Overview

The urgency of health promotion

Health and development today face unprecedented threats. The financial crisis threatens the viability of national economies in general and of health systems in particular. Global warming and climate change exert a toll in human life, especially in lower income countries. Security threats create a sense of shared uncertainty for communities around the world.

These new challenges compound the development problems which have yet to be solved. And as the internationally agreed development goals appear increasingly unattainable, newer threats are being recognized: the inexorable growth of noncommunicable conditions in low and middle-income economies, and the threat of potentially catastrophic pandemics.

As the aspirations of global health are falling short of the achievable, the burden of ill-health is increasingly recognized to be inequitably distributed, between and within countries.

In this context, health promotion has never been more timely or more needed. Over the period from the Ottawa Conference
(1986) through the six global conferences to Bangkok (2005), a large body of evidence and experience has accumulated about the importance of health promotion as an integrative, cost-effective strategy, and as an essential component of health systems primed to respond adequately to these emerging concerns.

A global conference

The world now needs to implement the lessons of the past two decades. Multiple charters, declarations and resolutions endorse the importance of health promotion yet implementation of these resolutions falls short of the commitments. Health promotion will be seen in this conference to be an essential, effective approach in line with the renewal of Primary Health Care as endorsed by the Executive Board of WHO:

• To achieve the agreed international health development goals: in the health arena, the development goals associated with the eradication of poverty include targets on addressing specific diseases like malaria, tuberculosis, HIV/AIDS and broader issues like undernutrition, reproductive, maternal and child health. The urgent need is for these goals to be met, and here health promotion has specific expertise that can accelerate the progress to attainment.
• To address the emergence of noncommunicable diseases, injury, and mental disorders, a group of conditions that are growing at epidemic rates in low and middle income countries. They cause over 60% of the world’s mortality and lead the rankings in terms of preventable disability. Furthermore, health systems often lack the mechanisms for sustainable funding of health promotion, even as they buckle under the increasing costs of the growing burden of noncommunicable conditions.
• To tackle the issue of inequities in the distribution of health by gender, social class, income level, ethnicity, education, occupation, and other categories. Development goals should explicitly promote an approach that fosters equity, or fairness of distribution across the divides of social structure as part of the renaissance in the Primary Health Care movement.

Meeting these challenges cannot be reduced to a technical problem, for example, of finding cases of a specific disease and treating them. These are also significant political challenges. How to ensure that development policies effectively promote health? How to ensure that the work of all sectors contributes to a healthy policy environment that improves the daily living conditions of disadvantaged populations? How can civil society itself help hold governments and international agencies accountable for their impact on health? How can societies promote positive health and offer social protection? Where, in all this, is the role of the private sector?

The implementation gap

There are three major gaps in the health and development effort that have to be effectively addressed:

• the gap in health programmes where the evidence about good health promotion practice could be more effectively incorporated
• the gap in policy-making and intersectoral partnerships where the social determinants of health, or the inequitable health impacts, have not been considered and
• the gap in health systems, making the capacity of a health system to promote health itself an indicator of performance.

Mobilizing global champions

The conference aims for a target 250 invited participants who represent a global voice for health promotion and who reflect the political nature of the conference agenda. They will reflect the multi-sectoral nature of health promotion and the challenges being addressed. They will be connectors and multipliers, people who are in a position to influence policy and extend the reach of health promotion at national or international levels. They will include health promotion practitioners and academics, together with:

• high level representatives from bilateral and multilateral development agencies
• national and local level policy-makers and multisectoral teams from developing countries
• representatives of civil society
• representatives from global health programs with an interest in health promotion.

Prior to the conference, and beyond it, a wider web-based consultative process will be set up to garner true global representation and follow-up for the call to action.

The process

The participants will examine the gaps and the role of health promotion in closing them. The discussions, workshops, case studies and plenary sessions will be organized in five main tracks and an Africa Day:

• Community empowerment
• Health literacy and health behavior
• Strengthening health systems
• Partnerships and intersectoral action
• Building capacity for health promotion
• Africa Day

Technical product

A consultation is under way with global health programs, developing a practical package of evidence on health promotion interventions that addresses the top health risks and the conditions with the highest disease burden. This product will be presented to the tracks of the conference and examined in the light of experience from countries, emerging as consolidated, practical guidance for countries.

Call to action

• A political statement that calls for the inclusion of health promotion outcomes within the design of development programs will be drafted through an expert- and Web-based consultation in the months leading up to the conference and will be adopted on the last day of the conference.
• Advocacy for extending the international development goals to include noncommunicable conditions will also proceed in parallel. The possibility of a launch of a Partnership Council on Noncommunicable Diseases is being considered.