History of HiAP
2.7 Conclusions and lessons for policy-makers
This short history of HiAP highlights that achieving coherence in policy in relation to health is not a new aim and has arisen in different contexts.
The following key lessons emerge from the history and should be taken into account by policy-makers charged with developing and implementing a HiAP approach.
• Assessing the health and health equity impacts of all sectors is not new and has long roots going back to at least the nineteenth century.
• Public health action, including HiAP, is inevitably a political activity and does not follow a rational linear development process.
• Public health reforms do not happen without political will. Social movements have been instrumental in creating that will – struggling for the right to health and the conditions that facilitate it – and acting as precursors to political and bureaucratic reforms which have improved social and environmental conditions.
• Past comprehensive efforts to improve public health have been undermined by a lack of support from those with power. In global health, important donors have been more eager to support time-bound interventions in which output can be measured and money tracked. Also, the medical community has failed to provide uniform support for interventions that go beyond their professional competence and immediate power.
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