Bangkok Charter for Health Promotion in a globalized world”
The Bangkok Charter for Health Promotion in a globalized world
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.
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
Note: This charter contains the collective views of an international group of experts, participants to the 6th Global Conference on Health Promotion, Bangkok, Thailand, August, 2005, and does not necessarily represent the decisions or the stated policy of the World Health Organization.
- Press release: New Bangkok charter for health promotion adopted to address rapidly changing global health issues
- The Ottawa Charter for Health Promotion