluation. Together, these factors can and do deliver positive change. The key features of these are set out in Annex 1.
Participants commitment
Participants committed to building on the Health in All Policies approach to advance the Sustainable Development Agenda consistent with the Shanghai Declaration. We recognise that health is a political choice, and we will continue to strongly advocate for health, wellbeing and equity to be considered in all policies.
Important Documents for Health in All Policies (HiAP)
Adelaide Statement on Health in All Policies 2010 & 2017
The Helsinki Statement on Health in All Policies 2013
What we need to know about Health in All Policies (HiAP)?
