At the recent IUHPE  'Best Practice for Better Health' conference in 
Stockholm (1-4 June) two presentation/consultation sessions on the proposed 
Bangkok Charter were given by WHO representatives. These were very well 
attended, and at the second of these sessions, there was considerable 
discussion on the name and nature of the proposed charter.

While there were many views put, it is fair to say that there was great 
concern that the proposed document will be called a 'Charter' which 
suggests that it is a replacement for the Ottawa one. This would be very 
unfortunate, even though there was wide support for much of what is written 
in the propose Bangkok document.

In the discussion on whether it should be called a Charter, it was clear 
that most felt that this title was inappropriate. For example, one speaker 
indicated that in his work (in Austria) it would not be sensible or 
possible to say that there are two charters that we should be working from 
in health promotion - this is confusing if not counter-productive. And 
people pointed out that we are a long way from achieving the Ottawa 
Charter, particularly in terms of its pre-requisites for health.

While the proposed Bangkok document acknowledges Ottawa, it does so only in 
a perfunctory manner where it indicates that it reaffirms the 'values, 
principles and purposes' of the earlier Charter. But if there is a 
perception that Bangkok replaces Ottawa, whether or not this is then 
intention, then we would be losing a lot - because we need to stress more 
than the values etc of the earlier charter.  Ottawa is an inherently 
practical document - I work with people every day who consider its five 
action areas to be a sound framework for action at a local, state and 
national levels. Bangkok's proposed action areas, overall, are aimed at an 
entirely different set of players. What community based health service or 
agency is going to be 'harnessing globalization' for the health of its 
local community, or 'making health promotion a core responsibilty of all 
governments' or making health a key component of sound corporate practices' 
etc?

These action areas of the draft Bangkok document do address significant 
forces that impact on the health of people in all nations, and they do need 
to be addressed. But apart of action area 4 (engaging communities) they are 
the actions that only the 'big' players in health are in a position to base 
their work around.  (There was a suggestion from WHO that they may not be 
called 'action areas' in the final document.)

In this context, it is clear that the draft Bangkok document flows on 
directly, in both content and intent, from the Jakarta Declaration, and so 
should logically be termed the Bangkok Declaration.

But it was clear from the WHO presentations in Stockholm, that there is an 
agenda in creating a new Charter, one that will be owned by developing as 
well as developed countries. There seems to be some perception, I'm not 
sure how widely held, that developing countries were not adequately 
involved in the development of the Ottawa Charter, and so we need a new 
one, one that is owned by a broader group of nations.  While this may be a 
very sensible agenda to be addressing, to lose the practicality and vision 
of the Ottawa Charter would be a real disaster.

One of the American delegates at these presentations suggested an 
interesting possibility. If there is to be a new Charter, then put Ottawa 
inside it.  So rather than just reaffirming the values, principles and 
purposes of the original Charter, include its five action areas in the 
action areas of the Bangkok one, and make specific reference to its 
pre-requisites for health, pre-requisites that are threatened in so many 
areas of the world.

Let's keep up the discussion going, but make sure that we channel our 
comments through to those who will be drafting the new document and/or 
attending Bangkok.



Bernie Marshall
Associate Head of School (Internationalisation)
School of Health and Social Development
Deakin University
221 Burwood Hwy
Burwood 3125, Australia

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