Charters, Declarations, World Conferences: Practical Significance for Health Promotion Practitioners ‘on the ground’

Maurice B. Mittelmark, Professor, University of Bergen and President, IUHPE

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We are on the cusp of the twentieth anniversary of the Ottawa Charter for Health Promotion. In 2005 in Bangkok, the World Health Organization will lead a re-examination of the Ottawa Charter, and the Bangkok Charter on health promotion will have be launched. At the International Union for Health Promotion and Education’s global conference in Vancouver in 2007, the Ottawa Charter will again be in the spotlight, as will, for that matter, the new Bangkok Charter.

One might wonder about the need for a new Charter, and what impact such documents have on the practical work of health promotion practitioners, if any. The need for a new Charter is the subject of lively debate at the time of this writing, a sign that the Ottawa Charter continues to have significance, even though the world has changed remarkably in the twenty years since its adoption. Perhaps the best test of the Bangkok Charter’s impact will be the degree of attention it receives in 2025, when the young readers of this book have aged into the vanguard of health promotion leadership.

That still leaves the question of if, and how, the high level political machinations which culminate in health promotion Charters and Declarations have significance for the day-to-day work of health promotion practitioners. For a start, it is clear that health promotion provides common ground for many health professionals, which enhances the quality and effectiveness of cross-discipline team work. Education in health promotion stimulates and enables cross-discipline dialogue, respect, and eagerness for collaboration. Regardless of a health professional’s discipline-specific training, education in health promotion creates bonds with other disciplines. It ensures a high regard for the principles of empowerment and participation. It instils appreciation for the expertise of non-health professionals. It creates commitment to community-based solutions, and to action in community settings. Health promotion’s conferences, continuing education offerings, journals, and newsletters, help maintain the bonds forged in early training.

So, health promotion does have practical significance for health professionals. A vital point is that for health promotion to ‘deliver’ in the ways mentioned, it must have mechanisms of action, it must have infrastructure, and it must have visibility in education, in practice, and in policy arenas. The existence of these essential elements should not be taken for granted. There exists an attractive logic that, since health promotion has relevance to all public health work, it should be diffused in health care systems. To the contrary, health promotion’s distinctiveness requires diligent preservation, in no small part because of its almost unique bridge-building capability.

That claim brings me back full circle, to the question of what relevance health promotion’s high level political processes, and Charters and Declarations, have for allied health professionals. The answer is that if health promotion is to remain vital, and to serve the practical functions described above, it requires periodic illumination, with critical debate. At the very least, global conferences and the Charters and declarations they spawn do illuminate health promotion. They do spark much needed debate. Two outcomes of discussion and debate swirling around the Bangkok conference and the Bangkok Charter can be safely anticipated: affirmation of health promotion’s foundational values, and agreement on the need for ever more innovative health promotion strategies and more effective collaboration in our rapidly changing times.

Note: This text has been adapted slightly, with authorisation from the Publisher and the Editor, from the Preface to: Scriven, A. (ed) (2005) Health Promoting Practice: The Contribution of Nurses and Allied Health Professions. Palgrave, London.  It will also be published in French and Spanish, as well as its original language, in Promotion & Education, Volume XII, Number 1, 2005 (in press).

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