Meeting: All projects will be subject to health impact assessment (HIA) after health ministry completes developing the necessary tools.

The National Health Policy states that impact assessment of mega projects in the country, including foreign direct investments, shall be conducted prior to their establishment to screen risks and impact on human health.

While the Gross National Happiness Commission has a policy-screening model, it is limited with just three broad indicators, most of which are sometimes subjective and inadequate to address pertinent and emerging health issues.

While Environment Impact Assessment (EIA) is a formal assessment that focuses on the impact of projects on the environment and prescribe mitigation measures, it does not include health aspects unlike in other countries where heath and environment are integrated for impact assessment, said health secretary Dr Dorji Wangchuk.

Health ministry initiated and developed the National Health Promotion Strategic Plan 2015-23 as a tool to promote health, protect individuals from diseases and to develop HIA tool. The draft national health bill has a chapter on the HIA.

Dr Dorji Wangchuk said: “We also have it [HIA] in our annual performance agreement with the government, the review of which is due February 29.” He added that Bhutan has enabling environment for policy and strong political commitment to support health impact assessment.

Officials from National Environment Commission said that communities are aware of the health impact of projects coming up in their localities as they are consulted with details of the projects to seek public clearance.

Health officials said with the decreasing engagement of international donors, it has become imperative for the country to reduce adverse impact on health from development activities.

“However, we don’t want the assessment to be a bottleneck,” said Dr Dorji Wangchuk.

Health officials said that sustainability of free health care remains a key concern in light of increasing healthcare cost and increased demand for quality services.

“It’s important to mitigate health impact from development activities before they add expenditure on health,” a health official said.

HIA is a systemic process through which health hazards, risks, and opportunities can be identified and addressed in the development planning process to avoid the transfer of hidden costs and to promote multi-sectorial responsibility for health and wellbeing.

“HIA offers a way of helping all sectors to contribute to improving health and to ensure that all public policies are fair, sustainable, and people-centered,” Dr Suvajee Good said.  She added that the low-income countries are increasingly realizing the need for HIA as more industries move to those countries that don’t have such regulations.

The meeting will discuss the different models of HIA from the region, share best practices from other countries, and identify those that will suit best for Bhutan.

There are 142 types of impact assessments, 15 screening tools, and 80 different methodological tools of HIA.

More than 23 participants, including officials from Druk Green Power Corporation, Gross National Happiness Commission, Paro Dzongkhag, health ministry, economic affairs ministry and NEC are participating in the WHO meeting.

The three-day meeting in Paro will end tomorrow after developing framework for the tool and community HIA guideline for the health ministry to work on.

Tshering Palden, Paro