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Gramsci, Antoni. Se/ecfibns from the Prison Notebook 12h editions New York : lnternational
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Marx, Cad "The German ldeology" ln Karl Marx : Se/ecfed Writings in Sociology & Social;
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1964.
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48 The Bangkok Charter for Health Promotion in a Globalized World

The Bangkok Gharter for Health Promotion in a Globalized world

Introduction

Scope The Bangkok Charter identifies actions, commitments and pledges

required to address the determinants of health in a globalozed world
through health promotion.

Purpose The Bangkok Charter 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 Chafter for Health Promotion and the recommendations of
the subsequent global health promotion conferences which have
been confirmed by Member States through the World Health
Assembly.

Audience The Bangkok Charter reaches out to people, groups and

organizations that are critical to the achievement of health, including :

a Governments and politicians at all levels

a Civil society
o The private sector, and
a International organizations
a Public health community

Health promotion The United Nations recognize that the enjoyment of the highest
attainable standard of health is one of the fundamental rights of every

luman being without discrimination.

nr:dr!r:orqrt{o{6u: qmrffiflnf{nrrrfunlvrr{qrnrv{ iufi g-s riuuruu 25+8 49

Health promotion is based on this critical human right and offers a

positive and inclusive concept of health as a determinant of the
quality of life and encompassing 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. lt is a core function of public health and contributes to
the work of tacking communicable and noncommunicable diseases
and other threats to health.

Addressing the determinants of health

Changing context The global context for health promotion has changed markedly since
the development of the Oftawa Chafter.

Griticalfactors Some of the critical factors that now influence health include :

o Increasing inequalities within and between countries

o New patterns of consumption and communication
o Commercialization
o Global environmental change, and
o Urbanization

Further Other factors that influence health include rapid and often adverse

Opportunities social, economic and demographic changes that affect working

conditions, learning environments, family patterns, and the culture
and social fabric of communities.

Women and men are affected differently and the vulnerability of

children and exclusion of marginalized, disabled and indigenous

peoples have increased.

50 The Bangkok Charter for Health Promotion in a Globalized World

New Globalization opens up new opportunities for cooperation to improve

opportunities health and reduce transnational health risks; these opportunities

include :

o Enhanced information and communications technology, and

o lmproved mechanisms for global governance and the sharing of
experiences

Policy To manage the challenges of globalization, policy must be coherent

coherence across all :

o Levels of governments
o United Nations bodies, and
o Other organizations, including the private sector.
The coherence will strengthen compliance, transparency and

accountability with international agreements and treaties that affect

health.

Progress made Progress has been made in placing health at the centre of
development,for example through the Millennium Development
Goals, but much more remains to be achieved; the active
participation of civil society is crucial in this process.
nrrdrr15ilqrfiu'ro"u, qntR,arf{nrrrLriun':nr.iqrn1il iufi a-s riuurou z5+a 61

Strategies for health promotion in a globalized world

Effeetive Progress towards a healthier world requires strong political action,

interventions broad participation and sustained advocacy.

Health promotion has an established repertoire of proven effective
strategies which need to be fully utilized.

Required actions these stratesies' arl

''o'"'"ntins
l:",1::1. ."*:Xffi,'i,
r Advocate for health based on human rights and solidarity
r lhvest in sustainable policies, actions and infrastructure to
address the determinants of health
r 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
r Partner and build alliances with public, private, nongovernmental

and international organizations and civil society to create

sustainable actions.

Gommitments of Health for All

Rationale The health sector has a key role to provide leadership in building
policies and partnerships for health promotion.

An integrated policy approach within government and international

organizations, and a commitment to working with civil society and the
private sector and across settings, are essential to make progress in

addressing the determinants of health.

52 The Bangkok Charter tbr Health Promotion in a Globalized World

Key commitment The four key commitment are to make the promotion of health :

1. Central to the global development agenda

2. A core responsibility for all of government
3. A key focus of communities and civil society
4. A requirement for good corporate practice

l.Make the Strong intergovernmental agreements that increase health and

promotion of collective health security are needed. Government and international

health centralto bodies must act close the health gap between rich and poor.
the global Effective mechanisms for global governance for health are required to

development address all the harmful effects of :

agenda
o Trade
o Products
o Services, and
o Marketingstrategies.

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.
nr:ffr!r:fl qlt{u'tfir, qnnn',crf{nrrrLriunwn{qtnrvr iufi s-s fiuutou 25+8 53

Commitments to health for all. continued

2. Make the All governments at all levels must tackle poor health and inequalities
promotion of as a matter of urgency because health determines socio-economic
health a core and political development .

responsibility for
Local, regional and national government must:
all of government
o Give priority to investments in health, within and outside the
health sector
o Provides 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.

3. Make the Communities and civil society often lead in initiating, shaping and
promotion of undertaking health promotion. They need of have the rights,
health a key resources and opportunities so that their contributions are amplified

focus of and sustained. In less developed communities, support for capacity

building is particularly important.
communities and
civilsociety
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.

54 The Bangkok Charter for Health Promotion in a Globalized World

Health professional associations have a special contribution to make.

4. Make the The corporate sector has a direct impact on the health of people and
promotion of on the determinants of health through its influence on :

health a
requirement for o Local settings

good corporate o Nation cultures

practice
. Environments. and
o Wealth distribution.

The private sector, like other employers and the informal sector, has
a responsibility to ensure health and safety in 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 wider global

health impacts, such as those associated with global environmental
change by complying 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 by supported by consumers and civil
society, and by government incentives and regulations.

A Global Pledge to Make it Happen

All for health Meeting these commitments requires better application of 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
 y ; f I l;
n15f,lrrruqxfio{o-u: gvrrf,rdnf{n'rrrfunlvrr{qtnil{ 5ufi s-s fiuuruu z5+8 55

around common goals and joint actions to improve the health of

populations.

Each sector-intergovernmental, government, civil society and private-

has a unique role and responsibility.

Closing the Since the adoption of the Ottawa Charter, a significant number of
implementation resolutions at national and global level have been signed in support

gap of health promotion, but these have not always been followed by
action. The participants of this Bangkok Conference forcefully call on
Member States of the World Health Organization to close this

implementation gap and move to policies and partnerships for action.

Call for action Conference participants request the World Health Organization, in

collaboration with others, and its Member States, to allocate

resources for health promotion, initiate plans of action and monitor

performance through appropriate indicators and targets, and to report

on progress at regular intervals. United Nations organizations are

asked to explore the benefits of developing a Global Treaty for
Health.

Worldwide This Bangkok Charter urges all stakeholders to join in a worldwide

partnership partnership to promote health, with both global and local engagement

and action.

Commitment to We, the participants of the 6tn Global Conference on Health

improve health Promotion in Bangkok, Thailand, pledge to advance these actions

and commitments to improve health.

11 August2005
56 The Banekok Charter for Health Promotion in a Globalized World

Note : This charter contains the collective views of an international group of expert, participants to the 6'n 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.