Regional Strategy for Health Promotion for South …apps.searo.who.int/pds_docs/B3147.pdfRegional Strategy for Health Promotion for South-East Asia This Regional Strategy for Health

Regional Strategy forHealth Promotion

for South-East Asia

This Regional Strategy for Health Promotion for South-East Asia wasdiscussed at the Inter-country Consultation Workshop, 26 to 29 June2006 at Chiang Mai, Thailand; and during the Regional CommitteeMeeting (RC59), Dhaka, Bangladesh, 22 - 25 August, 2006. The visualon the cover is derived from the 6th Global Conference on HealthPromotion held in Bangkok in August 2005 which resulted in theBangkok Charter for the health promotion.

SEA/HE/194

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Regional Strategy for Health Promotion for South-East Asia iiiiiiiiiiiiiii

ContentsContentsContentsContentsContents

Foreword ................................................................................ iv

Executive summary ................................................................. vii

Introduction ............................................................................ 1

Health promotion practice ........................................................ 4

Bangkok Charter for Health Promotion in a Globalized World ....... 6

Regional Strategy for Health Promotion for South-East Asia .......... 7

Objectives .............................................................................. 8

Conceptual framework .............................................................. 9

Strategic directions ................................................................ 11

Infrastructure for coordination and management ........... 11

Capacity building ...................................................... 12

Regulations and legislation ......................................... 12

Partnership, alliances and networks ............................. 13

Evidence for health promotion .................................... 14

Social mobilization and advocacy ................................ 15

Financing health promotion ........................................ 16

Management of change .............................................. 17

Role of Member States ........................................................... 19

Role of WHO ........................................................................ 20

Conclusion ........................................................................... 21

AnneAnneAnneAnneAnnexxxxxeseseseses

1. SEA/RC59/R4: Regional Strategy for Health Promotion........ 22

2. WHA60.24/12.11: Health promotion in a globalized world . 24

3. The Bangkok Charter for Health Promotion ina Globalized World .......................................................... 27

iviviviviv Regional Strategy for Health Promotion for South-East Asia

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The Regional Strategy for Health Promotion for the South-East Asia(SEA) Region has evolved from commitments and actions contained inthe Bangkok Charter for Health Promotion, which calls for Membercountries to make the promotion of health: (a) central to the globaldevelopment agenda; (b) a core responsibility for all of governments;(c) a key focus of communities and civil society; and (d) a requirementfor good corporate practice. It calls for a multidisciplinary andmultisectoral integration of health promotion into (a) disease or issue-specific interventions; (b) population-based interventions; or (c) settings-based interventions. The strategy also aims to ensure that healthpromotion activities are addressed within the existing social, economic,environmental, political and cultural contexts.

Health promotion consists of an array of strategies and techniquesthat draw on a body of knowledge emanating from disciplines such associal sciences, arts, education, marketing and communication, amongothers. Information dissemination in order to increase public knowledgeand awareness remains a pivotal function of health promotion. Itsexpanded strategies and techniques now include advocacy, socialmobilization, regulation and legislation, evidence-gathering, innovativefinancing and enhanced partnership among communities, civil societyand government ministries other than the Ministry of Health. Increasingly,health promotion finds itself requiring these strategies and techniquesto address health inequities and the negative impact of socialdeterminants of health associated with globalization, urbanization, tradeliberalization, population trends, social and political transitions andclimate change. These social determinants influence the lifestyles andhealth outcomes for individuals and communities negatively.

In order to develop and sustain health promotion interventionseffectively across sectors, it is prudent that the public health workforcecomprising both health and non-health professionals possesses thecontent and skills necessary to deliver health promotion adequately. Inthis regard, building the capacity of both health and non-healthprofessionals remains a top priority. In addition, there is need tostrengthen curriculum and faculty development at all training institutionsas well as civil society. The need to establish a mechanism to gather

Regional Strategy for Health Promotion for South-East Asia vvvvv

evidence on the effectiveness of health promotion across sectors isequally important.

Finally, the Regional Strategy offers countries of the SEA Region thevision to develop and sustain healthy public policies and programmesto address the causes of ill-health and premature deaths, and therebycontribute to the achievement of the Millennium Development Goalswithin the context of revitalizing primary health care. The RegionalStrategy is a tool to make the goal of "All for Health Promotion" a realityamong countries of the WHO SEA Region.

Samlee Plianbangchang, M.D., Dr.P.H.Regional Director

vivivivivi Regional Strategy for Health Promotion for South-East Asia

Promoting, supporting andprotecting health accross

issues, populations andsettings.

Regional Strategy for Health Promotion for South-East Asia viiviiviiviivii

ExExExExExecutive summarecutive summarecutive summarecutive summarecutive summaryyyyy(1) The main cause of high disease burden and premature death

among countries of the WHO South-East Asia Region(SEAR) is due to communicable and non-communicablediseases as well as new threats to heath. HIV/AIDS,tuberculosis and malaria remain a major public healthconcern, while non-communicble diseases, namely cancer,diabetes, hypertension and heart diseases are increasing evenamong the poor. SEAR countries also face new threats tohealth from natural disasters (floods, earthquakes andvolcanoes) and avian influenza. Finally, due to globalizationand trade, SEAR countries are experiencing drastic changesin consumption patterns of food, tobacco, alcohol and unsafesex as well as huge disparities between and within countries.

(2) Health promotion advocates for integration of activitiesacross sectors and also encourages multi-sectoralcollaboration. It mitigates the impact of risk factorsassociated with broad determinants of health that contributeto premature deaths and illness using various approachesat multiple levels. The three common approaches oftenapplied are (a) the issues-based approach, (b) population–based and (c) the setting-based approach. While the firsttwo remain indispensable approaches to address specificdiseases and population groups, the setting-based approachhas the greatest potential to produce desired healthoutcomes because it tackles risk factors in places whereindividuals live, work and play.

(3) The Strategic Directions meant to give guidance to Membercountries are all-encompassing of decisions reached atRegional Committee Meeting, Executive Board and WorldHealth Assembly Meeting as well as commitments andactions reflected from the Ottawa Charter (1986) to theBangkok Charter for Health promotion (2005).

(4) The Regional Strategy for Health Promotion propose thefollowing priority inter ventions: infrastructure forcoordination and management, capacity building, regulationand legislation, partnership, evidence for health promotion,policy and advocacy and social mobilization, financing healthpromotion, and management of change.

viiiviiiviiiviiiviii Regional Strategy for Health Promotion for South-East Asia

(5) To effectively manage change, the transition from “Healtheducation” to “Health promotion require concerted effortin advocacy and involvement of multiple stakeholdersincluding those outside the health field. The RegionalStrategy for Health promotion calls upon Member countriesto make Health promotion a core responsibility for the entiregovernment, key focus of communities and civil society, anda requirement for good corporate practice.

(6) In terms of responsiveness to policy and programme issues,the Regional Strategy calls for Member countries to reviewthe existing Health promotion organizational structureincluding leadership and management capability. It also callsfor countries to review existing financing with a view toincreasing budget allocation for Health promotion includingconsidering the use of dedicated tax.

(7) WHO is requested to strengthen the capacity for Healthpromotion across the Organization in the Region and tosupport Member countries build capacity for developingpolicies, programmes, plans of action and guidelines,innovative and sustainable financing, and documentation ofevidence.

Promoting nutrition, hygieneand sanitation through

schools.

Regional Strategy for Health Promotion for South-East Asia 11111

IntrIntrIntrIntrIntroductionoductionoductionoductionoduction(1) Health promotion is a core function of public health and is

effective in reducing the burden of both communicable andnoncommunicable diseases, including mitigating the socialand economic impact of such diseases. The goal inpromoting health is to mitigate the impact of risk factorsassociated with broad determinants of health leading topremature death and illness, and ultimately, to improve thequality of lives of individuals and communities. It is thereforea good public investment. To effectively address theidentifiable determinants of health, health promotion requiresthat strategic directions and policies be formulated inaddition to political commitment. Health promotion activitiesneed to be planned, monitored, and evaluated. Similarly,the outcomes and the process have to be documented anddisseminated widely in order to guide programming andresource allocation. Therefore, a sound strategy remains anessential pre-requisite for implementing effective healthpromotion interventions.

(2) Countries of WHO’s South-East Asia (SEA) Regionrecognize the need for addressing the growing burden ofnoncommunicable and communicable diseases as well asthe new and emerging threats to health, such as earthquakes,emerging diseases like avian influenza (bird flu), SARS andHIV/AIDS, and the re-emerging diseases like dengue, TBand malaria. Furthermore, they face inequalities within andbetween the countries, resulting in limited resources chasingunlimited social needs. All this is due in part to a growingmarginalized population that continues to place a hugeburden on social services and the environmental system.Health promotion holds the key to halting or reversing theexisting situation particularly in addressing primary riskfactors as well as the social and economic determinants ofhealth.

(3) Member States in the SEA Region have advocated forstrengthening health promotion as part of their efforts forhealth systems development in a series of global meetingsbeginning with the Alma-Ata Primary Health Care

22222 Regional Strategy for Health Promotion for South-East Asia

Conference (1978), Global Health Promotion Conferences,as well as at the various sessions of the World HealthAssembly. The resolutions WHA42.44, WHA51.12 andWHA57.16 called for Member States and WHO to givepriority to strengthening health promotion. Beginning withthe first Conference on Health Promotion held at Ottawa,Canada in 1986, Member States from the Region wererepresented at a series of conferences on health promotion,organized by WHO in collaboration with national, regionaland global players, in Adelaide, Australia (1988), Sundsvall,Sweden (1991), Jakarta, Indonesia (1997), Mexico City,Mexico (2000), and Bangkok, Thailand (2005). The Regionhosted two global conferences, in Jakarta and Bangkok, whichdemonstrated the Region’s active involvement andcommitment to health promotion.

(4) Globally, there is a disproportionately high number ofpremature deaths and illness, which are preventable. Amongthe global challenges that have a direct impact on the healthand social well-being of people including those in the SEARegion, include, but are not limited to:

• Increasing inequities within and between countries dueto socio-political and economic changes;

• Changing patterns of consumption, particularlyassociated with food and information;

• Demographic changes that affect working conditions,learning environments, family patterns, and the cultureand social fabric of societies;

• Socio-political and economic changes, includingcommercialization and trade, and

• Global environmental change.

(5) The efficacy and cost-effectiveness of health promotion inmitigating the impact of social and economic determinantsof health at individual and community levels is widelyrecognized and acknowledged. However, major challengesstill remain, especially in the countries, where both ruraland urban populations are most vulnerable to the changingsocial and economic situations that influence health and

Addressing the socially-determined health outcomesassociated with urbanization,

climate change, foodconsumption patterns,

communication,transportation and population

ageing, among others.


social outcomes. Therefore, the specific health promotionchallenges that require innovative approaches include:

• Resource mobilization and allocation, including theestablishment and adoption of alternative sources offinancing for promoting health;

• Addressing complex socioeconomic and culturalchanges at family and community levels;

• Involving the whole of government (not only theMinistry of Health) to address the social determinantsof health throughout the life cycle;

• Actively engaging civil society, the private sector andnongovernmental organizations in health promotion;

• Strengthening the capacity for health promotion acrosssectors and at multiple levels; and

• Evidence gathering regarding the efficacy of healthpromotion and the utilization of such evidence inpolicy decisions and programming.


Health prHealth prHealth prHealth prHealth promotion practiceomotion practiceomotion practiceomotion practiceomotion practice(6) The Ottawa Charter for Health Promotion, adopted at the

Global Conference on Health Promotion held at Ottawa,Canada in 1986 is credited for ushering the concept andprinciples of health promotion. Health promotion now hasan established inventory of proven effective strategies andtechniques to promote health since the Ottawa Conference(1986). Health promotion takes a more comprehensiveapproach to promoting health by involving various playersand focusing on multi-sectoral approaches compared tohealth education.

(7) Health education focuses on communicating healthinformation and knowledge, and providing skills in order tosupport the individual to adopt desired (positive) healthybehaviours voluntarily. It uses communication processes,namely individual discussions, mass and group media toreach target groups through a strategy known as information,education and communication (IEC). Health educationincorporates various social marketing techniques foradvocacy and social mobilization, but it uses thempredominantly for issue-specific interventions, e.g.reproductive health, condom promotion, immunization orspecific disease control. Health education practices areusually the sole responsibility of health professionals fromthe ministries of health, with support in some cases fromthe Ministry of Information in the form of graphic artistsand technicians from newspapers, radio and television.

(8) Health promotion practices, on the other hand, are criticalelements of primary health care and essential media in thedelivery of public health particularly tackling communicableand noncommunicable diseases, and other threats to health.It is proven to be effective in terms of both cost and efficacyin mitigating the social and economic impact of diseases. Itrecognizes health as a human right and seeks to promotethe highest attainable standard of health of every humanbeing without any form of discrimination.

(9) Health promotion seeks to respond to global developmentsthat contribute to increasing inequality, changes in the

Investing in the future throughpromotion of healthy lifestyles

among young people.


patterns of consumption, the environment, cultural valuesand traditions, communication and changes in family andsocial fabric among others. These major global changes havea major impact particularly among vulnerable groups suchas women, children and the elderly as well as among minorityand indigenous groups.

(10) Health promotion practices require support and action byall sectors and stakeholders to make concerted efforts inadvocacy, investment, capacity building, regulation andlegislation, and partnership and alliance building to promotehealth. Furthermore, health promotion encourages variousplayers to contribute to promoting health including civilsociety groups, communities, the private sector and all otherministries. In addition, the leadership and authority forproviding technical guidance in promoting health remainthe role and responsibility of the Ministry of Health.

(11) To achieve desired results, health promotion activities shoulduse the settings-based, population-based or issues–basedapproaches. Healthy settings such as schools, markets, cities,townships, villages, islands or various workplaces providean opportunity to address complex health and social needsor concerns of individuals and communities in places wheredaily decisions are made and where behaviours aremanifested. The settings approach also allows for integratingactivities into existing social activities that take intoconsideration cultural values, communication patterns andlocal leadership issues in a given socio-political environment.


BangkBangkBangkBangkBangkok Charter for Health Prok Charter for Health Prok Charter for Health Prok Charter for Health Prok Charter for Health Promotion inomotion inomotion inomotion inomotion ina Globalized Wa Globalized Wa Globalized Wa Globalized Wa Globalized Worldorldorldorldorld

(12) In August 2005, the Global Conference on HealthPromotion held in Bangkok, Thailand, adopted the BangkokCharter for Health Promotion. The WHO Executive Boardat its 117th session held in January 2006, also reviewed theprogress of work on health promotion including work relatedto the Bangkok Charter, and submitted a resolution to the59th WHA (Resolution EB117.R9).

(13) The Bangkok Charter confirms the need to focus on healthpromotion actions to address the determinants of health. Italso expands the five action areas identified in the OttawaCharter, and encourages stakeholders in all sectors andsettings to: (a) advocate for health based on human rightsand solidarity; (b) invest in sustainable policies, actions andinfrastructure to address the determinants of health; (c) buildcapacity for policy development, leadership, healthpromotion practice, knowledge transfer and research, andhealth literacy; (d) regulate and legislate to ensure a highlevel of protection from harm and enable equal opportunityfor health and well-being for all people; and (e) partner andbuild alliances with public, private, nongovernmental andinternational organizations and civil society to createsustainable actions.

(14) The Bangkok Charter also identifies four commitmentsessential for implementing health promotion by MemberStates and other partners, to make health promotion: (a)central to the global development agenda; (b) a coreresponsibility for all of government; (c) a key focus ofcommunities and civil society; and (d) a requirement forgood corporate practice. The policy actions andcommitments contained in the Bangkok Charter form thenucleus of the strategic directions for this Regional Strategy.

Promoting active and healthyageing through physical

activities.


Regional Strategy for Health PrRegional Strategy for Health PrRegional Strategy for Health PrRegional Strategy for Health PrRegional Strategy for Health Promotionomotionomotionomotionomotionfor South-East Asiafor South-East Asiafor South-East Asiafor South-East Asiafor South-East Asia

(15) In order for the countries of SEAR to translate the gains in lifeexpectancy seen over the past decades into improved qualityof life for the general population, concerted efforts are neededin addressing the determinants of health, particularly thosecontributing to premature death and illness due tocommunicable and noncommunicable diseases, and new threatsto health.

(16) The Regional Strategy for Health Promotion for South-EastAsia identifies the strategic directions that should address multi-sectoral and interdisciplinary needs of countries as well as beingapplicable throughout the health systems, namely, at thepreventive, curative, promotive and rehabilitation levels.Ultimately, implementation of the strategic directions shouldinvest available financial and technical resources in interventionsthat utilize the settings-based approach as these are likely toaddress comprehensively, the needs of individuals andcommunities in places were individuals live, play and work.The strategy also requires technical and financial support ofWHO and other partners, in addition to the active involvementand commitment of Member States to implement the strategicdirections identified.

(17) The Regional Strategy would provide a framework for countriesof the Region to build a critical mass of human resources forhealth promotion, drawn from health and non-health disciplines,public/private sector, civil society groups and communities toimplement multi-sectoral and multi-disciplinary interventionsat all levels of society, support planning and implementation ofhealthy lifestyle activities and health-supportive environmentsto address the determinants of health and other threats to healthacross sectors and settings. It seeks to provide direction toMember States and partners for addressing determinants ofhealth including new threats to health in order to reducemorbidity and premature mortality, and ultimately, to improvethe quality of life of individuals and communities in the Region.It supports all efforts to implement commitments and actionsrecommended in the Bangkok Charter, adopted at the SixthGlobal Conference on Health Promotion, as well as theattainment of targets set under the Millennium DevelopmentGoals (MDGs).


ObjectivesObjectivesObjectivesObjectivesObjectives(18) The objectives of the Regional Strategy for Health Promotion

for South-East Asia Region are to:

• Guide Member countries of the SEA Region inestablishing, implementing and maintaining adequateinfrastructure, policies, plans of action, legislationsand regulations, and alternative financing andevidence-gathering measures to mitigate the impactof identifiable determinants of health including newthreats to health across population groups;

• Provide mechanisms for supporting the fostering andsustaining of local, regional and global partnerships,alliances and networks towards harnessing newtechnical and financial resources in order to expandmultisectoral collaboration to promote health, and

• Strengthen the capacity to gather evidence, and todesign and implement policies on health promotionefficacy, and to support the utilization of such evidencein making decisions related to policy, advocacy and/or programmes of intervention.

Enhancing the competenciesfor health promotion practices

of programme managers toplan, deliver, monitor and

gather evidence throughworkshops, seminars and

conferences.


Conceptual frameworkConceptual frameworkConceptual frameworkConceptual frameworkConceptual framework(19) Health promotion practice is cross-cutting. As a function

public health intervention, Health promotion makes use ofthree interrelated approaches, namely: (a) issues-basedapproach;1 (b) population-based approach2; and (c) thesettings-based approach3.

(20) The Regional Strategy for Health Promotion for South-EastAsia is aligned to policy actions and commitments containedin the Bangkok Charter for Health promotion. It takes intoconsideration decisions taken at the SEA/RC, EB and WHAas well as being responsive to the Medium-Term StrategicPlan (MTSP) 2008-2013 in order to attain and/or sustaindesired health outcomes among individuals andcommunities. Finally, the Regional Strategy for HealthPromotion for South-East Asia advocate specific actions,namely:

• Integration of existing health promotion activities intohealth programmes across sectors in order to addresscommunicable and non-communicable diseases andnew threats to health such as avian influenza;

• Inter-sectoral collaboration involving communities,civil society groups, government ministries anddevelopment partners in order to address healthdisparities whose solutions are beyond the influenceof the Ministry of Health;

• Imparting health content and skills using information,education and communication (IEC) techniques andinformation, technology and communication (ITC)tools in places where individuals live, work, and playin order to increase awareness and achieve desiredactions;

1 Issues - HIV/AIDS, TB, diabètes, hypertension, cancer, etc.,2 Population - Women, children, elderly or the poor, etc.,3 Settings - Cities, schools, work place, villages, etc.,


• Generating evidence related to the effectiveness ofHealth promotion interventions through research, andmonitoring and evaluation of ongoing and newinterventions; and

• Strengthening the capacity for health promotion acrossthe Organization to develop policies, programmes,plans of action, guidelines, gathering of evidence, andestablishing innovative and sustainable financingmechanisms for health promotion activities.

Building the health promotioncompetencies for both the

health and non-healthprofessionals through

strengthening of training andcurriculum pertaining to

pre-service, in-service andcontinuing education.


Strategic directionsStrategic directionsStrategic directionsStrategic directionsStrategic directions

Infrastructure for coorInfrastructure for coorInfrastructure for coorInfrastructure for coorInfrastructure for coordination and managementdination and managementdination and managementdination and managementdination and management(21) There should be an established and sustained infrastructure

in each country to coordinate and manage health promotionactivities across sectors and administrative levels in thecountry. The technical and managerial capacity for healthpromotion should be composed of an interdisciplinary staff.Most ministries of health have a unit, a section or a centrefor health education, sometimes at the level of a Directorate.A few countries have changed such unit/section/centre tohealth promotion, but almost all of them are functioning asthe IEC arm of the Ministry. There should be clearlydelineated roles and responsibilities for the coordinationand management team and also an adequate budget andother technical resources in order to effectively supporthealth promotion in the country.

(22) Selected specific roles and responsibilities should includebut not be limited to:

PrPrPrPrProviding guidanceoviding guidanceoviding guidanceoviding guidanceoviding guidance regarding policy andprogrammatic issues across sectors and settings, inorder to manage the changing environment related toimplementing of the regional and global strategiesfor health promotion;

Responding to emerResponding to emerResponding to emerResponding to emerResponding to emergencies in a timely mannergencies in a timely mannergencies in a timely mannergencies in a timely mannergencies in a timely manner andalso with adequately planned health promotioninter ventions, e.g., risk communication andcommunity mobilization;

Creating and sustaining a supportive envirCreating and sustaining a supportive envirCreating and sustaining a supportive envirCreating and sustaining a supportive envirCreating and sustaining a supportive environmentonmentonmentonmentonmentconducive to planning, implementation and evaluationof health promotion activities; and,

Ensuring coorEnsuring coorEnsuring coorEnsuring coorEnsuring coordination and management of healthdination and management of healthdination and management of healthdination and management of healthdination and management of healthprprprprpromotion activities supportedomotion activities supportedomotion activities supportedomotion activities supportedomotion activities supported by sound policies,legislation and financial resources in order to respondto the multi-sectoral health promotion demands andexpectations.


Capacity buildingCapacity buildingCapacity buildingCapacity buildingCapacity building(23) Health promotion is an emerging discipline that requires

leadership for policy development, health promotionpractice, content and skill base, research and documentation,knowledge transfer and health literacy. Building nationalcapacity for health promotion is critical if countries are torealize the expected outputs. Till date, not many countriesin the Region have undergraduate and graduate training inhealth education, less on health promotion. Even where theyexist, many cater only to a handful of people. Except for afew institutions in India, Sri Lanka and Thailand, the trainingin health education has not been revised to incorporate skill-based health promotion modules.

(24) In this context, the Regional Strategy should encourageMember States to (a) ensure that a critical mass of trainedand qualified health promotion professionals exist in thecountry to address the multiple socio-cultural andbehavioural issues across sectors and population groups;(b) ensure that both health and non-health practitionersreceive under-graduate, graduate, and pre-and in-servicetraining in health promotion from competent trainers/teaching institutions in the country or outside the country;(c) allocate adequate financial and technical support toinstitutions of learning that are offering health promotion,in order to be able to allow these institutions to meet nationaldemands for health promotion workforce; and (d) availfellowships and/or scholarships for qualified nationals toundertake training in health promotion including thoseseeking advanced training outside the country.

Regulations and legislationRegulations and legislationRegulations and legislationRegulations and legislationRegulations and legislation(25) In order to ensure reduction of tobacco use and to have a

high level of protection from harm through consumableproducts, and to guarantee equal access to health and socialservices for all people, there must be legislation, regulationsand mechanisms for enforcement in the country. Nine ofthe 11 countries of the Region are the contracting Partiesto the WHO Framework Convention for Tobacco control(FCTC). Many countries have also adopted legislative

Responding to the threats ofavian influenza through

behaviour changeinterventions.


measures to reduce harm from use of alcohol. A fewcountries have drawn up a framework to implement the WHOGlobal Strategy on Diet, Physical Activity and Health.

(26) The role of government in promoting health throughlegislation and regulations should be to (a) introduce publiclegislation, policies and regulations that promote, supportand protect health of all citizens as well as establishmechanisms for enforcement with special attention onprotecting vulnerable groups such as women, children andthe elderly; and (b) ensure that existing strategies, legislationand policies regarding economic and social developmentare revised and re-aligned in order to promote, protect andsupport health, as well as remove ambiguity in interpretationand enforcement.

Partnership, alliances and networksPartnership, alliances and networksPartnership, alliances and networksPartnership, alliances and networksPartnership, alliances and networks(27) Partnership for health promotion plays an essential part in

resource mobilization and advocacy. The Ministry of Healthstands to benefit significantly in terms of other partnersjoining to support its work in the form of financial supportor human resource support or other forms of support.Parliamentarians of India were sensitized through a healthpromotion workshop and health checkup. Employees of theministry of health were screened for diabetes and a healthylifestyle centre was established in the premises of the healthministry. These advocacy efforts helped to raise the level ofawareness and commitment for health promotion in India.In Sri Lanka, the Sri Lanka Medical Association is workingwith the Ministry of Health through the Diabetes Taskforceto develop capacity building for health professionals inprevention and control of diabetes at the community level.

(28) In that regard, the regional strategy should seek to: (a)encourage Member States to create and sustain a politicaland economic environment conducive to initiating andmaintaining partnership, alliances or networks withnongovernmental organizations, private and publicstakeholders, local and international development partnersfor purposes of mobilizing financial and technical resourcesfor promoting health; (b) designate the coordinating rolefor establishing partnership, alliances and networks to the


Ministry of Health in order to avoid duplication and conflictwhich could result in wasting limited resources; (c) encouragethe participation of various players in forming partnershipsand networks for promoting health at different levelsincluding institutions of public health, private organizations,nongovernmental organizations, civil society groups andcommunity-based groups.

(29) The private sector and civil society groups should workclosely together in promoting health in order to reward goodbusiness practices and keep in check bad business practices.The private sector should return to the community some ofits profits in the form of support to grassroots initiatives topromote health. Community projects that target youngpeople or women are popular with communities andpoliticians and are likely to yield positive community relations.

Evidence for health prEvidence for health prEvidence for health prEvidence for health prEvidence for health promotionomotionomotionomotionomotion(30) While the utility of health promotion is widely acknowledged,

there is still a need to continue to demonstrate and documentthe evidence in order to close the gap between practice andevidence and to justify the allocation of resources. It isessential that a mechanism for gathering evidence as well asanalysis, documentation and dissemination is establishedand sustained to assess the performance of various aspectsof the Regional Strategy e.g., health promotion policies,programmes, infrastructure, investments or capacity building.

(31) The Strategy should recommend to: (a) monitorsystematically health promotion policies, programmes,infrastructure and investments related to health promotion;(b) establish indicators and expected products based onhealth promotion objectives for planned activities includingtechnical and financial support; (c) document all evidenceand disseminate it among local, regional and globalstakeholders; and promote the utilization of the evidenceby practitioners and policy makers in making informedprogrammatic and policy decisions including allocation ofresources or future programme direction.

Creating awareness andadvocating for policies and

legislations in order to reducethe risk factors associated

with noncommunicablediseases.


Social mobilization and advocacySocial mobilization and advocacySocial mobilization and advocacySocial mobilization and advocacySocial mobilization and advocacy(32) In order for health promotion to remain high on the global

and national agenda, there is a need to involve variousstakeholders to demand health. Social mobilization andadvocacy uses multiple approaches to increase publicawareness and interest in health. In order to ensure effectivecommunication, the actions being advocated for are oftenconveyed through the use of mass media and group mediachannels of communication in the language preferred bythe target audience.

(33) The Strategy encourages: (a) the participation of intendedbeneficiaries and other stakeholders in advocating for health;(b) advocating for the integration of health promotion acrosssectors and settings; (c) the involvement of high profilecitizens and international celebrities to become healthpromotion ambassadors for purposes of lobbyinggovernment officials and private corporations.

(34) The consumers and beneficiaries of public health services,that is, individuals, families and communities and civil societygroups, should be involved throughout all phases of healthpromotion activities, in order for them to gain greater controlover decisions and actions affecting their health. In thatregard, it is essential that individuals, communities and civilsociety groups participate in the setting of standards andnorms of production and distribution of consumableproducts as well as policies, strategies, legislation andregulations and information aimed at promoting health. It isessential to ensure the participation of all people in all aspectsof promoting health irrespective of age, gender, ethnicity,religious or cultural beliefs and values, among others.

(35) Civil society groups and other community-based groupsshould empower individuals, families and communities todemand for and have access to information and servicesthat promote health in various sectors and settings. Theformation of a functional partnership and alliance betweenMember States and the private sector, health promotionprofessional associations, and civil society and consumergroups, should be facilitated for the purpose of buildingcapacity for additional financial and technical resources topromote, support and protect health.


(36) The strategy should promote grassroots communityinitiatives by civil society groups and local and internationalnongovernmental organizations in health settings e.g.schools, “wet” and food markets, hospitals, clinics, villages,workplaces or youth centres, and to use these as “BestPractice Models” to demonstrate evidence for healthpromotion.

Financing health prFinancing health prFinancing health prFinancing health prFinancing health promotionomotionomotionomotionomotion(37) Health promotion activities are not spared from competing

for the limited budget of national or regional healthadministrations. Despite the fact that health promotion isan essential public health function, and any expenditure onhealth promotion is considered a justifiable investment, theseactivities often receive inadequate financial supportcompared to the demand placed upon it.

(38) Thailand adopted the “Health Promotion Act” in 2000 inorder to have sustainable financing for health promotion,through the use of dedicated taxation from sales of tobaccoand alcohol, managed by an autonomous body called, theThailand Health Promotion Foundation or ThaiHealth. Nepaladopted a similar legislation a few years ago but the dedicatedtaxation on cigarettes has to be used for the national CancerHospital. In Sri Lanka, new legislation for the establishmentof a National Tobacco and Alcohol Authority has beendiscussed in Parliament since 1994.

(39) The Regional Strategy, therefore, encourages Member Statesto: (a) request each sector or ministry to allocate adequatefinancial resources for supporting health promotion activities;(b) create and maintain a functional partnership with theprivate sector and donors including UN agencies in orderto mobilize extra-budgetary resources; (c) consider exploringthe possibility of establishing a Health Promotion Foundationalong the lines of ThaiHealth or a similar arrangement.Member States need to allocate adequate financial andtechnical resources to support and sustain the various healthpromotion strategy activities across sectors and settings.Where the national budget is not adequate to support healthpromotion activities, there is a need for Member States toconsider alternative funding sources e.g., the setting up ofa Health Promotion Fund using special taxes.

Involving both health andnon-health professionals, aswell as the civil society and

communities to promotehealth across sectors.


Management of changeManagement of changeManagement of changeManagement of changeManagement of change(40) The Regional Strategy also calls upon Member countries to

make Health promotion a core responsibility for the entiregovernment, key focus of communities and civil society, anda requirement for good corporate practice. This transitionfrom “Health education” to “Health promotion” approachesrequire concerted effort to re-orient both health and non-health professionals to adopt multi-sectoral policies andstrategies to promote health.

(41) In the SEA Region, new threats to health such as earthquakesor avian influenza, and neglected diseases such as denguecompete for limited financial and technical resources. Inorder to manage this demand, it is critical that alternativesources of funding be identified at country and regionallevels including considering the use of dedicated tax ontobacco and alcohol.

(42) Health outcome among individuals and communities isdirectly related to socio-cultural, behavioral and economicdeterminants associated with a wide range of risk factors. Inorder to halt or reverse the negative impact of identifiabledeterminants and risk factors, the Regional Strategy supportusing three approaches that cut across all levels of the healthsystem. The three distinct approaches that should beincorporated are:

The settings apprsettings apprsettings apprsettings apprsettings approachoachoachoachoach, which is associated withpromoting healthy settings, e.g. healthy cities, villages,islands, districts, workplaces, markets, schools andhospitals, among others,

The population-based apprpopulation-based apprpopulation-based apprpopulation-based apprpopulation-based approachoachoachoachoach, which seeks topromote healthy populations, e.g. children,adolescents, women, the elderly and workers, etc.,and

The issues-based apprissues-based apprissues-based apprissues-based apprissues-based approachoachoachoachoach, which promotes healthypractices on specific issues to address major, commonrisk factors in the areas of diet and nutrition, tobacco,physical activity, injury prevention, safe sex, patientsafety and food safety, among others.


(43) It is therefore essential that both Member States and otherpartners including WHO should:

(a) Formulate plans to respond and manage newchallenges in health promotion including capacitybuilding in order to re-orient health and non-healthprofessionals, financial and technical resources,controversial issues and organized resistance oropposition to health promotion;

(b) Establish mechanisms for evidence gathering,documentation and dissemination for use in policydevelopment, advocacy and programme direction;

(c) Provide technical support to establish norms,standards, guidelines and competencies for Healthpromotion professionals including those affiliated withcivil society groups, NGOs, the private sector orinternational organizations.

Promoting recreational andvoluntary community services

among the elderly as part ofhealthy lifestyles.


Role of Member StatesRole of Member StatesRole of Member StatesRole of Member StatesRole of Member States(44) Promoting health should not be left to the Ministry of Health

alone. Member States are encouraged to embrace a “whole-of-government approach” in order to promote health throughmulti-sectoral and multi-disciplinary collaboration. Existingnational planning and economic development policies andstrategies should be reviewed to ensure that healthpromotion is integrated into national development plans inorder to tackle the determinants of health associated withpremature deaths and morbidity. Ultimately, it is critical thatMember States make adjustments to current health andeconomic policies, strategies, approaches and resourcemobilization in order to align them to health promotion.

(45) Governments need to ensure that policies and strategiesthat seek to promote, support and protect health of thegeneral population reflect national aspirations and prioritiesincluding views from civil society groups, communities, theprivate sector and development partners.


Role of WHORole of WHORole of WHORole of WHORole of WHO(46) In order for Member States of the South-East Asia Region

to successfully implement the Regional Strategy, WHOshould:

• Continue to advocate for renewed and sustainedpolitical commitment at the highest level to healthpromotion.

• Strengthen the capacity for health promotion acrossthe Organization in the Region to provide bettersupport to Member States.

• Facilitate the establishment of innovative andsustainable financing mechanisms for health promotionat country and regional levels. There should beadequate human and financial resources to buildcapability for policy development, programmes, plansof action, guidelines, and evidence gathering anddocumentation.

• Support and sustain the establishment of partnerships,networks and alliances for harnessing additionaltechnical and financial resources for health promotionamong international development partners, includingother UN agencies.

• Facilitate and support the establishment andfunctioning of health promotion knowledge networksin the Region such as WHO Collaborating Centres ora Regional Network for Health Promotion in order tocreate a regional forum for dialogue on regional andglobal health promotion issues.

Placing health promotion highon the national and regionalagenda by convening high-

level meetings involvinggovernment ministeries other

than health.


ConclusionConclusionConclusionConclusionConclusion(47) The Regional Strategy takes into consideration historical

developments from Alma-Ata (1978), Ottawa Charter(1986) and Bangkok Charter for Health promotion (2005).It also incorporates Health promotion Resolutions from theRegional Committee Meetings, Executive Board, the WorldHealth Assembly. In addition, the strategic directions arederived from required actions and recommendedcommitments identified in Bangkok Charter for HealthPromotion.

(48) The aim of the Regional Strategy is to address socialdeterminants of health and risk factors associated withpremature death and ill-health. To achieve this, the Strategyadvocates for the involvement of other players outside thehealth profession including the private sector, civil societygroups and community-based groups.

(49) Ultimately, political will and commitment of the MemberStates to integrate health promotion across sectors, provideadequate resources and to provide an environment conducivefor various players to contribute remain a pre-requisite forsuccess.

(50) A report on the implementation status of the RegionalStrategy for Health Promotion will in presented at the sixty-first session of the Regional Committee in 2008 and duringthe 7th Global Conference for Health Promotion to be heldin Nairobi, Kenya (2009).

(51) If and when deemed necessary, the strategic directions couldbe modified.


AnneAnneAnneAnneAnnexuresxuresxuresxuresxures

AnneAnneAnneAnneAnnex 1:x 1:x 1:x 1:x 1: SEA/RC59/R4: Regional Strategy for HealthSEA/RC59/R4: Regional Strategy for HealthSEA/RC59/R4: Regional Strategy for HealthSEA/RC59/R4: Regional Strategy for HealthSEA/RC59/R4: Regional Strategy for HealthPrPrPrPrPromotionomotionomotionomotionomotion

The Regional Committee,

Recalling World Health Assembly and Executive Board resolutionsWHA57.16 and EB117.R9 respectively, and its own resolutions SEA/RC32/R6 and SEA/RC40/R3, as well as the outcomes of the fiveinternational conferences on health promotion, all of which called forstrengthening of health promotion through policies, strategies,legislation, partnership and allocation of resources, and by engagingcommunities.

Noting with satisfaction the active involvement of Member States of theRegion durinig the Sixth Global Conference on Health Promotion heldin Bangkok in August 2005, and having considered the follow-up onpolicy actions and commitments agreed to in the Bangkok Charter forHealth Promotion in Globalized World, and

Confirming the priority need to address social and other determinantsof health and the major common risk factors associated with preventablecauses of premature death and illness due to communicable and non-communicable diseases among the people of the Region through healthpromotion.

(1) URGES Member States:

(a) to consider health promotion as a core responsibility,central to the national and global developmentagendas; recognize the need for increasinginvestments in health promotion; establish mechanismsfor concerted efforts and foster active engagement ofcivil society, professional bodies, the private sectorand non-governmental organizations;

(b) to strengthen capability for planning, coordination,management and implementation of comprehensiveand multisectoral health promotion policies andprogrammes and to document evidence of effective

Strengthening the capacity ofprogramme managers to

coordinate and manage healthpromotion activities across

sectors.


health promotion interventions at national and locallevels, in order to facilitate development of effectivepolicies, and

(c) to adopt alternative, innovative and sustainable sourcesof financing for health promotion activities, with afirm institutional base for management, and

(2) REQUESTS the Regional Director:

(a) to strengthen the capacity for health promotion acrossthe Organization in the Region to provide bettersupport to Member States;

(b) to facilitate the establishment of innovative andsustainable financing mechanisms with a firminstitutional base for systematic and effective healthpromotion efforts;

(c) to support Member States with adequate human andfinancial resources to build capacity for developingpolicies, programmes, plans of action, guidelines anddocumentation of evidence, and

(d) to report on the progress of the implementation ofthe Regional Strategy to the sixty-first session of theRegional Committee in 2008.


AnneAnneAnneAnneAnnex 2:x 2:x 2:x 2:x 2: WHA60.24/12.11: WHA60.24/12.11: WHA60.24/12.11: WHA60.24/12.11: WHA60.24/12.11: Health prHealth prHealth prHealth prHealth promotion in aomotion in aomotion in aomotion in aomotion in aglobalized worldglobalized worldglobalized worldglobalized worldglobalized world

The Sixtieth World Health Assembly,

Recalling resolutions WHA42.44 on health promotion, publicinformation and education for health, WHA51.12 on health promotion,WHA57.16 on health promotion and healthy lifestyles, and the outcomesof the six international conferences on health promotion (Ottawa, 1986;Adelaide, Australia, 1988; Sundsvall, Sweden, 1991; Jakarta, 1997;Mexico City, 2000; Bangkok, 2005);

Having considered the report on follow-up to the 6th GlobalConference on Health Promotion (Bangkok in 2005), which confirmsthe need to focus on health promotion actions to address thedeterminants of health;

Drawing on the Declaration of Alma-Ata, the Ottawa Charter forHealth Promotion, and the Bangkok Charter for Health Promotion in aGlobalized World which sets out strategic directions for equitable healthimprovement in the first decades of the twenty-first century;

Considering the actions and recommendations set out in the BangkokCharter for Health Promotion in a Globalized World to make thepromotion of health central to the global development agenda, a coreresponsibility for all governments and a key focus of communities, civilsociety, and the private sector;

Noting that health promotion is essential for meeting the targets ofthe internationally agreed health-related development goals, includingthose contained in the Millennium Declaration, is intimately related tothe work of WHO’s Commission on Social Determinants of Health, andmakes an important contribution to realizing the objectives of theEleventh General Programme of Work;

Recognizing that the dramatic changes of the global burden ofdisease, notably due to noncommunicable diseases, require greaterattention, and call for adjustments in society at large and in resourceallocation in order to tackle the immediate and underlying determinantsof health;

Creating public awareness onand advocating for protecting

human health from climatechange.


Recognizing that health promotion contributes to the achievementof health for all;

Confirming the importance of addressing also the wider determinantsof health, and of implementing recommendations on, and undertakingaction for, health for all,

1. URGES all Member States:

(1) to increase, as appropriate, investments in, and to framesound policies for, health promotion as an essentialcomponent of equitable social and economic development;

(2) to establish, as appropriate, effective mechanisms for amultisectoral, including interministerial, approach in orderto address effectively the social, economic, political andenvironmental determinants of health throughout the life-course;

(3) to support and foster the active engagement in healthpromotion of communities, civil society, especially peopleor groups making positive contributions, the public includingprofessional and labour unions, businesses and associations,bodies, especially those involved in public health and healthpromotion, while avoiding any possible conflict of interestand promoting constructive engagement for mutual benefit;

(4) systematically to monitor, evaluate and improve health-promotion policies, programmes, infrastructure andinvestment, on a regular basis, including consideration ofthe use of health-impact assessments, to report results insolving problems related to health promotion and topublicize and use those results in the planning process;

(5) to reorient national public health systems towards thepromotion and adoption of healthier lifestyles by individuals,families and communities;

(6) to introduce into current practices effective, evidence-basedhealth promotion interventions;

(7) that have successfully implemented a national public healthpolicy, within which health promotion is the key to modifyingthe determinants of health, effectively to transfer theirexpertise to those countries that are stil l in theimplementation phase;


2. REQUESTS the Director-General:

(1) to strengthen the capacity for health promotion across theOrganization in order to provide better support to MemberStates by advancing knowledge and the active engagementof other appropriate organizations of the United Nationssystem and international organizations;

(2) to provide support to Member States in their continuousefforts to strengthen national health systems with a specialfocus on the primary health sector, in order to enhance theability to tackle serious threats to health;

(3) to optimize use of existing forums of Member States formultisectoral, including interministerial stakeholders,interested organizations and other bodies, while avoidingany possible conflict of interest, in order to support thedevelopment and implementation of health promotion;

(4) to encourage the convening of national, subregional, regionaland global multisectoral conferences on health promotionon a regular basis;

(5) to monitor and evaluate progress, to identify majorshortcomings in health promotion globally, and to reporton a regular basis and make the reports accessible to thepublic;

(6) to facilitate exchange of information with internationalnonhealth forums on key aspects of health promotion;

(7) to advocate political and socioeconomic policies that impactpositively on health;

(8) to report to the Sixty-first World Health Assembly, throughthe Executive Board, on progress in implementing thisresolution.

Eleventh plenary meeting, 23 May 2007A60/VR/11


AnneAnneAnneAnneAnnex 3:x 3:x 3:x 3:x 3: The BangkThe BangkThe BangkThe BangkThe Bangkok Charter for Health Prok Charter for Health Prok Charter for Health Prok Charter for Health Prok Charter for Health Promotion omotion omotion omotion omotion ininininina Globalized Wa Globalized Wa Globalized Wa Globalized Wa Globalized Worldorldorldorldorld

IntrIntrIntrIntrIntroductionoductionoductionoductionoduction

ScopeScopeScopeScopeScope The Bangkok Charter identifies actions, commitmentsand pledges required to address the determinants ofhealth in a globalized world through health promotion.

PurposePurposePurposePurposePurpose The Bangkok Charter affirms that policies andpartnerships to empower communities, and to improvehealth and health equality, should be at the centre ofglobal and national development.

The Bangkok Charter complements and builds uponthe values, principles and action strategies of healthpromotion established by the Ottawa Charter for HealthPromotion and the recommendations of the subsequentglobal health promotion conferences which have beenconfirmed by Member States through the World HealthAssembly.

AAAAAudienceudienceudienceudienceudience The Bangkok Charter reaches out to people, groupsand organizations that are critical to the achievementof health, including:

• governments and politicians at all levels

• civil society

• the private sector, and

• international organizations.

• Public health community

HealthHealthHealthHealthHealth The United Nations recognize that the enjoyment ofprprprprpromotionomotionomotionomotionomotion the highest attainable standard of health is one of the

fundamental rights of every human being withoutdiscrimination.Health promotion is based on this critical human rightand offers a positive and inclusive concept of health asa determinant of the quality of life and encompassingmental and spiritual well-being.Health promotion is the process of enabling people toincrease control over their health and its determinants,


and thereby improve their health. It is a core functionof public health and contributes to the work of tacklingcommunicable and noncommunicable diseases andother threats to health.

AAAAAddressing the determinants of healthddressing the determinants of healthddressing the determinants of healthddressing the determinants of healthddressing the determinants of healthChangingChangingChangingChangingChanging The global context for health promotion has changedcontecontecontecontecontextxtxtxtxt markedly since the development of the Ottawa Charter.

CriticalCriticalCriticalCriticalCritical Some of the critical factors that now influence healthfactorsfactorsfactorsfactorsfactors include:

• Increasing inequalities within and between countries

• New patterns of consumption and communication

• Commercialization

• Global environmental change, and

• Urbanization

FFFFFurtherurtherurtherurtherurther Other factors that influence health include rapid andchallengeschallengeschallengeschallengeschallenges often adverse social, economic and demographic

changes that affect working conditions, learningenvironments, family patterns, and the culture and socialfabric of communities.

Women and men are affected differently and thevulnerability of children and exclusion of marginalized,disabled and indigenous peoples have increased.

NewNewNewNewNew Globalization opens up new opportunities foropportunitiesopportunitiesopportunitiesopportunitiesopportunities cooperation to improve health and reduce transnational

health risks; these opportunities include:

• enhanced information and communicationstechnology, and

• improved mechanisms for global governance andthe sharing of experiences

PPPPPolicyolicyolicyolicyolicy To manage the challenges of globalization, policy mustcoherencecoherencecoherencecoherencecoherence be coherent across all:

• Levels of governments

• United Nations bodies, and


• Other organizations, including the private sector.

This coherence will strengthen compliance, transparencyand accountability with international agreements andtreaties that affect health.

PrPrPrPrProgress madeogress madeogress madeogress madeogress made Progress has been made in placing health at the centreof development, for example through the MillenniumDevelopment Goals, but much more remains to beachieved; the active participation of civil society is crucialin this process.

Strategies for health prStrategies for health prStrategies for health prStrategies for health prStrategies for health promotion in a globalized worldomotion in a globalized worldomotion in a globalized worldomotion in a globalized worldomotion in a globalized worldEffectiveEffectiveEffectiveEffectiveEffective Progress towards a healthier world requires stronginterinterinterinterinterventionsventionsventionsventionsventions political action, broad participation and sustained

advocacy.

Health promotion has an established repertoire ofproven effective strategies which need to be fullyutilized.

RequiredRequiredRequiredRequiredRequired To make further advances in implementing theseactionsactionsactionsactionsactions strategies, all sectors andsettings must act to:

• advocate advocate advocate advocate advocate for health based on human rights andsolidarity

• invest invest invest invest invest in sustainable policies, actions andinfrastructure to address the determinants of health

• build capacity build capacity build capacity build capacity build capacity for policy development, leadership,health promotion practice, knowledge transfer andresearch, and health literacy

• regulate and legislate regulate and legislate regulate and legislate regulate and legislate regulate and legislate to ensure a high level ofprotection from harm and enable equal opportunity

for health and well-being for all people

• partner and build alliances partner and build alliances partner and build alliances partner and build alliances partner and build alliances with public, private,nongovernmental and international organizationsand civil society to create sustainable actions.


Commitments to Health for AllCommitments to Health for AllCommitments to Health for AllCommitments to Health for AllCommitments to Health for AllRRRRRationaleationaleationaleationaleationale The health sector has a key role to provide leadership

in building policies and partnerships for healthpromotion.

An integrated policy approach within government andinternational organizations, and a commitment toworking with civil society and the private sector andacross settings, are essential to make progress inaddressing the determinants of health.

KKKKKeyeyeyeyey The four key commitments are to make the promotioncommitmentscommitmentscommitmentscommitmentscommitments of health:

• central to the global development agenda

• a core responsibility for all of government

• a key focus of communities and civil society

• a requirement for good corporate practice

1. Mak1. Mak1. Mak1. Mak1. Make thee thee thee thee the Strong intergovernmental agreements that increaseprprprprpromotion ofomotion ofomotion ofomotion ofomotion of health and collective health security are needed.health centralhealth centralhealth centralhealth centralhealth central Government and international bodies must act to closeto the globalto the globalto the globalto the globalto the global the health gap between rich and poor. Effectivedevelopmentdevelopmentdevelopmentdevelopmentdevelopment mechanisms for global governance for health are

required to address all the harmful effects of:

• Trade

• Products

• Services, and

• Marketing strategies.

Health promotion must become an integral part ofdomestic and foreign policy and international relations,including in situations of war and conflict.

This requires actions to promote dialogue andcooperation among nation states, civil society, and theprivate sector. These efforts can build on the exampleof existing treaties such as the World HealthOrganization Framework Convention for TobaccoControl.


2. Mak2. Mak2. Mak2. Mak2. Make thee thee thee thee the All governments at all levels must tackle poor healthprprprprpromotion ofomotion ofomotion ofomotion ofomotion of and inequalities as a matter of urgency because healthhealth a corehealth a corehealth a corehealth a corehealth a core determines socio-economic and political development.responsibilityresponsibilityresponsibilityresponsibilityresponsibilityfor all offor all offor all offor all offor all of Local, regional and national governments must:governmentgovernmentgovernmentgovernmentgovernment • give priority to investments in health, within and

outside the health sector• provide sustainable financing for health promotion.

To ensure this, all levels of government should makethe health consequences of policies and legislationexplicit, using tools such as equity focussed healthimpact assessment.

3. Mak3. Mak3. Mak3. Mak3. Make thee thee thee thee the Communities and civil society often lead in initiating,prprprprpromotion ofomotion ofomotion ofomotion ofomotion of shaping and undertaking health promotion. They needhealth a khealth a khealth a khealth a khealth a keyeyeyeyey to have the rights, resources and opportunities so thatfocus of com-focus of com-focus of com-focus of com-focus of com- their contributions are amplified and sustained. In lessmunities andmunities andmunities andmunities andmunities and developed communities, support for capacity buildingcivil societycivil societycivil societycivil societycivil society is particularly important.

Well organized and empowered communities are highlyeffective in determining their own health, and are capableof making governments and the private sectoraccountable for the health consequences of their policiesand practices.

Civil society needs to exercise its power in themarketplace by giving preference to the goods, servicesand shares of companies that exemplify corporate socialresponsibility.

Grass-roots community projects, civil society groups,and women’s organizations have demonstrated theireffectiveness in health promotion, and provide modelsof practice for others to follow.

Health professional associations have a specialcontribution to make.


4. Mak4. Mak4. Mak4. Mak4. Make thee thee thee thee the The corporate sector has a direct impact on the healthprprprprpromotion ofomotion ofomotion ofomotion ofomotion of of people and on the determinants of health throughhealth ahealth ahealth ahealth ahealth a its influence on:requirement forrequirement forrequirement forrequirement forrequirement forgood corporategood corporategood corporategood corporategood corporatepracticepracticepracticepracticepractice • local settings

• national cultures

• environments, and

• wealth distribution.

The private sector, like other employers and the informalsector, has a responsibility to ensure health and safetyin the workplace, and to promote the health and well-being of their employees, their families and communities.

The private sector can also contribute to lessening widerglobal health impacts, such as those associated withglobal environmental change by complying with localnational and international regulations and agreementsthat promote and protect health. Ethical and responsiblebusiness practices and fair trade exemplify the type ofbusiness practice that should be supported byconsumers and civil society, and by governmentincentives and regulations.

A Global Pledge to MakA Global Pledge to MakA Global Pledge to MakA Global Pledge to MakA Global Pledge to Make it Happene it Happene it Happene it Happene it HappenAll for healthAll for healthAll for healthAll for healthAll for health Meeting these commitments requires better application

of proven strategies, as well as the use of new entrypoints and innovative responses.

Partnerships, alliances, networks and collaborationsprovide exciting and rewarding ways of bringing peopleand organizations together around common goals andjoint actions to improve the health of populations.

Each sector – intergovernmental, government, civilsociety and private – has a unique role and responsibility.


Closing theClosing theClosing theClosing theClosing the Since the adoption of the Ottawa Charter, a significantimplementationimplementationimplementationimplementationimplementation number of resolutions at national and global level havegapgapgapgapgap been signed in support of health promotion, but these

have not always been followed by action. Theparticipants of this Bangkok Conference forcefully callon Member States of the World Health Organizationto close this implementation gap and move to policiesand partnerships for action.

Call forCall forCall forCall forCall for Conference participants request the World Healthactionactionactionactionaction Organization, in collaboration with others, and its

Member States, to allocate resources for healthpromotion, initiate plans of action and monitorperformance through appropriate indicators and targets,and to report on progress at regular intervals. UnitedNations organizations are asked to explore the benefitsof developing a Global Treaty for Health.

WWWWWorldwideorldwideorldwideorldwideorldwide This Bangkok Charter urges all stakeholders to join in apartnershippartnershippartnershippartnershippartnership worldwide partnership to promote health, with both

global and local engagement and action.

Commitment toCommitment toCommitment toCommitment toCommitment to We, the participants of the 6th Global Conferenceimprimprimprimprimprove healthove healthove healthove healthove health on Health Promotion in Bangkok, Thailand, pledge to

advance these actions and commitments to improvehealth.

11 August 2005

Note: This charter contains the collective views of an international groupof experts, participants to the 6th Global Conference on HealthPromotion, Bangkok, Thailand, August, 2005, and does notnecessarily represent the decisions or the stated policy of the WorldHealth Organization.

Documents

Regional Strategy for Health Promotion for South …apps.searo.who.int/pds_docs/B3147.pdfRegional Strategy for Health Promotion for South-East Asia This Regional Strategy for Health