1. PAHO-2K 048TEN2K 1 Pan American Health Organization Inter ministerial in the context of the Working Groups I and II Meetings Pan American Health Organization Strategic Alliance of Ministers of Labor, Health, Education and Environment Dr. Sofialeticia Morales OPS Consultant

2. PAHO-2K 048TEN2K 2 Pan American Health Organization Background  III Summit of the Americas  Extraordinary Summit Monterrey, Nuevo León México  Agreement with TROIKA  Proposed Resolutions  Decision 45 of the Directive Council for Pan American Health Org.  Intervention of the Authorities  Technical Meeting for the Plan of Action for IACML  IV Meeting for the Plan of Action Meeting of the Authorities of CIE  Preparatory Meeting for Health and Environment for the IV Summit of the Americas.  III Summit of the Americas  Extraordinary Summit Monterrey, Nuevo León México  Agreement with TROIKA  Proposed Resolutions  Decision 45 of the Directive Council for Pan American Health Org.  Intervention of the Authorities  Technical Meeting for the Plan of Action for IACML  IV Meeting for the Plan of Action Meeting of the Authorities of CIE  Preparatory Meeting for Health and Environment for the IV Summit of the Americas. IV Cumbre de las Américas: "Crear Trabajo para Enfrentar la Pobreza y Fortalecer la Gobernabilidad Democrática"

3. PAHO-2K 048TEN2K 3 Pan American Health Organization Background  III Cumbre de las Américas The development of the workforce to increase the investment in the capacity of human resources, the prevention of child labor, the protection of workers’ rights in light of occupational accidents, the protection against gender discrimination, and the incorporation of vulnerable and marginalized groups into the workforce.  III Cumbre de las Américas The development of the workforce to increase the investment in the capacity of human resources, the prevention of child labor, the protection of workers’ rights in light of occupational accidents, the protection against gender discrimination, and the incorporation of vulnerable and marginalized groups into the workforce.

4. PAHO-2K 048TEN2K 4 Pan American Health Organization Background  Cumbre Extraordinaria Monterrey, Nuevo León México  The promotion of decent work. Political, Economic, and Social development that is coordinated and integrated to combat inequality and marginality. Respect workers’ rights in order to reduce poverty and promote sustainable economic and social development. The extension of social health protection. Drive policies that reinforce systems of social security and implement standards of social protection. Assurance of environmental health for the population as an investment in long term well being and prosperity.  Cumbre Extraordinaria Monterrey, Nuevo León México  The promotion of decent work. Political, Economic, and Social development that is coordinated and integrated to combat inequality and marginality. Respect workers’ rights in order to reduce poverty and promote sustainable economic and social development. The extension of social health protection. Drive policies that reinforce systems of social security and implement standards of social protection. Assurance of environmental health for the population as an investment in long term well being and prosperity.

5. PAHO-2K 048TEN2K 5 Pan American Health Organization Background  Agreement with TROIKA Reinforce the dialogue and relationship between the Ministries of Labor and Health and include the same discussion in both ministerial meetings.  Proposed Resolutions Promote the exchange of information on good practices in matters of health and workers’ occupational health and safety. To look for mechanisms to reinforce information, research, and training of human resources.  Agreement with TROIKA Reinforce the dialogue and relationship between the Ministries of Labor and Health and include the same discussion in both ministerial meetings.  Proposed Resolutions Promote the exchange of information on good practices in matters of health and workers’ occupational health and safety. To look for mechanisms to reinforce information, research, and training of human resources.

6. PAHO-2K 048TEN2K 6 Pan American Health Organization Background  45 th Directive Council of the Pan American Health Organization To include a session with the pro tempore presidents of the Inter-American Conference of the Ministers of Labor and the Ministers of Education in the preparatory meeting of the Ministers of Health and Environment at the IV Summit of the Americas, with the purpose of articulating the work of labor, environment, and education sectors in relation to working conditions and employment, particularly in the health sector.  45 th Directive Council of the Pan American Health Organization To include a session with the pro tempore presidents of the Inter-American Conference of the Ministers of Labor and the Ministers of Education in the preparatory meeting of the Ministers of Health and Environment at the IV Summit of the Americas, with the purpose of articulating the work of labor, environment, and education sectors in relation to working conditions and employment, particularly in the health sector.

7. PAHO-2K 048TEN2K 7 Pan American Health Organization Background  Intervention of the Authorities of Mexico, Canada, Argentina, Brasil, El Salvador, and others  Employment constitutes priviledged access to social protection.  Occupational health and safety require renewed attention in light of globalization.  Workplaces that are healthy and safe reflect the capacity to grant quality attention to health related services.  Work policies based in effective uses of human capital contribute to increased benefits from economic integration.  It is necessary to promote the reinforcement of the human dimension to globalization.  Intervention of the Authorities of Mexico, Canada, Argentina, Brasil, El Salvador, and others  Employment constitutes priviledged access to social protection.  Occupational health and safety require renewed attention in light of globalization.  Workplaces that are healthy and safe reflect the capacity to grant quality attention to health related services.  Work policies based in effective uses of human capital contribute to increased benefits from economic integration.  It is necessary to promote the reinforcement of the human dimension to globalization.

8. PAHO-2K 048TEN2K 8 Pan American Health Organization Sustainable Human Development Education Human Rights Economic Growth EnvironmentHealth “It is about creating an environment in which people can develop to their full potential and lead productive and creative lives in accordance with their needs and interests”. Sustainable Human Development

9. PAHO-2K 048TEN2K 9 Pan American Health Organization

10. PAHO-2K 048TEN2K 10 Pan American Health Organization Health and Development Synergy 123456789101112131415161718 Under 5 MORTALITY MATERNALMORTALITY HIV/AIDS MAL/INF DIS Safewater Poverty Hunger Primary education Gender disparity Environment Slumdwellers Essentialdrugs Financialsystem Trade Smallnations Debt relief Work IT MDG

11. PAHO-2K 048TEN2K 11 Pan American Health Organization Indivisibility and Synergy The goals need to be seen as an indivisible package.

12. PAHO-2K 048TEN2K 12 Pan American Health Organization Labor and Health Statistics ILO (1999) world 250 mill. Accidents per yerar 685,000/daily 475/ minute 9/ second PAHO Rate of Accidents 4.2 x 10,000 1.1 mill/ deadly LAC 5 thousand labor acc/ year 36 labor accidents/minute 90,000 deadly / year 300 dead/ day 2003 1.9mil 2.3 thousand deaths 355,000 labor acc. 1,574,000 work related illness 158,000 trafic acc. ILO (1999) world 250 mill. Accidents per yerar 685,000/daily 475/ minute 9/ second PAHO Rate of Accidents 4.2 x 10,000 1.1 mill/ deadly LAC 5 thousand labor acc/ year 36 labor accidents/minute 90,000 deadly / year 300 dead/ day 2003 1.9mil 2.3 thousand deaths 355,000 labor acc. 1,574,000 work related illness 158,000 trafic acc. WHO world Work related illness 30-50 x 10,000 workers 68-157 mill. Professional related illness 35% cronic 10% permanently disabled 1% dead ILO (1997) Loss $ x’ illness and injuries 4.4% (GNP) World PAHO and IDB y BID 2-11% (GNP) Country estimate in dollars 50% work related illness and labor accidents

13. PAHO-2K 048TEN2K 13 Pan American Health Organization Those earning less than the cost of basic goods: 20%-40% of waged workers Sevices for Occupational Health: 30% of the informal sector Ration of non-professional mortality rate/ professional mort. rate: 3:1 Lethal Accidents LAC/EEUU: 3:1 Mortality for Hispanics in the U.S.: + 40% Major Impacts: Children, women, migrants, elderly, indigenous 31 Million unemployed and 69 million workers live below the poverty line Those earning less than the cost of basic goods: 20%-40% of waged workers Sevices for Occupational Health: 30% of the informal sector Ration of non-professional mortality rate/ professional mort. rate: 3:1 Lethal Accidents LAC/EEUU: 3:1 Mortality for Hispanics in the U.S.: + 40% Major Impacts: Children, women, migrants, elderly, indigenous 31 Million unemployed and 69 million workers live below the poverty line Labor Inequities

14. PAHO-2K 048TEN2K 14 Pan American Health Organization 150 million people are excluded from health care 36 Accidents/ minute 5 Million/ year 90,000 Lethal acc./year 300 Deaths/ day 9%-12% of GNP in LAC 150 million people are excluded from health care 36 Accidents/ minute 5 Million/ year 90,000 Lethal acc./year 300 Deaths/ day 9%-12% of GNP in LAC Impacts of Occupational Accidents and Illnesses

15. PAHO-2K 048TEN2K 15 Pan American Health Organization Inter ministerial Strategic Alliance Presentation in the Working Group II Meeting April 11 th -12 th XIV IACML Mexico September 2005 Strategic Alliance: Minister of Labor (CIMT) and Minister of Education (CIE) session at the Ministerial Meeting of Ministers of Health and Environment in the context of the IV Summit of the Americas Date: June 17 th-18th Buenos Aires Argentina Strategic Alliance Working Group PAHO’s 46 th Directing Council September 2005 XVII World Safety Congress on Safety and Health at Work September 2005 I Inter Ministerial Technical Meeting in the context of the CIE May 2005 Washington, D.C II Inter Ministerial Technical Meeting June 11 Mar del Plata Argentina Presentation at the Preparatory Meeting for the XIV CIMT January 31 st February 1 st

16. PAHO-2K 048TEN2K 16 Pan American Health Organization Inequities in Social Protection: Health, Education, and Labor Education and Health are the largest employers in the public service. 8 million education workers 7 million health workers The Education Sector impacts 220 million students at the level of basic education. 92 million people> 15 years old without primary education. Trends: Globalization, State Reforms, Flexibilization, Privatization. Traditional and New Problems: ¨Burn out syndrome¨ (23% of health workers and 25% of education workers) Lack of Information systems, ecosystemic/ gender approach HIV/AIDS Education and Health are the largest employers in the public service. 8 million education workers 7 million health workers The Education Sector impacts 220 million students at the level of basic education. 92 million people> 15 years old without primary education. Trends: Globalization, State Reforms, Flexibilization, Privatization. Traditional and New Problems: ¨Burn out syndrome¨ (23% of health workers and 25% of education workers) Lack of Information systems, ecosystemic/ gender approach HIV/AIDS 5 - 10% EAP each sector 10 -15 % GDP

17. PAHO-2K 048TEN2K 17 Pan American Health Organization Inequities of Social Protection: Health, Education and Labor. Trends: Globalization, State Reforms, Flexibilization, Privatization. Traditional and New Problems: Precarious Labor Conditions Professional Migration Lack of Labor Stability Lack of Competencies Reoccurring Cycle of emotional strain High rates of absenteeism and disability. ¨Burn out syndrome¨: 23% of health workers and 25% of education workers Lack of Information systems, (ecosystemic/ gender approach). Trends: Globalization, State Reforms, Flexibilization, Privatization. Traditional and New Problems: Precarious Labor Conditions Professional Migration Lack of Labor Stability Lack of Competencies Reoccurring Cycle of emotional strain High rates of absenteeism and disability. ¨Burn out syndrome¨: 23% of health workers and 25% of education workers Lack of Information systems, (ecosystemic/ gender approach) Technological Developments Contractual Modalities Poverty and Social Vulnerability

18. PAHO-2K 048TEN2K 18 Pan American Health Organization Good Practices from the Alliance  Standard of Occupational Health and Safety in Latin America (RSST) Central America Toolbox CERSSO OIT/BID Plagsalud The Caribbean National Plans for Healthy Hotels for 14 countries North America Hispanic Forum XVII World Congress for Occupational Health and Safety Andean Region Child Workers OPS/OMS Bolivia Ecopetrol in Colombia Mercosur Health and Safety on workers in the Education Sector Modification of the law of the Superintendent of Occupational Health and Safety

19. PAHO-2K 048TEN2K 19 Pan American Health Organization Objectives of the Strategic Alliance General Objectives 1.Strengthen the Strategic Alliance between the four sectors in order to respond to the challenges of the IV Summit of the Americas around the concept of sustainable human development and healthy environments, in the framework of social protection and to advance towards the Millennium Development Goals through joint actions. 2. Make a strategic proposal that may be included in the Plan of Action of the IV Summit of the Americas to develop programs that guarantee the health and occupational safety of workers, the quality of their professional development, and assure that their institutions maintain healthy environments.

20. PAHO-2K 048TEN2K 20 Pan American Health Organization STRATEGIC ALLIANCE We recognize the importance of tailoring macroeconomic, microeconomic, commercial, productive, infrastructure, labor, social, migratory, educational, and social security policies to meet quality employment and productivity goals. Furthermore, we undertake to generate greater opportunities for our peoples in education, security, health care, housing, social development, and infrastructure and to strengthen regional development policies and local management. INTEGRATION OF SOCIAL POLICY 1 Declaration Proposal of the IV Summit of the Americas

21. PAHO-2K 048TEN2K 21 Pan American Health Organization PROFESSIONAL DEVELOPMENT 2 We will devise efficient, high-quality professional development and vocational training systems and services attuned to economic, educational, and employment policies, by increasing both public and private investment in vocational training, with a view to boosting the productivity of enterprises and individual’s employability. PROFESSIONAL DEVELOPMENT DECLARATION PROPOSAL OF THE IV SUMMIT OF THE AMERICAS STRATEGIC ALLIANCE

22. PAHO-2K 048TEN2K 22 Pan American Health Organization 3 I.1.1. Fostering integration of economic, labor, and social policies to achieve quality employment and productivity. I.1.4. Promoting social protection and improving income and productivity in the informal and rural economy. I.1.6. Promoting high-quality skills development systems and services, that are coordinated with educational, employment and economic policies, with a view to enhancing corporate productivity and individual employability. CREATING DECENT WORK STRATEGIC ALIANCE DECLARATION PROPOSAL OF THE IV SUMMIT OF THE AMERICAS

23. PAHO-2K 048TEN2K 23 Pan American Health Organization I.3.1. Promoting a social agenda that integrates health, eductaion, housing, and social development programs, and reduces the vulnerability of all households I.3.2. Ensuring sufficient and adequate social protection mechanisms, based on the principle of the universality of benefits I.3.3 Increasing the protection of unemployed workers, promoting their employability and establishing unemployment insurance or similar mechanisms with broad coverage. 4 GENERATIING PUBLIC POLICIES TO ERADICATE POVERTY DECLARATION PROPOSAL OF THE IV SUMMIT OF THE AMERICAS STRATEGIC ALLIANCE

24. PAHO-2K 048TEN2K 24 Pan American Health Organization Strategic Alliance Proposal for the IV Summit of the Americas The Heads of State and Government agree to mandate to their Ministries of Health, Education, Labor and Environment, through a Strategic Alliance, to develop programs that guarantee healthy educational and work environments in the framework of social protection; promote conditions that support the health and safety of workers and provide continuous opportunities for professional development. We request that PAHO, together with the support of the OAS, the ILO and UNEP support this effort.