Challenges to implementing HIA:

ADB Perspective

G. Peralta and P. Moser Asian Development Bank

Manila, Philippines

Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank( ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. Terminology used may not necessarily be consistent with ADB official terms.

About the Asian Development Bank

• Founded in 1966 based in Manila with s 67 member countries and 30 country offices. Mission is to have an Asia and Pacific free from poverty (1.8 billion poor people are in this region).

• With $22 billion in approved financing in 2011, more than 2,900 employees from 59 countries work towards fighting poverty in Asia and Pacific.

ADB Strategy 2020 (2008-2020)

ADB has five core sectors:

• infrastructure

• environment, including climate change

• regional cooperation and integration

• financial sector development

• Education

ADB has 2 non-core sectors:

• Agriculture

• Health

Operational Plan on Health

Support health outcomes through

• Infrastructure (roads, WSS, etc)

• Governance and public expenditure management

• Regional public goods

• Self-standing health projects for MDGs with partners

• Public-private partnerships

• Knowledge, analysis, policy dialogue

Health benefits of a project

• Currently ADB does not take into account all health benefits of a project in the calculation of EIRR, economic internal rate of return.

• Perhaps inclusion of health benefits could raise the EIRR, or make some projects, e.g. clean energy, more attractive.

• How to value health benefits with methodologies that are easy, quick and reliable.

Examples

• Some examples shall be provided on typical ADB-financed public sector infrastructure projects to illustrate the various stages of the project cycle over time, and possibly illustrate how health impacts could be considered at each stage.

Infrastructure Projects

HIA

• Definition

There are many definitions

• Methodology

(i) Qualitative assessment

(ii) Quantitative assessment

What is ADB doing on HIA?

• ADB published 2 HIA publications:

• Peralta, G.L. and Hunt, J.M. (2003) A Primer on Health Impacts of Development Programs, ADB Manila

• Birley, M. and Peralta, G. (1992) Guidelines for the Health Impact Assessment of Development Project, Asian Development Bank Environment Paper No. 11.

What is ADB doing on HIA?

• Pilot HIA in Cambodia (Water and Transport sectors)

• HIV Impact Assessment in Infrastructure Projects in Greater Mekong Subregion

• HIA in several EIA for Category A projects

• Climate change and health

Collaborative Approach in Climate Change and Health

What is ADB doing on HIA?

• New IPSA (Initial Poverty and social

Analysis) template

• Health Impacts in other Communities of

Practice other than health

• Climate Change and Health TA,

highlighting the importance of available

health benefits/impacts when ADB does

the economic analysis.

Current approach

• Limited ADB HIA practice is safeguards approach to reducing negative health impacts;

• No HIA guidance for proactive health approaches in infrastructure and other non-health activities to yield better health outcomes.

Safeguard Policy Statement (SPS)

• To comply with the SPS 2009, Borrowers have to follow applicable national and local regulatory requirements, relevant international conventions, as well as identify significant environmental impacts and implement mitigation measures to reduce the potential impacts.

1. Project screening and categorization

2. Environmental assessment

3. Alternatives examination

4. Environmental management plan

5. Consultation and grievance redress mechanism

6. Information disclosure

7. Monitoring and reporting

8. Biodiversity protection and natural resources management

9. Pollution prevention and abatement

10.Occupational and community health and safety

11. Physical cultural resources

Environmental Safeguards

Principles and Requirements

Policy Principles and Requirements

Occupational Health and Safety

• Provide workers with safe and healthy

working conditions (World Bank Group’s

EHS)

• Prevent accidents, injuries, and disease by

(i) hazards identification

(ii) preventive/protective measures

(iii) training

(iv) documenting and reporting

(v) emergency preparedness/response

Policy Principles and Requirements

Community Health and Safety (Cont.)

• Identify/assess the impacts/risks to affected

communities during the project design,

construction, operation, and

decommissioning, and establish

measures/plans to prevent and address

them

• Water quality and availability; structural

safety; fire safety; traffic safety; hazardous

materials; disease prevention

Policy Principles and Requirements

Community Health and Safety

(Cont.)

• Establish emergency preparedness and

response (training, resources,

responsibilities, communications,

emergency response procedures)

• Provide appropriate information to affected

communities

• Engage external experts to assure the

safety of communities

There is ESHIA

• The International Finance Corporation already requires ESHIA or Environmental, Social, and Health Impact Assessment. However, evidence based HIAs are still challenging to undertake and this might be the reason why the World Bank and other regional banks including ADB have not followed this approach towards ESHIA.

Which approach?

Varying opinions regarding the best approach to take on HIA whether 1. to incorporate HIA into a safeguards approach or

2. to use HIA to optimize health impacts (upstream stage).

EIA and HIA relationships

EIA

HIA EIA

HIA

Upstream stage HIA

• Consider health impacts with environmental impacts throughout the program/project cycle.

• At the upstream stage, where project or site selection could be undertaken early on for alternatives which have greater potential for producing health outcomes.

Challenges within ADB

• Lack of awareness and appreciation among Bank staff

• The perception that HIA belongs to the health sector

• Poor understanding of HIA among Government and public

• There is not yet clear policy on HIA

Future steps

ADB plans to take the necessary steps to address these challenges:

(i) Provide short training on HIA as part of in-house staff development

(ii) Explore more pilot projects to do HIA

(iii) Review policies to consider health

(iv) Strengthen link with IFIs such as WB & IFC

For more information

Please contact:

• Patricia Moser, Lead Health Specialist

Email: pmoser@adb.org

• Gene Peralta, Senior Environment Specialist

Email: gperalta@adb.org

• Acknowledgement: CoP Health

• Vincent de Wit

• Rikard Elfving Thank you!