OHS Hemispheric Leadership Meeting PANAMERICAN HEALTH ORGANIZATION

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Pan American Health OrganizationPan American Health Organization

OHS Hemispheric Leadership Meeting

PANAMERICAN HEALTH ORGANIZATION

PREVENTION IN A GLOBALIZED WORLD

SUCCESSS TRHOUGH PARTNERSHIPS

GOALS, OBJECTIVES AND PARTNERSHIPSWSC

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Pan American Health OrganizationPan American Health OrganizationPAHO as a Specialized Agency of the UN and the

Inter–American System

Regional Office of theRegional Office of the

World Health OrganizationWorld Health Organization

Health Agency of the Organization Health Agency of the Organization

of American Statesof American States

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048TEN2K4


Workers’ Health in the AmericasWorkers’ Health in the Americas

Human Sustainable DevelopmentHuman Sustainable Development

HumanRights

DemocracyEquity

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Pan American Health OrganizationPan American Health OrganizationBurden of Disease: Economic Impact

Least-Development

Countries

Lower-Middle-Income

Countries

High-Income

Countries

Life Life ExpectancyExpectancy

Mortality Under Mortality Under Five YearsFive Years

PopulationPopulation

(Millions)(Millions)Development Development

CategoryCategory

891 25,730 78

2,094 1,200 70

643 296 51

GNP Per CapitaGNP Per Capita

(US Dls)(US Dls)

159

39

6

Ref: Macroeconomics and Health. Investing in

Health for Economic Development. WHO, 2001

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Sources: World Competitiveness Report,Lausanne; ILO/SafeWork

90

0

80 70

60

50

40

30

20

10

USAFi

nlan

d

Nethe

rland

s

Switz

erla

ndIre

land

Ger

man

ySw

eden

Can

ada

Aus

tral

iaU

KN

orw

ayJa

pan

Fran

ceB

elgi

umS

pain

Mal

aysi

aC

hile

Hun

gary

Kor

ea R

.P

ortu

gal

Chi

naTh

aila

ndB

razi

lM

exic

oS

outh

Afr

ica

Indo

nesi

aR

uss

ia

Ind

ex

Competitiveness and Safety

Fatal accidents/100 000 workers

Competitiveness (World Competitiveness Report)

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Pan American Health OrganizationPan American Health Organization Workers’ Health

“Occupational Health and Safety:

a high priority in the global,

international and national

agenda”Kofi A. AnnanSecretary General United Nations

Johannesburg Summit 2002

• Protect the health and safety of workers

• Strengthen and promote ILO and WHO programmes to reducr occupational

deaths, injuries and illnesses.

•Link occupational health with public health promotion”

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1. Halving extreme poverty

2. Universal primary education

3. Promoting equality

4. Reducing under 5 mortality

5. Reducing maternal mortality

6. Reversing the spread of HIV/AIDS

7. Environmental sustainability

8. Global Partnership for Development

MILLENNIUM DEVELOPMENT GOALS

2000

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Community participation

Inter-sectorality

Social Protection

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Pan American Health OrganizationPan American Health OrganizationUN Millennium Development Goals

Relation to Workers’ Health

GOALS: CONTRIBUTION:

• Eradicate Extreme Poverty and Hunger

•Promote Gender, Equality and Empower Women

•Reduce Child Mortality and Improve Maternal Health

•Combat HIV/AIDS

•Synergy with Labor Ministers, Private Sector, NGOs Unions to Create and

Maintain a Healthy Workplaces

•Basic Skills for Women to Utilize Housing and Working

Facilities

•Improvement in Working Conditions to promote and

protect parental Health

•Through Promotion in the Workplace and healthcare

Sector

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Pan American Health OrganizationPan American Health OrganizationUN Millennium Development Goals Ensuring Environmental Sustainability

TARGET

TARGET

CONTRIBUTION

CONTRIBUTION

Integrate the Principles of Sustainable Development into Country Policies and

Programs and reverse the loss of Environmental Resources

•Regional Plan on Workers’ Health/Health Workplaces Initiatives

•Linkages between Health and Labor PAHO/ILO

By 2020 to have achieve a significant improvement in the Lives of at least 100 million

slum Dwellers – phase out and eradication

Creation of Healthy, Safe and Decent Workplaces

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•Human Rights Declaration.

•Global Strategy on Occupational Health for All. Resolution WHA 49.12 1996.

• Regional Plan on Workers’ Health. Resolution XIII. PAHO 41st DC. 1999

• PAHO Strategic and Programmatic Orientations 1999-2002.

• PAHO Strategies Plan 2003-2007

• Summit of the Americas . Quebec 2001. Globalization and Labor.

• Inter-American Conference of Ministers of Labor (IACML) . OAS

WORKERS’HEALTH MANDATESWORKERS’HEALTH MANDATES

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Pan American Health OrganizationPan American Health OrganizationThe Regional Workers Health Plan

Strategic and Programmatic Orientations 1999-2002

Resolution DC XIII 1999

Inter-disciplinary

Transnational

Intersectoral

Human Sustainable Development

Strategic Plan 2003-2007

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Pan American Health OrganizationPan American Health OrganizationGlobalization: Strengths and weaknesses

Beneficial effect Adverse effect 5–7 % annual

growth trade and world production

Harder competition developing countries

Global market provides benefit of scale

Home markets are put under pressure

Higher efficacy and quality

Compromising health and safety standards

Elimination of time dimension from global market

Unphysiological time schedules, sleep debt,

vigilance problems

< costs of storage, high flow of production

Tight deadlines, psychological stress.

physical overload

Adapt to global market unconventional work

hours, source of flexibility: human labour

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StateWorkforce Composition,

Migration, Precarious L.M, Poverty Feminization

EffectLost workdays,

Occupational Accidents & Diseases, Lower Productivity, Social

Costs

ACTION

Health Policies and Legislation

Quality of the Work

Environment

Promotion of Workers Health

Comprehensive Workers’

Services

PressureTechnology Transfer, Non-

traditional Expoprt Production Increase

Maquila

Exposure (Environmental)

Psychosocial, Ergonomic,Chemical, Biological,

Safety & Physical

DPSEEA Model

Driving ForcesGlobalization, Integration,

Technological ChangeReform of the State, Inequities

The Workers’ Health Plan

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Pan American Health OrganizationPan American Health OrganizationSITUATION ANALISIS IN THE AMERICASSITUATION ANALISIS IN THE AMERICAS

INEQUITIES – INSTITUTIONAL DISPERSION - REFORMS

• EAP: 351 million (> 50% Americas population).

- 69 million below poverty line.

- 52% Informal Sector ( women, children, migrants, indigenous)

- 49% women

- 24 million children work.

36 Injuries / minute

5 Million injuries / year


90,000 Fatal Injuries / year

• Morbidity: Traditional occupational illnesses, along with cancer,

asthma, depression, cardiovascular, musculoskeletal , immunological,

and nervous system, and re-emerging diseases.

9% - 12% of GDP in LAC

30% Receives Occupational Health Services (formal sector)

• EAP: 351 million (> 50% Americas population).

- 69 million below poverty line.

- 52% Informal Sector ( women, children, migrants, indigenous)

- 49% women

- 24 million children work.

36 Injuries / minute



90,000 Fatal Injuries / year

• Morbidity: Traditional occupational illnesses, along with cancer,

asthma, depression, cardiovascular, musculoskeletal , immunological,

and nervous system, and re-emerging diseases.

9% - 12% of GDP in LAC

30% Receives Occupational Health Services (formal sector)

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Pan American Health OrganizationPan American Health Organization Economic impact

Musculoskeletal 40%

Heart diseases 16%

Injuries 14%

Respiratory diseases9%

Nervous Central System8%

Others13%

Other diseases include cancer, skin diseases and mental disorders

The Breakdown of Costs for Work-related Injuries and Diseases

Source: ILO, 1999

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Pan American Health OrganizationPan American Health Organization Regional Plan: Objectives

Actors:

- International

- Governmental

- Labor Organizations

- Private Sector

- NGOs

- Universities

- Media

- Collaborating Centers

““To improve the living To improve the living conditions, health and safety at conditions, health and safety at work and the well-being of the work and the well-being of the working population, in order to working population, in order to

advance towards human advance towards human sustainable development with sustainable development with

equity and social justice. ”equity and social justice. ”

•Strenghten the Strenghten the technical and technical and

institutional capacityinstitutional capacity

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Pan American Health OrganizationPan American Health Organization Workers’ Health Prevention

PrimaryPrevention Primary

Prevention

SecondaryPrevention

SecondaryPrevention

Tertiary Prevention

Tertiary Prevention

Clean Production

Pre-market Testing

Substitution and Elimination

Engineering Control

Environmental Monitoring

Personal Protective Devices

Biological Monitoring

Pre-clinical Medical Examination

Diagnosis

Therapy

Rehabilitation

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Regional Plan: Programmatic AreasRegional Plan: Programmatic Areas

Policy andLegislationPolicy andLegislation

ComprehensiveHealth ServicesComprehensiveHealth Services

Quality of Work Environment

Quality of Work Environment

Workers’ Health Promotion

Health for All

Equity Universal Access Poverty Reduction MDG’s

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Organization of American States

The Regional Workers’ Health Plan

III Summit of the Americas October 2001

XII`-XIII Inter-American Conferences of the Ministers of Labor

Declaration and Plan of Action

* COSATE - CEATAL

* OAS, ILO, PAHO, IDB, WB, ECLAC

Workers’ Health Proactive Actions

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1. More efficient social protection system

XII-XIII IACML

Priority Areas

2. Safety and Health Surveillance at work In the context

of the sub regional and regional integration

3. Institutional strengthening of Labor Ministries

with a multidisciplinary and interinstitutonal approach

4. Enhance the efficiency of policies and actions directed

to the promotion of decent work

5. Child Labor Eradication

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Pan American Health OrganizationPan American Health Organization Agreement PAHO - ILO

Extend Social Protection and Health Coverage within Excluded Groups

(ESPHC)

Agreement PAHO - ILOExtend Social Protection and Health Coverage

within Excluded Groups(ESPHC)

Approved by Directive Council

2002

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PAHO/WHO-ILO INITIATIVEExpected Results

PAHO/WHO-ILO INITIATIVEExpected Results

Country Level Greater knowledge of

social exclusion and its

potential solutions

Increase awareness of

the problem

Enhance political and social

dialogue

Development in technical

cooperation

Regional Level Share of national

experiences and lessons

learned

Developing methods

for establishing, evaluating

and applying policies and

strategies for ESPHC

Support activities among countries

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Pan American Health OrganizationPan American Health OrganizationHealthy Workplaces Initiative (HWI)

Nicaragua, Honduras,El Salvador and Guatemala

Maquila and Floriculture

SIDA-Sweden/IADB

•Implementation Toolkit – ValidationImplementation Toolkit – Validation•* Development of Health Standards* Development of Health Standards

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8 Min. of Labor, PAHO, SICA, COMISCA, RESSCAD

OPPORTUNITIES• FTAA 2005• CA – NAFTA• IACMT• SICA• COMISCA• RESSCAD• PRIVATE SECTOR

HWICONSTRAINTS

• POLITICAL INSTABILITY

• STRIKES

• NATIONAL EMERGENCIES

• HRR SLOW PROCESS

COORDINATION

• CERSSO

• SICA / IRET

• ILO

• IDB

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NETWORKS

HEALTHY WORPLACE INITIATIVE

NETWORKS

HEALTHY WORPLACE INITIATIVE

INTEGRATION MECHANISMS

INTERINSTITUTIONAL AND INTERSECTORIAL

COORDINATION

INTERPROGRAMMATIC

ACTION

PARTICIPATIVE

PLANNING

PAHO/WHO - IDB - PROALCA/USAID - ILO – SIDA – USDOL -NIOSH

SICA

COMMISCA

RESSCAD

CERSSO

PLAGSALUD

IRET

ICAES

ITCA

Network NGOs, Workers, Employers, Civil Society

MoH MoL ISS MoENational Councils of Occupational Health

Health and Safety Committees

NICM*

NICM*

ELSM*

ELSM*

HONM*

HONM*

GUAF*

GUAF*

* Maquiladora (M) - Floriculture (F)

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INTERCONNECTIVITY

IRET PAHO

COSTA RICA

SAN LUIS UNIVERSITY, GUATEMALA

OEA

IDB

AREAS OF COLLABORATION

• Research

• Training

• Information

• Outreach

COLOMBIA

COMBIOSE QUEBEC

U. LEON NICARAGUA

CCOHS HAMILTON ONTARIO

CERSSO, EL SALVADOR

ECOSYSTEM APPROACH

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•Research

•Training

•Information

•Outreach


•Research

•Training

•Information

•Outreach

COLLABORATING CENTERS PAHO/WHO

FUNDACENTRO

U Illinois

U Michigan

U Texas

MINSA

ISP

ACHS

CCOHSCentre Hospitalier

de Québec

INSAT

CINBIOSE

NIOSH

John Hopkins U

U Mass. Lowell

CBNS

•IRET

IAPA

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HISPANIC FORUM

INITIATIVE

Vision•Vision

VISION

Reduce the disparities in Occupational and Environmental Health Status and

Services within the Hispanic Population

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Hispanic Forum Sponsors Memorandum of Understanding

HISPANIC FORUM

The National Safety Council

Pan American Health Organization

The Environmental Protection AgencyOccupational Safety

and Health Administration

OAS (IACD-ESDU)

National Higway Traffic Safety

Administration

National Alliance for Hispanic Health

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Hispanic population grew by 58% between 1990 and 2000:38.3 Million in the US, 3.8 Million in Puerto Rico

12.5% of the workforce is Hispanic. They bear 15% of the total US fatal occupational injuries.

Fatal occupational accidents have decreased overall, but risen alarmingly among the Hispanic labor force.

In the US there has been a 40 % increase in fatalities among Hispanic workers in the construction sector.

Alarming Increases in Work Accidents among Hispanics

0

200

400

600

800

1000

1200

1400

1600

1800

2000

0

1000

2000

3000

4000

5000

6000

7000

Fatal Work Injuries involving Hispanics Hispanic Construction Workers

Fatal Work Injuries Counts 2 per. Mov. Avg. (Fatal Work Injuries Counts)

2 per. Mov. Avg. (Fatal Work Injuries involving Hispanics) 2 per. Mov. Avg. (Hispanic Construction Workers)

Work Related Fatalities are Projected to Keep rising without preventive interventions

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US-Mexico Chamber of Commerce

IDB

Hispanic Workers Safety and Health

Susan Harwood Grants

OSHA

PAHO

Hispanic Forum

3M

Summit of the Americas-

OAS

NIOSH

Communications

Workshop

US-Mexico BHA

NSC

Puerto Rico

NATIONWIDE NETWORK: AN INVITATION TO JOIN AND SUPPORT

Interconnectivity and Support

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Pan American Health OrganizationPan American Health Organization Border Issues

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Pan American Health OrganizationPan American Health Organization Migrant Farm Workers

•Most farm workers have no insurance.

• 3 to 5 million of them are Hispanic.

•Most migrant workers are men in their 20s and send their earnings home to their families in Mexico, Guatemala, Honduras, El Salvador or Haiti.

•Most live in poor housing and unsanitary living conditions.

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High Burden of Disease attributable to Occupational EnvironmentHealth Systems’ Lower Performance

Healthcare Sector in LAC>7 million workers, gender and labor inequities, Scarcity of Data

PAHO Series of Manuals for the Healthcare SectorIn Preparation: Manual for Managers

PAHO “Learning Projects”Awareness raising , Mobilizing, Capacity building

Assessingthe Situation

Proposing Interventions

Empowering and Learning

Physical Hazards Chemical Hazards Biological HazardsOrg. & Psychological

Hazards

Occupational Health Promotion in the Health Sector

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INTER-AGENCY SUPPORTINTER-AGENCY SUPPORTPAHO - OASPAHO - OAS

1. Portfolio of Consolidated Programs

2. Hemispheric Workshop. CERSSO

3. Workshop of Leadership on Occupational Safety and Health

4. Alliances and Innovations for Development: Corporative Social Responsibility

5. Self instructive course on Occupational Health and Safety

6. Agreement with the European Agency of Safety and Health at Work

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www.oea-ue-sso.or www.oas-eu.ohs.orgwww.oea-ue-sso.or www.oas-eu.ohs.org

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Pan American Health OrganizationPan American Health Organization Risk Evaluation and Occupational

Surveillance

Srengthening of

Occupational

Hygiene,

Ergonomics,

Toxicology, etc.English Caribbean

Injuries

Plagsalud: TCC

D.C.

UCLAQueens

NIOSH

Back pain

Pesticides

Injuries

University of StockholmEcotoxicology

Lulea University of TechnologyCenter for Ergonomics for Developing Countries (CEDC)

University of StockholmEcotoxicology

Lulea University of TechnologyCenter for Ergonomics for Developing Countries (CEDC)

Cuba

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Pan American Health OrganizationPan American Health OrganizationOCCUPATIONAL SURVEILLANCEOCCUPATIONAL SURVEILLANCE

Central America PLAGSALUD

Central America PLAGSALUD

ChileSAISOChile

SAISO

VenezuelaSUAVIDERO/WIZARD

VenezuelaSUAVIDERO/WIZARD

USANIOSHUSA

NIOSH

Chile, Jamaica, Mexico

Injuries

Chile, Jamaica, Mexico

Injuries

CubaCuba

BrazilSUS

BrazilSUS

Canada Compensation

System

Canada Compensation

System

Experts Meeting1999

Experts Meeting1999

Regional Meeting2000

Regional Meeting2000

Indicators Guidelines 2004

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Directing Council September 2004

(Proposal Strategic Alliance Health-

Labor)

Preparatory Meeting for Summit

Argentina June 2005

Strategic Alliances Health and Labor

Implications for 2005 IV Summit of the Americas

XIV IACML

XVII WSC

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Pan American Health OrganizationPan American Health Organization Next Steps

Continue working along with the working groups from the XIII Interamerican Conference of Ministers of Labor toward the XIV IACML

Third Hispanic Forum within the XVII World Congress on Safety and Health at Work, (Orlando, Florida 2005)

Summit of the Americas, (Argentina 2005)

OHS Hemispheric Leadership Meeting PANAMERICAN HEALTH ORGANIZATION

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