PHA-Exchange> Final Bangkok Charter

[Kumanan Rasanathan]

Dear all

The final Bangkok Charter is now available at:

http://www.who.int/healthpromotion/conferences/6gchp/bangkok_charter/en/index.html

I have also pasted it below. It has changed quite significantly from
previous drafts, so please have a close read of it.

Between PHM members in Bangkok and those of us who have taken a
particular interest in this document, we aim to circulate a draft PHM
press release soon for comment from the list in the next day. Due to
time constraints there will be a 24 hour turnaround on this, so please
look out for this over the weekend if you are interested. We will aim
for a Monday release.

Of course, it would be great to have any comments on the draft itself
posted to the list as soon as possible. 

Kind regards

Kumanan

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The Bangkok Charter for Health Promotion in a globalized world

Introduction

The Bangkok Charter identifies the strategies and commitments that are
required to address the determinants of health in a globalized world
through health promotion. It affirms that policies and partnerships to
empower communities, and to improve health and health equality should
be at the centre of global and national development.

The Bangkok Charter complements and builds upon the values, principles
and action strategies of health promotion established by the Ottawa
Charter for Health Promotion and the recommendations of the subsequent
global health promotion conferences. These are shared by activists and
practitioners around the world and have been confirmed by Member States
through the World Health Assembly.

The Bangkok Charter reaches out to people, groups and organizations
that are critical to the achievement of health. This includes
governments and politicians at all levels, civil society, the private
sector and international organisations.

Health promotion

The United Nations recognize that the enjoyment of the highest
attainable standard of health is one of the fundamental rights of every
human being without discrimination. Health promotion is based on this
critical human right. It offers a positive and inclusive concept of
health as a determinant of the quality of life, and encompasses mental
and spiritual well being. Health promotion is the process of enabling
people to increase control over their health and its determinants, and
thereby improve their health. Health promotion is a core function of
public health and contributes to tackling communicable and
noncommunicable diseases and other threats to health. It is an
effective investment in improving health and human development. It
contributes to reducing both health and gender inequities.

Addressing the determinants of health

The context for health promotion has changed markedly since the
development of the Ottawa Charter. Increasing inequalities within and
between countries, new patterns of consumption and communication,
commercialisation, environmental degradation, and urbanization are some
of the critical factors that influence health. Rapid and often adverse
social change affects working conditions, learning environments, family
patterns and the culture and social fabric of communities. Evolving
patterns of health and demographic transitions have also contributed to
change. Women and men are affected differently by these developments;
the vulnerability of children and exclusion of marginalised, disabled
and indigenous peoples have increased.

Globalization can open up new opportunities for cooperation to improve
health, for example through improved mechanisms for global governance
and enhanced information technology and communication, and sharing of
experiences. Health promotion strategies can address avoidable
transnational health risks by enabling policies and partnerships which
ensure that benefits for health from globalization are maximised and
equitable, and the negative effects are minimised and mitigated.

To manage the challenges of globalisation, policy must be coherent
across all levels of governments, United Nations bodies and other
organizations, including the private sector. This will strengthen
compliance, transparency and accountability with international
agreements and treaties that affect health. The global commitment to
reduce poverty by addressing all of the Millennium Development Goals is
a critical entry point for health promotion action. The active
participation of civil society is crucial in this process. Progress has
been made in placing health at the centre of development, but much more
remains to be achieved.

Strategies for health promotion in a globalized world

Progress towards a healthier world requires strong political action,
broad participation and sustained advocacy. Health promotion has an
established repertoire of proven effective strategies which need to be
fully utilised. To make further advances all sectors and settings must
act to:

Advocate for health based on human rights and solidarity; 
Invest in sustainable policies, actions and infrastructure to address
the determinants of health; 
Build capacity for policy development, leadership, health promotion
practice, knowledge transfer and research, and health literacy; 
Regulate and legislate to ensure a high level of protection from harm
and enable equal opportunity for health and well being for all people; 
Partner and build alliances with public, private, nongovernmental
organizations and civil society to create sustainable actions. 
Commitments to health for all 

Make the promotion of health central to the global development agenda

Government and international bodies must act to close the gap in health
between rich and poor. Strong intergovernmental agreements that
increase health and collective health security need to be in place.
Effective mechanisms for global governance for health are needed to
address all harmful effects of trade, products, services and marketing
strategies. Health promotion must become an integral part of domestic
and foreign policy and international relations, including in situations
of war and conflict. This requires actions to promote dialogue and
cooperation among nation states, civil society, and the private sector.
These efforts can build on the example of existing treaties such as the
World Health Organization Framework Convention for Tobacco Control.

Make the promotion of health a core responsibility for all of
government

Health determines socio-economic and political development. Therefore
governments at all levels must tackle poor health and inequalities as a
matter of urgency. The health sector has a key role to provide
leadership in building policies and partnerships for health promotion.
Responsibility to address the determinants of health rests with the
whole of government, and depends upon actions by many sectors as well
as the health sector. An integrated policy approach within government,
and a commitment to working with civil society and the private sector
and across settings, is essential to make progress in addressing these
determinants. Local, regional and national governments must give
priority to investments in health, within and outside the health
sector, and provide sustainable financing for health promotion. To
ensure this, all levels of government should make the health
consequences of policies and legislation explicit, using tools such as
equity focussed health impact assessment, and intersectoral national or
local health plans.

Make the promotion of health a key focus of communities and civil
society

Communities and civil society often lead in initiating, shaping and
undertaking health promotion. They need to have rights, resources and
opportunities so that that their contributions are amplified and
sustained. Support for capacity building is particularly important in
less developed communities. Well organized and empowered communities
are highly effective in determining their own health, and are capable
of making governments and the private sector accountable for the health
consequences of their policies and practices. Civil society needs to
exercise its power in the marketplace by giving preference to the
goods, services and shares of companies that exemplify corporate social
responsibility. Grass roots community projects, civil society groups,
and women’s organizations have demonstrated their effectiveness in
health promotion, and provide models of practice for others to follow.
Health professional associations have a special contribution to make.

Make the promotion of health a requirement for good corporate practices

The private sector has a direct impact on the health of people and on
the determinants of health through their influence on local settings
and national cultures, environments and wealth distribution. The
private sector, like other employers and the informal sector, has a
responsibility to ensure health and safety in the workplace, and
promote the health and well being of their employees, their families
and communities. They also contribute to wider global health impacts,
such as those associated with global environmental change. The private
sector must ensure that its actions comply with local, national and
international regulations and agreements that promote and protect
health. Ethical and responsible business practices and fair trade
exemplify the type of business practice that should be supported by
consumers and civil society, and by government incentives and
regulations.

A global pledge to make it happen

Meeting these commitments requires better application of existing,
proven strategies, as well as the use of new entry points and
innovative responses. Partnerships, alliances, networks and
collaborations provide exciting and rewarding ways of bringing people
and organizations together around common goals and joint actions to
improve the health of populations. Each sector - government, civil
society and private - has a unique role and responsibility. Progress in
addressing the underlying determinants of health in many cases will
only occur by working together so that resources can be used more
effectively and efficiently to achieve lasting results.

Since the adoption of the Ottawa Charter, a significant number of
resolutions at national and global level have been signed in support of
health promotion, but this has not always been followed by action. The
participants of this Bangkok Conference forcefully call on Member
States and the World Health Organization to close this implementation
gap and move to policies and partnerships for action. This will require
political leadership.

Conference participants expect the World Health Organization, in
collaboration with others, to work with Member States to allocate
resources, initiate a plan of action, monitor performance through
appropriate indicators and targets, and report on progress at regular
intervals. To support this process United Nations organisations are
asked to explore the benefits of developing and implementing a Global
Treaty for Health.

This Bangkok Charter urges everyone to join in a worldwide partnership
to promote health, with both global and local engagement and action.

We, the participants of the 6th Global Conference on Health Promotion
in Bangkok, Thailand, pledge to advance these commitments to improve
health and to advocate for the required resources, policies and
practices.

11 August 2005