introduction to Dialogue for Montreal July 2002

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(No Transcript)
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INTEGRATED VECTOR MANAGEMENT
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Prospects for intersectoral collaboration
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INTEGRATED VECTOR MANAGEMENT Prospects for
intersectoral collaboration Robert Bos WHOs
Water, Sanitation and Health Programme
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Integrated Vector Management prospects for
intersectoral collaboration

• Definitions
• Essential functions in support of IVM
• Regulations and mechanisms for intersectoral
  action
• Lessons from other cross-cutting health issues

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IVM prospects for intersectoral
collaborationSome definitions

• Health
• a complete state of physical, mental and social
  (and spiritual) well-being and not merely the
  absence of of disease and infirmity

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IVM prospects for intersectoral
collaborationSome definitions

• IVM (working definition)
• A process of evidence-based decision-making
  procedures aimed to plan, deliver, monitor and
  evaluate targeted, cost-effective and
  sustainable combinations of regulatory and
  operational vector control measures, with a
  measurable impact on transmission risks,
  adhering to the principles of subsidiarity,
  intersectoral collaboration and partnership

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IVM prospects for intersectoral
collaborationSome definitions

• Sectors
• reflections of societal vested interests able to
  mobilise sufficient political clout to ensure a
  territorial niche in a governance structure
• Therefore intersectoral collaboration is a
  contradiction in terms (Degeling et al. 1991)

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IVM prospects for intersectoral
collaborationSome definitions

• Intersectoral action
• Integrated programming and budgeting for
  efficient governance and implementation.
• Lack of co-ordination between sectors can be
  detrimental to cross-cutting issues, of which
  health is one. By affecting environmental and
  social determinants of health, through their
  planning and operations, other sectors may have
  major adverse impacts on the health status of
  vulnerable groups. They may also miss health
  opportunities. Effective institutional
  arrangements foster efficient intersectoral
  action, for example for IVM, and reduce the
  burden on the health sector.

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IVM - Integrated Vector Management
Tools
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IVM prospects for intersectoral collaboration
Essential Health Sector Functions in support
of IVM

• Periodic ecosystem assessment for environmental
  and social determinants of vector-borne disease
  transmission risks
• Monitoring of genetic, biological and ecological
  characteristics of vector species
• Epidemiological surveillance and data synthesis
  into solid evidence and information, targeted
  dissemination to other sectors
• Regular evaluation of the state of the knowledge
  base to update the agenda of priority research
  and development needs

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IVM prospects for intersectoral collaboration
Essential Health Sector Functions in support
of IVM (continued)

• Establishing, maintaining and periodically
  reviewing an operational framework based on
  agreed decision making criteria and procedures
• Establishing and periodically updating effective
  institutional arrangements
• Harmonised sectoral policies and legislation with
  explicit reference to health issues and
  high-level policy incentives for intersectoral
  action
• Regular evaluation of the policy, institutional
  and operational framework against the evolving
  vector control needs and limitations

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IVM prospects for intersectoral collaboration
Essential Health Sector Functions in support
of IVM (continued)

• Carrying out health sector-specific vector
  control measures
• Monitoring compliance of other sectors with
  voluntarily agreed or enforced vector control
  activities
• Quality control of all vector control activities
• Regular capacity building needs assessment
  considering the evolution of vector control,
  especially the development of new vector control
  options

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IVM prospects for intersectoral collaboration
Functions of other sectors in support of IVM

• Including health criteria in sectoral operational
  frameworks and procedures
• Carrying out adequate Health Impact Assessment
  procedures for new development projects
• Carrying out vector control measures in line with
  sectoral mandates
• Participating in joint activities of an
  integrated nature
• Informing the health sector about new technical
  developments with a bearing on vector control

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IVM prospects for intersectoral collaboration
Parameters of intersectoral action in support
of IVM

• IVM activities take place at different levels
  intersectoral barriers are sharply reduced at
  lower administrative levels. Therefore,
  requirements for the promotion of intersectoral
  action are different at different levels.

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IVM prospects for intersectoral collaboration
Parameters of intersectoral action in support
of IVM

• IVM activities take place at different levels
  intersectoral barriers are sharply reduced at
  lower administrative levels. Therefore,
  requirements for the promotion of intersectoral
  action are different at different levels.
• The health sector itself is compartmentalised
  intra-sectoral collaboration is as important as
  inter-sectoral collaboration the position of the
  IVM programme in the health sector is critical
  for its performance at the interface between the
  core of the health sector and the other sectors.

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IVM prospects for intersectoral collaboration
Parameters of intersectoral action in support
of IVM

• IVM activities take place at different levels
  intersectoral barriers are sharply reduced at
  lower administrative levels. Therefore,
  requirements for the promotion of intersectoral
  action are different at different levels.
• The health sector itself is compartmentalised
  intra-sectoral collaboration is as important as
  inter-sectoral collaboration the position of the
  IVM programme in the health sector is critical
  for its performance at the interface between the
  core of the health sector and the other sectors.
• Intersectoral action must have clearly
  demonstrable added value for ALL parties through
  economies of scale and other synergies

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IVM prospects for intersectoral collaboration
Development policy and health
Health Policy
DevelopmentPolicy
Social determinants
Environmentaldeterminants
Healthcare
Poverty
Health
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IVM prospects for intersectoral collaboration
Institutional Arrangements

• First, look at existing intersectoral structures
• National Economic Planning Council
• Environmental Protection Agency
• Science and Technology Council

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IVM prospects for intersectoral collaboration
Institutional Arrangements

• Next, consider what new intersectoral
  arrangements are desirable
• With the Environment Sector - a strategic
  alliance
• With the Development Sectors (Agriculture,
  Energy)
• With institutes involved in Science and
  Technology
• With the Ministry of Finance

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IVM prospects for intersectoral collaboration
The nature of a strategic alliance

• It needs to overcome the obstacles of vested
  interests
• It needs to have tools to resolve potential and
  real conflicts
• Its combined output must be greater than the sum
  of the outputs of its individual partners
• There must be agreement on a number of principles
• Integration must be a rational process based on
  agreed criteria and common goals
• Effective mechanisms should be custom-designed
  to meet needs at different levels
• It needs to be solidly anchored in the overall
  governance structure

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IVM prospects for intersectoral collaboration
Lessons learned in intersectoral collaboration

• The example of Health Impact Assessment of
  Development
• The current WHO definition of HIA
• a combination of procedures, methods, and tools
  by which a policy, program or project may be
  judged as to its potential effects on the health
  of a population, and the distribution of those
  effects within the population

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IVM prospects for intersectoral collaboration
Lessons learned in intersectoral collaboration

• Identification
• Operation Design
• Evaluation Pre-feasibility TOR
• Hand-over Feasibility
• Construction Appraisal
• Negotiations
• THE PROJECT CYCLE

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IVM prospects for intersectoral collaboration
Lessons learned in intersectoral collaboration

• Identification
• Operation Design
• Maintenance
• Evaluation Pre-feasibility TOR
• Hand-over Feasibility
• Construction Appraisal
• Negotiations
• THE PROJECT CYCLE
• Critical stages for HIA decision-making Critical
  stages for intersectoral action

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IVM prospects for intersectoral collaboration
Inter-agency co-operation in the UN

• UN specialised agencies reflect the sectoral
  division of national government structures
• The UN agencies have their entry points into
  countries through sectoral ministries
• Agencies themselves are highly compartmentalised
  internally
• Bilateral and multilateral donors reflect the
  same sectoral fragmentation in the funding
  policies and operations
• Inter-agency links frequently hinge on personal
  relationships
• Resource constraints hit the margins first

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IVM prospects for intersectoral collaboration
Take home messages

• In setting up an operational framework for IVM,
  identify the needs and opportunities for
  intersectoral action, consider the position of
  the IVM programme in the health sector and
  establish a strategic alliance with the
  environment sector
• Work with other sectors on harmonisation of
  policies and the incorporation of health into the
  policies of non-health sectors
• Design effective institutional arrangements
  between relevant institutions in diferent sectors
• Assess the balance between regulatory and
  operational activities