WHO is the directing and coordinating authority for health within the United Nations system. Itis responsible for providing leadership on global health matters, shaping the health researchagenda, setting norms and standards, articulating evidence-based policy options, providingtechnical support to countries and monitoring and assessing health trends.In the 21st century, health is a shared responsibility, involving equitable access to essential careand collective defence against transnational threats.1979 Eradication of smallpoxThe eradication of smallpox – a disease which had maimed and killed millions – inthe late 1970s is one of WHO’s proudest achievements. The campaign to eradicatethe deadly disease throughout the world was coordinated by WHO between 1967and 1979. It was the first and so far the only time that a major infectious disease hasbeen eradicated.WHO is working to ensure that everyone has access to quality health care.In many countries,there is little money available to spend on health. This results in inadequate hospitals and clinics,a short supply of essential medicines and equipment, and a critical shortage of health workers.Worse, in some parts of the world, large numbers of health workers are dying from the verydiseases which they are trying to prevent and treat. WHO works with countries to help themplan, educate and manage the health workforce, for example, by advising on policies to recruitand retain people working in health.Definition of healthHealth is a state of complete physical, mental, and social well-being and not merely the absenceof disease or infirmity.The "first and best known" definition of health promotion, promulgated by the American Journalof Health Promotion since at least 1986, is "the science and art of helping people change theirlifestyle to move toward a state of optimal health".This definition was derived from the 1974Lalonde report from the Government of Canada, which contained a health promotion strategy"aimed at informing, influencing and assisting both individuals and organizations so that theywill accept more responsibility and be more active in matters affecting mental and physicalhealth". Another predecessor of the definition was the 1979 Healthy People report of the SurgeonGeneral of the United States, which noted that health promotion "seeks the development ofcommunity and individual measures which can help... [people] to develop lifestyles that canmaintain and enhance the state of well-being".In 1986, Jake Epp, Canadian Minister of National Health and Welfare, released Achieving healthfor all: a framework for health promotion which also came to be known as the "Eppreport".
This report defined the three "mechanisms" of health promotion as "self-care"; "mutual aid, orthe actions people take to help each other cope"; and "healthy environments"WHO called to return to the Declaration of Alma-AtaInternational conference on primary health careThe Alma-Ata Declaration of 1978 emerged as a major milestone of the twentieth century in thefield of public health, and it identified primary health care as the key to the attainment of the goalof Health for All. The following are excerpts from the Declaration: The Conference strongly reaffirms that health, which is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. The existing gross inequality in the health status of the people, particularly between developed and developing countries as well as within countries, is politically, socially, and economically unacceptable and is, therefore, of common concern to all countries. The people have a right and duty to participate individually and collectively in the planning and implementation of their health care. Primary health care is essential health care based on practical, scientifically sound, and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the countrys health system, of which it is the central function and main focus, and of the overall social and economic development of the community. It is the first level of contact of individuals, the family, and community with the national health system bringing health care as close as possible to where people live and work, and constitutes the first elements of a continuing health care process. An acceptable level of health for all the people of the world by the year 2000 can be attained through a fuller and better use of the worlds resources, a considerable part of which is now spent on armaments and military conflicts. A genuine policy of independence, peace, détente, and disarmament could and should release additional resources that could well be devoted to peaceful aims and in particular to the acceleration of social and economic development of which primary health care, as an essential part, should be allotted its proper share.
Canada Health ActThe Canada Health Act is federal legislation that puts in place conditions by which individualprovinces and territories in Canada may receive funding for health care services.There are five main principles in the Canada Health Act: Public Administration: All administration of provincial health insurance must be carried outby a public authority on a non-profit basis. They also must be accountable to the province orterritory, and their records and accounts are subject to audits. Comprehensiveness: All necessary health services, including hospitals, physicians andsurgical dentists, must be insured. Universality: All insured residents are entitled to the same level of health care. Portability: A resident that moves to a different province or territory is still entitled tocoverage from their home province during a minimum waiting period. This also applies toresidents which leave the country. Accessibility: All insured persons have reasonable access to health care facilities. In addition,all physicians, hospitals, etc, must be provided reasonable compensation for the services theyprovide.
Ottawa Charter for Health PromotionFirst International Conference on Health PromotionOttawa, 21 November 1986 - WHO/HPR/HEP/95.1The first International Conference on Health Promotion, meeting in Ottawa this 21st day ofNovember 1986, hereby presents this CHARTER for action to achieve Health for All by theyear 2000 and beyond.This conference was primarily a response to growing expectations for a new public healthmovement around the world. Discussions focused on the needs in industrialized countries, buttook into account similar concerns in all other regions. It built on the progress made throughthe Declaration on Primary Health Care at Alma-Ata, the World Health OrganizationsTargets for Health for All document, and the recent debate at the World Health Assembly onintersectoral action for health.Health PromotionHealth promotion is the process of enabling people to increase control over, and to improve,their health. To reach a state of complete physical, mental and social well-being, an individualor group must be able to identify and to realize aspirations, to satisfy needs, and to change orcope with the environment. Health is, therefore, seen as a resource for everyday life, not theobjective of living. Health is a positive concept emphasizing social and personal resources, aswell as physical capacities. Therefore, health promotion is not just the responsibility of thehealth sector, but goes beyond healthy life-styles to well-being.Prerequisites for HealthThe fundamental conditions and resources for health are:_ peace,_ shelter,_ education,_ food,_ income,_ a stable eco-system,_ sustainable resources,_ social justice, and equity.Improvement in health requires a secure foundation in these basic prerequisites.AdvocateGood health is a major resource for social, economic and personal development and animportant dimension of quality of life. Political, economic, social, cultural, environmental,behavioural and biological factors can all favour health or be harmful to it. Health promotionaction aims at making these conditions favourable through advocacy for health.EnableHealth promotion focuses on achieving equity in health. Health promotion action aims atreducing differences in current health status and ensuring equal opportunities and resources toenable all people to achieve their fullest health potential. This includes a secure foundation ina supportive environment, access to information, life skills and opportunities for makinghealthy choices. People cannot achieve their fullest health potential unless they are able totake control of those things which determine their health. This must apply equally to women
and men.MediateThe prerequisites and prospects for health cannot be ensured by the health sector alone. Moreimportantly, health promotion demands coordinated action by all concerned: by governments,by health and other social and economic sectors, by nongovernmental and voluntaryorganization, by local authorities, by industry and by the media. People in all walks of life areinvolved as individuals, families and communities. Professional and social groups and healthpersonnel have a major responsibility to mediate between differing interests in society for thepursuit of healthHealth promotion strategies and programmes should be adapted to the local needs andpossibilities of individual countries and regions to take into account differing social, culturaland economic systems.Health Promotion Action Means:Build Healthy Public PolicyHealth promotion goes beyond health care. It puts health on the agenda of policy makers in allsectors and at all levels, directing them to be aware of the health consequences of theirdecisions and to accept their responsibilities for health.Health promotion policy combines diverse but complementary approaches includinglegislation, fiscal measures, taxation and organizational change. It is coordinated action thatleads to health, income and social policies that foster greater equity. Joint action contributes toensuring safer and healthier goods and services, healthier public services, and cleaner, moreenjoyable environments.Health promotion policy requires the identification of obstacles to the adoption of healthypublic policies in non-health sectors, and ways of removing them. The aim must be to makethe healthier choice the easier choice for policy makers as well.Create Supportive EnvironmentsOur societies are complex and interrelated. Health cannot be separated from other goals. Theinextricable links between people and their environment constitutes the basis for asocioecologicalapproach to health. The overall guiding principle for the world, nations, regionsand communities alike, is the need to encourage reciprocal maintenance - to take care of eachother, our communities and our natural environment. The conservation of natural resourcesthroughout the world should be emphasized as a global responsibility.Changing patterns of life, work and leisure have a significant impact on health. Work andleisure should be a source of health for people. The way society organizes work should helpcreate a healthy society. Health promotion generates living and working conditions that aresafe, stimulating, satisfying and enjoyable.Systematic assessment of the health impact of a rapidly changing environment - particularlyin areas of technology, work, energy production and urbanization - is essential and must befollowed by action to ensure positive benefit to the health of the public. The protection of thenatural and built environments and the conservation of natural resources must be addressed inany health promotion strategy.Strengthen Community ActionsHealth promotion works through concrete and effective community action in setting priorities,making decisions, planning strategies and implementing them to achieve better health. At theheart of this process is the empowerment of communities - their ownership and control of
their own endeavours and destinies.Community development draws on existing human and material resources in the communityto enhance self-help and social support, and to develop flexible systems for strengtheningpublic participation in and direction of health matters. This requires full and continuousaccess to information, learning opportunities for health, as well as funding support.Develop Personal SkillsHealth promotion supports personal and social development through providing information,education for health, and enhancing life skills. By so doing, it increases the options availableto people to exercise more control over their own health and over their environments, and tomake choices conducive to health.Enabling people to learn, throughout life, to prepare themselves for all of its stages and tocope with chronic illness and injuries is essential. This has to be facilitated in school, home,work and community settings. Action is required through educational, professional,commercial and voluntary bodies, and within the institutions themselves.Reorient Health ServicesThe responsibility for health promotion in health services is shared among individuals,community groups, health professionals, health service institutions and governments. Theymust work together towards a health care system which contributes to the pursuit of health.The role of the health sector must move increasingly in a health promotion direction, beyondits responsibility for providing clinical and curative services. Health services need to embracean expanded mandate which is sensitive and respects cultural needs. This mandate shouldsupport the needs of individuals and communities for a healthier life, and open channelsbetween the health sector and broader social, political, economic and physical environmentalcomponents.Reorienting health services also requires stronger attention to health research as well aschanges in professional education and training. This must lead to a change of attitude andorganization of health services which refocuses on the total needs of the individual as a wholeperson.Moving into the FutureHealth is created and lived by people within the settings of their everyday life; where theylearn, work, play and love. Health is created by caring for oneself and others, by being able totake decisions and have control over ones life circumstances, and by ensuring that the societyone lives in creates conditions that allow the attainment of health by all its members.Caring, holism and ecology are essential issues in developing strategies for health promotion.Therefore, those involved should take as a guiding principle that, in each phase of planning,implementation and evaluation of health promotion activities, women and men shouldbecome equal partners.Commitment to Health PromotionThe participants in this Conference pledge:_ to move into the arena of healthy public policy, and to advocate a clear politicalcommitment to health and equity in all sectors;_ to counteract the pressures towards harmful products, resource depletion, unhealthy livingconditions and environments, and bad nutrition; and to focus attention on public healthissues such as pollution, occupational hazards, housing and settlements;_ to respond to the health gap within and between societies, and to tackle the inequities inhealth produced by the rules and practices of these societies;
_ to acknowledge people as the main health resource; to support and enable them to keepthemselves, their families and friends healthy through financial and other means, and toaccept the community as the essential voice in matters of its health, living conditions andwell-being;_ to reorient health services and their resources towards the promotion of health; and toshare power with other sectors, other disciplines and, most importantly, with peoplethemselves;_ to recognize health and its maintenance as a major social investment and challenge; and toaddress the overall ecological issue of our ways of living.The Conference urges all concerned to join them in their commitment to a strong publichealth alliance.Call for International ActionThe Conference calls on the World Health Organization and other international organizationsto advocate the promotion of health in all appropriate forums and to support countries insetting up strategies and programmes for health promotion.The Conference is firmly convinced that if people in all walks of life, nongovernmental andvoluntary organizations, governments, the World Health Organization and all other bodiesconcerned join forces in introducing strategies for health promotion, in line with the moraland social values that form the basis of this CHARTER, Health For All by the year 2000 willbecome a reality.CHARTER ADOPTED AT AN INTERNATIONAL CONFERENCE ON HEALTHPROMOTION*The move towards a new public health, November 17-21, 1986 Ottawa, Ontario, Canada* Co-sponsored by the Canadian Public Health Association,Health and Welfare Canada,and the WorldHealth Organization