Many countries in developing Asia are establishing Special Economic Zones (SEZs) to offer an attractive investment climate for the private sector and to foster industrial and economic development outside of major cities. Across the Greater Mekong Subregion (GMS) there are over 500 SEZs and industrial estates, many of which have been strategically located along or near the 11 GMS economic corridors. The aim is to create a “seamless production zone” within the subregion.

One major development impact of SEZs is job creation. In the GMS alone, SEZs are estimated to have already provided employment for millions. Also, as SEZs are often situated in less developed areas, investing in infrastructure is a must. Infrastructure development, in turn, gives nearby communities better access to jobs and services, so SEZs and their surroundings soon become growth engines.

But SEZ development can come at a price in terms of health: environmental degradation and waste management; air pollution; and illness, injury and disease. Another health risk stems from social disruption from changes in lifestyle. This affects people who move to new communities leaving close family and friends behind, threatening their sense of community and belonging – all important factors in a person’s health and wellbeing.

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To mitigate these potential negative health impacts and harness the benefits of SEZs as development engines, GMS countries need support and tools. One of those tools is a proposed Health Impact Assessment (HIA) framework for SEZs, which has been developed by ADB in consultation with country experts.

An HIA is a well-established evidence-based method of calculating the costs of infrastructure projects to human health and to the health sector in general, and assess how the health co-benefits of such projects can be maximized. It considers how community health is affected by changes in the environmental and social determinants. Assessing the health impact of SEZs should foster public health management plans to address the social determinants of health (living conditions and environment) as well as access to health services.

Within the GMS, each country organizes and manages its SEZs in a different way. For instance, some are purely managed by the private sector and others through public-private sector collaboration. Also, HIA policies and guidelines differ slightly in each country. This has prompted the need to develop an overarching HIA framework that is flexible so it can be applied to meet the context for each country.

GMS needs common HIA framework

A common HIA framework for all GMS countries should be a priority for SEZ development, since only a healthy workforce and community is a productive one. This approach also leverages the private sector to invest in the health of its workers, since the implementation of a SEZ-wide public health management plan requires public-private collaboration to ensure good health for SEZ workers.

The framework aims to provide enhanced guidance for identifying, mitigating, and managing health risks and impacts related to the unprecedented industrial and economic development at and around SEZs in GMS countries. It seeks to address cross-border health issues associated with mobile/migrant worker populations.

Cross-border health issues include transmission of vector-borne diseases like malaria and dengue, which we can only aspire to prevent with proper cross-border surveillance and response. Likewise, cross-border referral and health financing systems would support seamless health care for communities in border areas.

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HIA can deliver benefits for businesses involved in an SEZ and for communities affected by it. The framework places people directly affected by or associated with SEZ development at the center of health planning, by prioritizing their health and wellbeing in the SEZ’s associated facilities and activities.

Finally, the HIA process needs to be responsive to the pace of SEZ development. As SEZs change and grow, new businesses will emerge, and demographics will change over time. This can create different and new health risks that HIA and public health management plans must tackle.

Investing in HIA at SEZs not only mitigates the potential negative health impacts of economic development, but also enhances health benefits. Ultimately it improves health service delivery to people in and around SEZs, while fostering public-private collaboration. It’s a vision that acknowledges that good health at SEZs is not the responsibility of one, but of all.