International health promotion leader Dr Trevor Hancock has helped put health on the agenda of thousands of cities and towns around the world.
Dr Hancock was a plenary speaker at the 23rd International Union for Health Promotion and Education (IUHPE) World Health Promotion Conference in Rotorua from April 7 – 11, 2019. Although recently retired from his position as a Professor and Senior Scholar at the School of Public Health and Social Policy at the University of Victoria he’s as busy as ever as he shares with us from his home in Canada about keeping the Healthy Cities Movement “moving”, plans for broadening, deepening and connecting the “Conversations for a One Planet Region” and about some spin-off projects in the works.
Hauora: Trevor you are one of the founders of the (now global) Healthy Cities and Communities movement? Can you please tell us what prompted you to launch this movement, what its aims are and what has been achieved so far?
TH: Well, I didn’t exactly launch the movement, but I did help pioneer it. I trained in medicine in the late 1960s/early 1970s in London and then spent four years in family practice in Canada. The last two years were in a community health centre in Toronto, where we served a somewhat under-privileged community. It was clear to me that many of the health problems my patients experienced were economic, social and environmental problems, not really medical problems, which cemented my interest in public health, so I did a Masters at the U of Toronto, graduating in 1980.
You can’t do public health without becoming keenly aware of the roots of modern-day public health in the struggle to address the terrible living and working conditions in the towns of the industrialising world in the 19th century, and to the stories of John Snow, Edwin Chadwick and other leaders. One of those leaders I found particularly inspiring was Sir Benjamin Ward Richardson, a self-professed ‘disciple’ of Chadwick. In 1875 he gave an inspirational address to the Social Science Association on “Hygeia: A City of Health”, which is still well worth reading.
So when I started work as the Health Planner for the City of Toronto in the Department of Public Health’s new Health Advocacy Unit in 1980 , I had this work in mind. One of my tasks was to create a mission statement for the Department, and we adopted the following: Our mission is to help to make the City of Toronto the healthiest city in North America”. Note we said ‘help to’ – health is not created by a public health department any more than it is created by the health care system; we recognised that many other City departments – and many other players outside City government – contibuted a great deal to the health of the city’s people, starting with clean water, sanitation, safe and healthy buildings and so on.
So we started to ask ourselves’what exactly is a healthy city, how would we get one, and how would we know we were one?’. As you can imagine, that led to a great deal of discussion and innovation. Luckily, as it happened – and never discount luck as a factor, but when you have it, exploit it! – 1984 was a banner year – the sesqui-centennial of the City, the centenary of the Board of Health, the 75th anniversary of the Canadian Public Health Association and the tenth anniversary of the Lalonde Report. This made it possible for me – working with a great conference committee – to put on ‘Beyond Health Care’, an international working conference on healthy public policy, a term, but not a concept, I had created in about 1980, inspired by the work of people like Nancy Milio and Peter Draper.
As part of the conference, we had a theme on healthy cities, but also – because it was after all a Toronto-based conference – we had a day we called ‘Healthy Toronto 2000’, looking at what it would take to make Toronto a healthy city by then. One of the keynote speakers was Len Duhl, a professor of public health and urban planning at Berkely, and one of the attendees was Ilona Kickbusch, then the Health Promotion Officer for WHO Europe and already working closely with Ron Draper at Health Canada -who had invited her – on what was to become two years later the Ottawa Charter for Health Promotion.
Ilona brilliantly saw in the idea of a healthy city a way to take the concepts of health promotion out into the city and make them real, and thus was born the WHO Europe Healthy Cities initiative, which had its first planning meeting in Copenhagen (WHO Europe’s HQ) in early 1986. Len Duhl and I were part of the planning committee, and together wrote the original background paper – and the rest is history!
As to the aims and achievements, they are quite simple: To put health on the agenda of city governments and governance processes, and to help cities plan with health in mind as a key objective. In that, I think we have been highly successful, the idea has been taken up – with varying degrees of success – in cities, towns and villages around the world – inevitably, with varying degrees of success.
But I think the key word here is ‘movement’. There is, inevitably, a wish to evaluate the work, but its rather like evaluating the women’s movement, the labour movement, the peace movement or the environment movement. They are always working, always pushing, and they have their succeses and failures, but they just keep going; that is what a healthy cities movement must do too.
Hauora: One of the challenges you point out for the 21st century is that we’re going to have to look at dramatically different ways of organising our cities, our countries, our neighbourhoods, our own personal ways of life etc…What progress are we making on this and how big a role can health promoters play?
TH: There are many parts to this question – or questions. For me, the central question for cities – and for governments at all levels – is ‘what business are we in?’. If you ask that of national governments the answer you get – if not in their words, at least in their deeds – is ‘grow the economy/the GDP’. (New Zealand has recently proved itself the exception, with a budget focused on wellbeing.)But this focus on economic growth and the GDP has been a tragic mistake, especially for high-income countries. First, that growth has resulted in the massive and rapid extraction and depletion of the Earth’s natural resources, in particular forests, fisheries, wildlife, freshwater, topsoils, minerals and fossil fuels. That extraction has been accompanied by massive and rapid pollution of the air, water, soils and food chains, with perhaps the most worrying – at least right now – being CO2 pollution from fossil fuel combustion, leading to the global climate emergency.
“… this focus on economic growth and the GDP has been a tragic mistake, especially for high-income countries.”
Also, some, perhaps much of that growth is what Herman Daly, a leading ecological economist, has called ‘Uneconomic growth’; economic activity that harms people, communities or the planet – or all three. Yet all this uneconomic growth is included in the GDP, which does not distingish between good and bad economic activity. In the health field, the most obvious example is tobacco production and use (although we could also include production of unhealthy food, alcohol, etc.) which kills millions and maims millions more. Even worse, all the money spent on health care for people with tobacco-caused or diet-caused disease also adds to GDP; how stupid is that?
What’s more, this economic growth does not improve our lives, even if it gets us more ‘stuff’. We know that above about $20,000 GDP per capita, further increases in GDP do not correlate well, if at all, with life expectancy and other health and social outcomes. In The Spirit Level, Kate Pickett and Richard Wilkinson show that in high-income countries, it is the degree of equity, not the level of wealth, that correlates with these outcomes, while the World Happiness Report and other studies show that GDP is not well correlated with happiness.
As a result, further aggregate growth is impossible, we already exceed the Earth’s biocapacity and need to reduce our use of these ecosystem goods and services – quite drastically in the high-income countries, whose ecological footprints are well above our fair share, in the range of 3 to 5 planet’s’ worth of biocapacity. Meanwhile, low income countries have the opposite problem; they do not have the wealth it takes to achieve high levels of human and social development.
We need to take less so that others in need can have more, which means a redistribtion of power, wealth and resources both between and within countries and communities, as called for by the WHO Commission on the Social Determinants of Health.
All of this leads to the conclusion of Kate Raworth in her book Doughnut Economics: we need an economy that is ecologically restorative and socially just, that is focused on meeting the social needs of everyone while living within planetary limits. And that means a very different set of values to live by, very different communities and societies to those we have today. I have an abiding faith that this can only happen from the local level up, it will not come down from the top, where elites have too much money and power at stake. Progress on this is slow, but it is happening, as I will discuss shortly.
But what can health promoters do?
- First, learn about the global challenges of the Anthropocene – the new age of humanity as a dominant global force that I discuss below – and what new approaches and solutions we need. Recognise that this calls for an eco-social approach in all our work and all our communities.
- Second, discuss it with your colleagues, your families and friends, your clients and communities.
- Third, work to create it, identifying allies and partners who are working to create this new world – especially young people (think of the climate strikers), environmentalists and the new social/green entrepreneurs who are working to create the new economy we need.
- Fourth, apply the two fundamental principles of public health that I identified 40 years ago: Ecological sanity and social justice (today we would say sustainability and equity), ideas that directly relate to Kate Raworth’s call for an economy thast is both restorative and distributive.
- Finally, never lose sight of Margaret Mead’s wise words: “Never believe a small group of people cannot change the world; indeed it is the only thing that ever has changed the world”.
One final point: We are not simply health promoters, more importantly we are citizens. So if we can make it part of the work we do, that is definitely a bonus. But if not, we did not surrender our citizenship when we took on our professional roles. So take it on as a family, a citizen activist, a school parent, a club member or a faith community member or whatever other social role makes sense. Find your allies and work with them. Or simply change the way you live, in big or small ways. It all matters, it all makes a difference.
Hauora: You have said one thing that is important to understand about the Anthropocene is that it’s just not about climate change and we need to look at the bigger picture? Can you please elaborate on this?
TH: The Anthropocene is a new geologic epoch, identified in geological terms as a layer of new materials (e.g. glass, plastic, concrete, radioactive elements and their decay products, elevated CO2 levels) and a change in future fossil deposits (e.g. wild animals now make up only 4% of the mass of land vertebrates, with humans (anthropos in Ancient Greek) and their domesticated species making up the rest) that will be clearly seen as anthropogenic – caused by humans – by future geologists.
In May 2019 the Anthropocene Working Group of the International Commission on Stratigraphy voted strongly to recommend it be recognised, with a start date in the mid-20th century. This corresponds to what has been called ‘The Great Acceleration’; a sharp acceleration, especially since 1950, in changes in a wide variety of natural systems (e.g. climate, nitrogen and phosphorus flows, species extinctions etc. ), in turn driven by a similar sharp increase in socio-economic forces (e.g. population – especially urban population, global GDP, fertiliser-use, fish catch etc.).
So the Anthropocene needs to be understood not only as a geological phenomenon, but one that reflects and indeed records global ecological changes that in turn are driven by economic and social development.
In the 2015 report I led for the Canadian Public Health Association on the ecological determinants of health, we made two key points:
- First, the world’s natural systems are our life support systems, the most fundamental determinants of our health; we do not last long without air, water or food. Nor can societies exist without the materials and fuels we take from nature, the recycling of nutrients and wastes is the protection from UV radiation that all come from nature. Moreover, for the past 11,000 years we have benefited from a generally benign, warm and stable climate during which agriculture and cities – what we think of as civilisation – have developed.
- Second, all of these ecosystem goods and services are being massively and rapidly disrupted, and all at the same time. It is not just climate change, but ocean acidification, pollution and ecotoxicity, resource depletion and the start of a sixth Great Extinction. Moreover, they often interact and reinforce each other, usually in negative ways.
Faced with these widespread, rapid and massive changes, we need widespread, rapid and massive responses; again, my belief is that these are much more likely to come up from the bottom than down from the top. Tobacco control is but one of many examples where it has been persistent grassroots activism and local leadership that has ultimately led to signifant national and international change; the same can be said of gay marriage.
But I am also very conscious of the fact that when it comes to creating social and cultural transformation and large value shifts, this is not done simply by applying science, evidence and logic. We need to reach people emotionally and spiritually as human beings, what I call ‘heart, gut and spirit stuff’, and for that we need to work with faith communities, the arts community and other ‘unusual suspects’.
Hauora: In Victoria British Colombia where you live you started what is called “Conversations for a one planet region”. What is the aim of this initiative and how many countries has it spread to? Can you give us some tips on how to get it started in NZ?
TH: The Conversations came out of an initiative I started at the University of Victoria (UVic) before I retired. UVic in the Anthropocene is an attempt to bring together faculty and students from all disciplines across the university to address the challenge of the Anthropocene. In my opinion, this is the greatest threat facing us in the 21st century, but it also contains many opportunities. So how will universities respond (so far, no better than governments or other instituons, which is to say hardly at all!)
We realised early on that we needed to do work with the community, in this region of 350,00 people and 13 local municipalities, to explore what should be the response to the Anthropocene at the local level. We suggested the concept of a One Planet Region as a way to address this locally (an idea we later learned had been pioneered by Bioregional in the UK, a group we now work with). We defined a One Planet Region as one that achieves social and ecological sustainability, with a high quality of life and a long life in good health for all its citizens, while reducing its ecological footprint to be equivalent to one planet’s worth of biocapacity.
We started the Conversations in early 2017 because we were concerned that people were not even talking about this issue; climate change, yes, but not the entire complex of global ecological changes that constitute the Anthropocene, and not about how we need to respond locally. So our mission is to establish and maintain community-wide conversations on One Planet living and a One Planet Region. We adopted as our slogan “Learn – Discuss – Imagine – Design – Create”, because if we are not learning about the situation we face and discussing it, we can’t begin to fully imagine both the future we face and the alternative future we want. And if we can’t imagine it, we can’t design and create it.
We meet monthly in the Community Room at the Central Branch of the Public Library. Our meetings are free and open to anyone, and we have no budget; use only local volunteer speakers – since we know we have the knowledge and expertise here to address these issues successfully. We cover a wide range of issues, from energy and food to housing and transportation, economics, the role of the arts and of faith communities – and much else.
But while we have been doing this for three years, have a group of 30 – 70 people each month, get good discussions and have a good reputation and some influence and local political impact, we recognise that this is of limited utility. Our participants are generally the ‘usual suspects’ – older, whiter, wealthier, better educated, and living near the downtown. An important and potentially influential group, to be sure, often with good connections to important people and groups, but far from enough.
So we have plans for broadening, deepening and connecting the Conversation. We want to expand the Conversation to engage a much wider range of participants, both geographically and demographically; deepen the Conversation by creating safe spaces where people can explore the mental, social and spiritual dimensions of the change we seek; and connect the Conversation to others doing similar work across the region. To that end, we have recently incorporated as a non-profit society so we can pursue funding, because while having no budegt is in many ways commendable, it is also limiting. Some of the new activities we want to pursue are:
- Video, webcast and livestream the current Conversations programme, enabling people in other sites in the Greater Victoria Region to join in from where they live.
- Establish a Kitchen Table Conversations programme to facilitate and support families, neighbors, workmates and others to have smaller, more personal Conversations.
- Undertake One Planet Neighborhood Co-design Charettes that bring community members and design professionals together to imagine and design such a place.
- Establish People for a One Planet Region, a group of citizens in every municipality who are able to speak at Council meetings to support the One Planet approach and to oppose proposals that take us in the wrong direction.
- [Perhaps] create One Planet Region Awards to recognise people, organisations, businesses and governments that are working to create a One Planet region.
We also have several spin-off projects that we are pursuing, in collaboration with others:
- We are working with the Community Social Planning Council to look at the social justice and employment implications of a One Planet Region.
- We are starting a discussion about an initiative around art, nature and place as a way of engaging people through the arts in considering the global ecological challenges, and possible actions.
- An ecological economics group is forming, linked to the Green New Deal, looking at what an ecological economy would look like locally.
- We are planning sessions based on Joanna Macy’s “The work that re-connects”, to help people come to terms with the climate anxiety and eco-grief they may be experiencing.
I hope this has given you some ideas, but remember, it takes very little to make things happen. You don’t need a budget, an organisation or staff, just some willing and like-minded people, a bit of energy and good will. Remember Margaret Mead’s wise words and just do it!
Hauora: You were in NZ for the 23rd IUHPE World Health Promotion Conference, co-hosted by HPF in Rotorua last April? What were some of the highlights of the conference for you?
TH: The first highlight was the fact that the greetings from the Maori Elders were all in Maori! Oh sorry, you don’t understand Maori? Too bad, this is Aotearoa and here we speak Maori – it was assertive and yet was done in a respectful way. I loved the self-confidence of that, and indeed the strong participation of Maori people throughout was an inspiration.
Second, of course, the fact that ecological change and the need for an ecological awaresss was finally getting the attention it deserves in health promotion.
Third, shmoozing! Not only do I love seeing my friends from all over the world (and yes, I am aware of the irony, if not ineed the incompatability, of the carbon footprint involved), but those personal contacts facilitate the sharing of ideas, work and commitments for years to come. There is a lot you can do apart, via Skype and webinars and teleconferences, but there is an energy that comes from being together in the same place, sharing food and drink and relaxation, that boosts your energy and enthusiasm when you return home.
Fourth, of course, New Zealand itself, a beautiful country I have now visited twice, with friendly and welcoming people, certain challenges notwithstanding. Certainly the New Zealand government is proving inspirational, both in its response to the Christchurch mosque shootings and in its commitment to a wellbeing budget.
Hauora: You retired in July 2018 from your position as a Professor and Senior Scholar at the School of Public Health and Social Policy at the University of Victoria. What have you been doing since then and what are your plans for the future?
Well, I only retired from a job, not from life or work – or dancing for that matter! I have been busy organising the Conversations – as noted above, writing, speaking at all levels from global events such as IUHPE to local community groups about these ideas and generally being an activist. I am very excited by the growing activism of young people and looking for ways I can help and support them – without taking over or getting in the way!
In particular, I hope to write several books for the general public about the work of public health. I have been writing a weekly column on population and public health issues for five years (see https://trevorhancock.org/) and I have come to recognise that we do a lousy job of communicating what we do, and the importance of our work – and then we wonder why nobody knows about us or loves us or funds us! So, I have committed to do no more writing for academic or professional journls or books, other than the commitments I already have.
And of course I am dancing. I have been a Morris dancer for 40 years – traditional English folk dance, think non-violent rugby involving dancing, singing and drinking! It brings me great pleasure, even joy, and is an antidote to the serious nature of so much of my life – although that too is fun, it has to be if you are to keep doing it.
I dance twice a week, walk our dog in the woods, parks and coastlands every day with Franny, my wife and companion for almost 50 years (her retirement project is a Masters in Medieval Studies, we are well matched) and generally stay active. In one of the two Morris sides I dance with I am, at 71, the second youngest dancer; our oldest dancer is almost 95, and comes to practice every week and then to the pub. I intend to be Fred when I grow up!
© Trevor Hancock, 2019
With HPF’s online courses you can study at your own pace and time and from anywhere in the world.
If you are already working in the field of health promotion or public health, these courses will further enhance your knowledge and skills. The courses are also designed to enable those who are new to health promotion and public health to learn new knowledge and skills.
“We are responding to the need of the health promoters and other health and social service workers, by taking the knowledge to them through technology,” says HPF Executive Director Sione Tu’itahi.
“Learners can always contact our health promotion team for questions and discussion, if they need to.”
The courses are on Maori health promotion, Pasifika health promotion, and mainstream health promotion. All are at level one but future courses in the three categories will be designed for level two and level three.
You can use this link to navigate to the courses: https://www.onlinecpd.co.nz/course-providers/hauora/
HPF’s Executive Director Sione Tu’itahi talks to Hauora about the outcomes, goals and lasting impact of the global Health Promotion Forum conference in Rotorua from April 7-11, 2019
Last April the Health Promotion Forum co-hosted the 23rd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion in Rotorua. With a timely theme of ‘Hauora: Promoting Planetary Health and Sustainable Development for All’, more than a 1000 delegates and organisations from 73 countries participated.
H: There has been very positive feedback about the conference. Are you happy with the results, and did you achieve the outcomes you set?
ST: Yes, I am happy to say we achieved our three major outcomes, and more. The knowledge that was exchanged was very relevant, crucial and very timely for the needs of health promotion, and the world today. Health promoters and other health workers, as well as those who work in sustainable development enhanced existing networks and formed new ones. And the legacy initiatives of two legacy statements, and initiating the process for a healthy city, were also achieved.
H: Let’s talk more about those outcomes in details. What is some of the relevant knowledge shared?
ST: Among other important features, at least three major areas emerged and moved closer together, offering comprehensive knowledge and practical tools for the delegates to take home and implement on addressing the health of the planet and its peoples. These were the social determinants of health with an equity and social justice approach, planetary health and ecological determinants with an eco-social approach and an inter-generational understanding and goal for health and wellbeing, and indigenous knowledge and health promotion with a clear philosophy and practice that humans are inseparable from the ecology. On another level, the spiritual dimension of wellbeing, and spiritual health promotion also came to the fore during the conference. It was great to see these major areas of health knowledge coming together, offering a profound understanding on planetary health, and relevant, practical tools.
What was significant was that the presenters in all these areas of knowledge were complementary in their addresses, presenting a balanced, and comprehensive big picture of where the health of the planet and its peoples are at, and the comprehensive set of strategies to address those challenges at all levels.
H: What else was significant about the knowledge shared at the conference?
ST: Two other significant contents of the conference were the leading contributions of Maori research, policy, practice and leadership to Indigenous health promotion, and how pronounced climate change and ecological challenges are in our Pacific region. In fact, we decided to host the conference here in order for our New Zealand knowledge and experience to be shared with the world, and for the world to understand our greater Pacific region and its challenges, as well as our collective effort to address those challenges. For example, 20 years after introducing Te Pae Mahutonga as a health promotion model for New Zealand, Sir Mason Durie presented a new model, Matariki, at the conference for Indigenous peoples. Tuhoe Nation Leader Tamati Kruger shared the challenging but progressive and resilient journey of his tribe from the ravages of colonisation to mana motu hake/autonomy today. Delegates were in awe at such profound knowledge and courageous, moral leadership.
H: You mentioned some legacy initiatives. What are they?
ST: There were three legacy initiatives: two legacy statements, and Rotorua to become a healthy city under the WHO (World Health Organization) scheme of the same name. Led by two editorial teams, the conference delegates drafted and approved by acclamation the two statements on the final day. The first statement is the Rotorua Statement which summarises the important themes and knowledge that emerged from the conference, calling for action on those crucial areas for the health and wellbeing of the planet and its peoples. The second statement is the Waiora Indigenous Peoples Statement. It outlines the loss of Indigenous peoples under colonisation around the world, and calls for privileging indigenous knowledge as a right, and articulates how Indigenous health promotion can contribute to addressing the challenges on planetary health. On the healthy initiative, Rotorua’s mayor Steve Chadwick agreed to explore with us how Rotorua can become a ‘healthy city’ under the WHO’s scheme of the same name. Rotorua can be the model for other cities. All social, economic, cultural and ecological challenges, health included, are related, and cities are a manageable setting where these challenges can be addressed in a well-coordinated and effective way. The vision is for our cities to become healthy, liveable and sustainable.
H: So, it was not just a talkfest?
ST: No, certainly not. You can watch the videos of those keynote speakers on the IUHPE and HPF YouTube channels. Maori equity and social justice were articulated by the likes of Sir Michael Marmot and Fran Baum, indigenous health promotion was clearly embedded by the addresses by Sir Mason Durie, Tamati Kruger of Tuhoe Nation, Dame Anne Salmond, and Professor Anthony Capon. Professor Capon and Professor Trevor Hancock also highlighted planetary health, ecological determinants and the eco-social approach.
H: What lessons have you learned as a result of hosting the conference?
ST: Quite a few. One is that our nation’s founding document, Te Tiriti o Waitangi, was very effective as a framework for negotiating the terms of the conference and for co-hosting it with the International Union for Health Promotion and Education. Using Te Tiriti enables us to work as equal partners, sharing our knowledge and experience, and achieving outcomes agreed on, such as the theme of the conference where we highlight Indigenous knowledge, having Te Reo Maori as one of the four languages of the conference.
Twenty years after introducing “Te Pae Mahutonga” as a framework for health promotion in New Zealand at an HPF conference in 1999, Sir Mason Durie introduced another star-based framework to guide health promotion for Maori and other Indigenous peoples.
Sir Mason introduced “Matariki” at the 23rd World Conference on Health Promotion in Rotorua, last April.
“Matariki is the Māori name for the cluster of stars also known as the Pleiades (or Subaru in Japan). It rises in mid-winter and for many Māori, it heralds the start of a new year, a time for remembering the dead, celebrating new life and planting new crops,” he said. “The focus on stars reminds us that we are part of an unbounded universe.”
Based on the eight main stars in the cluster, he named eight Matariki dimensions of health: Mana Tangata -Human dignity, Whānau Ora – Families, Hapori – Communities, Ranginui – The sky, Papatuanuku- The land, Nga Wai – Rivers and oceans, Ngahere – The forests, and Te Ao Tuturu – Rhythms of nature.
“Matariki provides a health promotion agenda for Māori and Indigenous peoples that endorse Indigenous rights, keep our skies clean and fresh, protect our lands, preserve our native forests, enable whānau and families to flourish, support community initiatives, safeguard our rivers and ocean, and restore nature’s balance, ” Sir Mason asserts.
He also pointing out that when combined, the six stars of Te Pae Mahutonga and the eight stars of Matariki can continue to guide health promotion for Indigenous peoples into the future.
Details of Sir Mason’s presentation can be found on the IUHPE2019 website.
Dr Viliami Puloka, HPF’s Pacific Strategist looks back at the amazing Pacific experience at IUHPE2019 in Rotorua.
Fakafeta’I, malo lava, vinaka vakalevu are the words that come to mind – hearts full of joy and gratitude to be part of this world-wide event right here at home in Aotearoa New Zealand.
All the Pacific participants especially those from the islands were so thrilled and appreciative of the fact that they did not have to paddle far to get here. It was only a three-hour flight from Tonga, Fiji, Samoa, Vanuatu, Kiribati, Solomon Islands and New Caledonia. It confirmed the fact that Aotearoa is squarely part of the Pacific islands.
Arriving in Rotorua was heart-warming to many who thought New Zealand was the land of the palangi. But all were excited to meet and share the experience of their Maori cousins. Many commented on the spiritual experience they had during the Powhiri, which reminded them of their own version at home.
Some were moved to tears when exchanges the “breath of life” with Maori delegates while walking between sessions or at various meeting venues.
We really felt at home and immediately identified with our Maori cousins and their environment. When Tamati Kurger spoke, we were already in awe, excited, joyful, appreciative and motivated for action. It was a big deal for us to come in to a very enabling, encouraging and empowering environment. That really prepared our hearts and minds to focus on the contents of the conference.
Pacific Community (SPC) commitment and partnership through sponsorship of participants to attend, give presentations led by the Director General Colin Tukuitoga as one of the Plenary speakers shows great leadership and very much appreciated.
A highlight for Pacific Youth was the SPC Pacific Youth WAKE UP art project unfolds itself through out the days of the conference. It was a call on young people to wake up to the facts that “today is the tomorrow you dreamt about yesterday”. What you do today as far as Noncommunicable diseases are concerned will return to haunt you at your later years.
WAKE UP NOW!
HPF’s Deputy Executive Director Trevor Simpson, one of the principal architects of the Waiora Indigenous Statement reflects on its significance
The Waiora Indigenous Statement adopted at this year’s IUHPE World Conference in Rotorua provided a watershed moment for indigenous health promotion at the global level. It is a call to action which leverages on the assertion that indigenous people’s perspectives, worldviews and human experience informs a “new” way to think about health promotion and by virtue of this, a different perspective on planetary health and human wellbeing.
Of course, health promotion in its current format, largely based on western world views associates human health with the health of the planet. The Ottawa Charter identifies eight prerequisites, the fundamental conditions for health amongst which a stable eco-system and sustainable resources are but two. As broad fields of study these two areas remain vitally important, but it seems odd that planetary health and wellbeing is not specifically addressed within the existing health promotion framework. From observation it is more implied than defined. Further, it is difficult to discern where health promotion makes a clear and concerted effort to think past the Anthropocene, the current focus on an individual, human centred approach to health.
The Waiora Indigenous Statement provides some interesting componentry to help us understand at a fundamental level where indigenous thinking positions itself in the planetary and human wellbeing discussion. As the document rightfully points out, indigenous people and worldviews are diverse. However, when we overlay these aspects of diversity, we can then identify the commonalities which draw indigenous peoples together.
This provides a powerful construct, particularly when we centre on the core features; the interactive relationship between the spiritual and material realms, intergenerational and collective alignments and that the Mother Earth is a living being. It posits that Planet Earth and human beings have a special relationship to each other, one founded on interconnectedness and interdependence. We are therefore in the indigenous perspective, part of nature and not above it.
In a pre-conference discussion with Tamati Kruger, one of the highly acclaimed plenary speakers at this year’s event, he touched on a key principle of the Tuhoe Iwi’s Waitangi claim settlement outcome, principally the section in the Te Urewera Act 2014 in which the Crown (Government of Aotearoa New Zealand) and the Tuhoe people agreed that the Urewera (previously the Urewera National Park) was a “living person”. He suggests that this aspect was an imperative in the settlement negotiations. Without it, it would have been very difficult to reach an agreement.
As a significant precedent in law it is also nevertheless an assertion of world views.
It comes with a necessary proviso of course, duties on both parties: a living person should be cared for and nurtured. Care and nurture have in turn strong elements of responsibility and obligation. Indigenous Tuhoe people, therefore, have no choice but to provide for and nurture their piece of nature and in return have their place and wellbeing secured. As Tamati said in his plenary speech in Rotorua, “the Tuhoe people do not own the Urewera. The Urewera owns itself”.
This indigenous viewpoint leaves much to ponder. It questions our current thinking. It touches on the need for a paradigm shift in the way human beings see themselves in their relationship with this living planet. And it is now urgent.
As a living document we encourage all to endorse, use and critically analyse the Waiora Indigenous Statement. It is an offering for health promoters, policy makers and leaders. An intergenerational gift that seeks to define what health promotion means from an indigenous worldview. It is also a very useful resource to inform the development of health promotion itself- to be part of the actual framework rather than sitting outside it. To be part of a new design for people and planet.
The Waiora Indigenous Statement is a statement for all. It asks that we make space for and privilege indigenous peoples voices and indigenous knowledge in promoting planetary health and wellbeing. It offers a new way of thinking, resetting the course for health promotion and sustainable development. It suggests that if we listen carefully, we just might hear something beautiful and profound. Something to learn, something to embrace. Something for you, me and the generations to come.
This Statement from Indigenous participants in the 23 rd IUHPE World Conference on Health Promotion (Rotorua, Aotearoa New Zealand) is a call on the health promotion community and the wider global community to make space for and privilege Indigenous peoples’ voices and Indigenous knowledges in promoting planetary health and sustainable development for the benefit of all. It should be read alongside the Rotorua Statement from all participants in this Conference.
Indigenous peoples are diverse and our worldviews, which have developed over millennia of human experience, are specific to peoples and place. However, there are fundamental commonalities in these worldviews that have provided the basis for Indigenous peoples’ movements that draw us together around our shared interests. Core features of Indigenous
worldviews are the interactive relationship between spiritual and material realms, intergenerational and collective orientations, that Mother Earth is a living being – a ‘person’ with whom we have special relationships that are a foundation for identity, and the interconnectedness and interdependence between all that exists, which locates humanity as part of Mother Earth’s ecosystems alongside our relations in the natural world.
Understanding our place in the natural world in relational ways leads us to consider how access to the natural environment shapes human health and wellbeing, the impacts of our activities on the environment, and our inalienable collective responsibilities of stewardship which will benefit future generations.
Within Indigenous worldviews our relationship with the natural world is characterised by reverence and values that include sustainability, guardianship and love. Planetary health is understood as the health and wellbeing of Mother Earth and of humanity as an inextricable part of natural ecosystems. It should also be noted that Indigenous languages are critical in articulating Indigenous worldviews as they
enable the most full and accurate expression of Indigenous conceptualisations, and should be protected.
The forces of colonisation, capitalism and globalisation have caused massive environmental degradation, climate change, loss of biodiversity and the devastation of Indigenous communities. Further, they have led to intellectual imperialism and the widespread subjugation and exclusion of Indigenous worldviews, bodies of knowledge and voices.
Prevailing Western and other worldviews promote individualism and anthropocentric perspectives that to human peril separate humanity from the natural world. This has encouraged human activity that accelerates the depletion of planetary resources, the destruction of ecosystems, pollution, climate change and increase in the risk of ecological collapse.
Environmental degradation impacts disproportionately on Indigenous peoples because of close relationships with the natural world and our already marginalised circumstances in nation states. The silencing of Indigenous voices and the subjugation of Indigenous bodies of knowledge has been detrimental to all, most evident in our global environmental crisis.
Indigenous health promotion (as opposed to the generic form of health promotion which has largely Western origins) emerged in response to Indigenous peoples’ needs to make space for our own ways of seeing the world and as a vehicle to realise our aspirations to sustain future generations who are healthy, proud and confident as Indigenous peoples. It is an Indigenous-led endeavour with origins that stretch back in time to customary systems to maintain health and wellbeing that emphasised social and ecological connections. At the same time, Indigenous health promotion is open to knowledge generated from within other worldviews where there is alignment. Indigenous health promotion can be understood as the process of increasing Indigenous peoples’ control over the determinants of health and strengthening our identities as Indigenous peoples.
Ecological collapse is the greatest threat to human health and survival globally. Health promotion (policy, research, education and practice) needs to change to effectively respond to the challenges of the Anthropocene and bring intergenerational health equity into its systems and frameworks. Engaging with indigenous worldviews and bodies of knowledge
provides opportunities to find solutions to this most pressing threat and ways forward to promote the health of Mother Earth and sustainable development.
We call on the health promotion community and the wider global community to make space for and privilege Indigenous peoples’ voices and Indigenous knowledge in taking action with us to promote the health of Mother Earth and sustainable development for the benefit of all.
This Statement represents the collective voice of the social movement members, researchers, practitioners and policymakers who participated in the 23rd IUHPE World Conference on Health Promotion, held in Rotorua, Aotearoa New Zealand in April 2019. It should be read alongside the Indigenous Peoples’ Statement for Planetary Health and Sustainable Development from this Conference.
The conference participants call on the global community to urgently act to promote planetary health and sustainable development for all, now and for the sake of future generations. Planetary health is the health of humanity and the natural systems of which we are part. 1 It builds on Indigenous peoples’ principles of holism and interconnectedness, strengthening public health and health promotion action on ecological and social determinants of health. It puts the wellbeing of people and the planet at the heart of decision-making, recognising that the economy, as a social construct, must be a supportive tool fit for this purpose in the 21 st century.
Waiora is an Indigenous concept of our host country, Aotearoa New Zealand, which expresses the interconnections between peoples’ health and the natural environment, and the imperative of sustainable development. 2 3 Waiora represents a call to work with Indigenous peoples to draw on Indigenous knowledge, and to share knowledge from our diverse cultural systems for the wellbeing of the planet and humanity. Sustainable development for all is a clear way to ensure environmental, social and health justice for the people of today and for future generations.
Urgent action is needed because mounting evidence tells us that the current
economic and social development paradigm of infinite growth and endless exploitation of limited natural resources is unjust and unsustainable, leading to inequities within and among countries and across generations.
In 2015, the UN General Assembly adopted the new development agenda
“Transforming our world: the 2030 agenda for sustainable development”. 4 The 17 Sustainable Development Goals (SDGs) integrate economic, social and environmental development around the themes of people, planet, prosperity, peace and partnership. In doing so, they provide an action plan for the global community.
They prioritise the fight against poverty and hunger while focusing on human rights for all, and the empowerment of women and girls as part of the push to achieve gender equality. The SDGs recognise that eradicating poverty and inequality, creating inclusive economic growth and preserving the planet are inextricably linked to each other and to population health. 5
Conference participants call for immediate action from the global community in four key areas.
- Ensure health equity throughout the life course, within and among countries, and within and across generations. This requires:
The development of all peoples as empowered lifelong learners and
engaged contributors to individual health and the health of families,
communities and the planet.
Action and accountability to address the wide and enduring inequities
experienced by Indigenous peoples, while ensuring the protection of
cultural identity and customary ways of life.
Tackling the structural factors that drive the inequitable distribution of power, money, and resources; improving daily living conditions especially of those most in need; and measuring and understanding the problem and assessing the impact of action as outlined by the Commission on Social Determinants of Health. 6 Prioritising intergenerational health equity in systems, frameworks and
decision-making, as a central tenet of a planetary approach to health
- Make all urban and other habitats inclusive, safe, resilient, sustainable and conducive to health and wellbeing for people and the planet. This requires: Renewing and strengthening our relationship with planetary ecosystems. Protection of the planet from degradation, including through sustainable production, management and consumption of natural resources so that the planet can support the needs of present and future generations. This requires taking, enabling and advocating for immediate action on climate change and the loss of biodiversity.
Action to reduce disparities in the quality and quantity of resources
available to communities as these disparities are at the root of inequities in health. Current threats will accentuate such disparities. These include threats to food and water supplies associated with climate change, depletion of both renewable and non-renewable resources, the degradation of the environment such as contamination of food chains and ecosystems, poor air quality and massive forced migrations.
Greater cross-sectoral action to protect and improve the health of
populations experiencing inequities, including those in the world’s fast- growing urban areas.
Fostering of peaceful, just and inclusive societies which are free from fear, racism, violation and other violence.
The realisation of the health co-benefits of sustainable ‘One Planet’ living.
Ensuring urban decision-makers apply a “health equity lens” to assess the
risks and opportunities posed by policies and programmes and measure
their effects. 7
- Design and implement effective and fair climate change adaptation strategies.
The development of new approaches to global, regional, national and local governance and stewardship that will equitably promote health and well- being and prevent and mitigate disastrous climate and environmental breakdown, particularly in Low and Middle-Income Countries.
Repositioning Indigenous and traditional knowledge systems to be on an equal footing with science and other knowledge systems to promote health and well-being and prevent and mitigate disastrous climate change and environmental breakdown.
Development of action-oriented policies and partnerships between health and other sectors to develop policies addressing health and climate.
- Build collaborative, effective, accountable and inclusive governance, systems and processes at all levels to promote participation, peace, justice, respect of human rights and intergenerational health equity. This requires:
Respect for and adherence to the inherent rights of Indigenous peoples as articulated in the UN Declaration on the Rights of Indigenous Peoples.
Effective global governance free from the domination of economic considerations and commercial interests.
The promotion of participatory democracy, coherent policy-making and regulation in the public interest and to restrict conflict of interest.
Participants at the 23rd IUHPE World Conference in Rotorua also confirm the critical role and relevant expertise of the health promotion community in promoting human health, planetary health and sustainable development, including implementing the SDGs. Participants urge the health promotion community to provide leadership across our one planet.
- Whitmee S, Haines A, Beyrer C, et al. Safeguarding human health in the Anthropocene epoch:
report of The Rockefeller Foundation–Lancet Commission on planetary health. The Lancet
- Durie M. An Indigenous Model of Health Promotion. 18th World Conference on Health Promotion
and Health Education. Melbourne, 2004.
- Durie M. An Indigenous model of health promotion. Health Promotion Journal of Australia
- UN General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development.
New York: United Nations 2015
- World Health Organization. Health in 2015: from MDGs, millennium development goals to SDGs,
sustainable development goals. Geneva: World Health Organization, 2015
- Marmot M, Friel S, Bell R, et al. Closing the gap in a generation: health equity through action on
the social determinants of health. The Lancet 2008;372(9650):1661-69.
- World Health Organization. Health as the pulse of the new urban agenda: United Nations
conference on housing and sustainable urban development, Quito, October 2016. Geneva:
World Health Organization, 2016.
There is an unprecedented opportunity for indigenous health promotion leaders to use this platform to share our ideas, strengthen our resolve and promote wellbeing from a specific indigenous perspective.The overarching theme of the conference for the first time includes the indigenous term “Waiora” loosely meaning “life-giving water”. Similar to “Vaiola” in Pacific vernacular the word relates to the sacred nature of water as a life-giving element. Appropriately, delegates will be situated in the south of the Pacific Ocean, the largest body of water on Earth, the historical home to many indigenous people, all of whom maintain a deep appreciation and affection for the ocean and the islands upon which they depend. Te Reo Maori a world-first For the first time Te Reo Maori as an indigenous language will be one of the four official languages of the conference. It will not only be used and encouraged throughout but also built into the official programme. Delegates will be able to experience this from the opening powhiri (Maori welcome ceremony), the inaugural speech in the Maori language by a plenary speaker, Tamati Kruger through to the poroporoaki (closing ceremony) where in each case the language will take precedence. Broadly, indigenous Maori themes, language, storytelling, arts and performance will provide a wonderful array of cultural features to enhance what is shaping up to be a wonderful scientific programme. Significantly, along with Tamati Kruger four of the other 11 plenary speakers are from indigenous backgrounds. Stanley Vollant, Sir Mason Durie, Tony Capon and Colin Tukuitonga will bolster what is already a strong format for indigeneity at the plenary level. In terms of leadership this group provides a global perspective that will influence indigenous health promotion practice well into the future. The programme also includes an Indigenous sub-plenary and opportunities to observe and participate in oral presentations, workshops and poster walks where indigenous health promoters and those working in indigenous communities can share their ideas. Committed to the cause Some wonderful work is also going on in the background. For the first time a team of guest editors will pull together an Indigenous Supplement to the IUHPE Global Health Promotion Journal to be released in time for the conference. The propensity for a supplement such as this to reach across the globe is not underestimated and the leadership of the IUHPE team working on the journal, the editors and guest editors to engage in such a project is a fine example of commitment to an important cause. Additionally, a small team is working on drafting a Rotorua Indigenous Statement (yet untitled) to be considered for ratification in Rotorua. Not underestimating the magnitude of this project, the team is looking to include a wide range of perspectives, draw on expert knowledge and finally put out a call for support. At this stage the proposal is to release draft one version early in the New Year for members to consider, followed by a second draft in early March. The third and final draft will be presented at the conference itself and with the support of the delegates, formally endorsed. In mentioning Rotorua, it should be noted that Te Arawa, the tribal hosts and supporters of the conference are renowned not only for their hospitality but also for their cultural strengths in history, language and arts. These are significant factors which have contributed to tribal, social and economic development not only in the city but across the lake’s region. It is impossible to escape indigeneity in this part of the world. It is an indelible asset that speaks to a world of possibilities, not only for Aotearoa New Zealand but for everyone and every place. Trevor Simpson is HPF’s Deputy Executive Director / Senior Health Promotion Strategist (with Portfolio in Māori development).
Hauora catches up with HPF’s Executive Director, Sione Tu’itahi, on the significance of the conference for New Zealand and the world.What made you decide to invite the conference to NZ? There were three major reasons. First, New Zealand is part of the global community. And we have common, global challenges that determine our health and wellbeing, such as the environment, economy, education, governance and leadership, which directly impact at the national and local levels. To address these challenges, we must engage on all levels, especially at the global level. No man is an island anymore. The world is but one country. Second, and as part of the significant damage caused mostly by us humans to our natural and built environment, climate change is the most urgent issue to be addressed today. Our Pacific region, is where climate change is most evident – eroding and sinking islands, sea level-rise because of global warming, tsunamis, cyclones, and people having to migrate from their homelands because of these disasters. Clearly, the environment is one of the major determinants of our health and wellbeing. So our region must engage in finding solutions to these issues through health promotion and other professional fields. And it is timely and propitious to have that conversation in our region so that health promoters, other health workers, policy makers and other professionals whose work impacts on our health and wellbeing, come together to share experience and explore solutions. That is why we have the conference over-arching theme as “Waiora: Promoting Planetary Health and Sustainable Development for All,” and the 17 UN Sustainable Development Goals (SDGs) as the framework. Third, New Zealand is a world leader in Indigenous knowledge and health promotion. Indigenous knowledge systems are now being acknowledged as contributors of solutions to world problems. We can share our experience with the rest of the world, and we can learn from their experience too. For example, Indigenous cultures see humanity as part of and inseparable from the environment. Therefore, we humans must live in harmony with nature, and within its limits. The dominant cultural paradigms of the last two centuries regard humans as not only separate from but also owners of the environment, which is seen as a limitless resource to exploit for their insatiable wants. Today we all experience the folly of such perspectives and practices. I think we are beginning to learn some lessons from that erroneous worldview and its underlying values and principles. Overall, we decided to host because we think that New Zealand health promotion can contribute to addressing inequities and the wellbeing of the world. But also, we have a lot to learn from colleagues around the world, and to strengthen our relationship with IUHPE which leads the ongoing advancement of health promotion, including the development of the global accreditation framework for health promoters. HPF is party to the development of that global accreditation framework which will enhance the efficacy of the health promotion profession for the competency of health promoters and the wellbeing of peoples and communities they serve around the world. Among other benefits, it will also give international recognition to national health promotion qualifications, with positive implications for work in other countries. What other benefits can New Zealand gain from the conference? There are a few major benefits, not just for New Zealand but for the rest of the world. Evidence-based knowledge that works will be shared and everyone will learn at the conference. Also, national, regional, and international networks and collaborative efforts will be further enhanced and strengthened among professionals across health and other sectors. We have no choice but to work together, or we suffer and perish together, whether we like it or not. A third benefit is that two statements from the conference will provide future pathways for policy makers, health professionals and communities on how to address our common, global challenges that impact on our common home, planet earth. One of these two future-focus statements will be on Indigenous health promotion. A fourth benefit is that Te Reo Maori is elevated to one of the four official languages of the conference. This is a world-first for IUHPE and for New Zealand. It might be a small step, but to have an indigenous language as one of the official languages of a world conference is a giant step for indigenous human rights. It is also a most empowering message to indigenous peoples and ethnic minorities in terms of championing their rights, their wellbeing, and preserving their knowledge systems through preserving their languages. Actually, having Te Reo as an official language is part of our using of Te Tiriti o Waitangi as the framework for organising the conference. It is another way of sharing our New Zealand experience with the rest of the world. A fifth benefit for New Zealand is the aspirational goals for Rotorua to be a ‘healthy city’ under the World Health Organization (WHO) system. And, of course the 2000 participants will bring economic gains for the country, and not just the tourism sector. It is our experience that participants travel to gain knowledge and enhance their professional networks, but they also take their families and loved ones to visit the host country. It’s a great way of promoting our beautiful country to the world. So you see, the conference will bring many benefits to all parties. It is a win-win initiative. But what challenges do you and your team face in organising this world event in NZ? There are the usual logistical challenges that come with organising events, such as finance, appropriate venues, communication, transport, accommodation and food. All this while trying to create a high-quality scientific and social programmes that will attract the top of your profession as keynote speakers, as well as other participants who will bring their latest research findings and professional experience to share and to learn from one another. What makes it more challenging is that you have to build an international organisational structure at three levels – global, national and local – to plan and manage across different time zones with colleagues around the world. Put on top of that the fact that you have to have keynote speakers from the four official languages of the conference – English, French, Spanish, and Te Reo Maori, and consider gender balance, linguistic & ethnic diversity, and age. But thanks to technology, our 100 HPF member organisations, our professional conference company (The Conference Company), and the help of Tourism New Zealand, as well as our co-organiser, IUHPE, we are managing well, with the usual hiccups, of course. Challenges are good and timely incentives to help ensure you do your utmost best and become more innovative and prudent at the same time. (Sione pictured catching up with Pacific delegates from Tuvalu and Kiribati at the WHO congress on health promotion, Shanghai, 2016) From an educational perspective, this is excellent professional development training for our team and others in the country and overseas who have volunteered to help organise the conference. It gives you a real sense of how we live and work as a global village – i.e. we work together across national, geographic and cultural borders to address challenges that confront us all as one human family. As for the conference programme, we have a line-up of public health and health promotion leaders, such as Sir Michael Marmot, Professors Fran Baum, Anthony Capon, and Sir Mason Durie, as keynote speakers. And we are shaping up a highly educational and informative scientific programme that our expected 2000 participants will enjoy and learn a lot from. You will find more details on the conference website http://www.iuhpe2019.com/ We would love to see all our health promotion and public health colleagues around the world, especially those here in the country, join us. Because public health and health promotion is so relevant to other sectors, such as education, local government, social work, community development, and sustainable development, we would like to think that this is also a conference for colleagues working in those sectors. Health and wellbeing in its broadest meaning and dimensions, such as physical wellbeing, mental wellbeing, economic wellbeing, social wellbeing, cultural wellbeing, and environmental wellbeing, are at the core of the work of most sectors. You started planning the conference in 2016, but you have been involved with IUHPE for more than 10 years now. For example, you have been a member of the IUHPE Global Executive Board, and Vice President of IUHPE for the South West-Pacific region for some six years. What prompted you to be involved with IUHPE? The main reason is we are now a global village. Our global challenges are not only inter-connected but they impact on all levels – from the local to the global, and vice-versa. IUHPE provides that global platform and network for health promotion and HPF, hence my involvement. Our focus is still New Zealand, but we include other levels in our work here at HPF. Take smoking and climate change as two health challenges. They impact on all levels. New Zealand’s involvement at the global level helps to find more lasting solutions at its national level for both issues. The other reason is that good governance and effective leadership is needed if we are to be effective in whatever field we work. HPF saw the opportunity to lead and we took it up on behalf of the South-West Pacific region, which covers NZ, Australia, all other Pacific island nations, and some countries in South East Asia. My first IUHPE world conference on health promotion was in 2007 in Vancouver, Canada. I attended along with former HPF Executive Director, Dr Alison Blaiklock, and another former HPF co-worker, Joanne Aoake. I saw then the opportunity to build the relationship with IUHPE, and bring my experience and learning to our team and the health promotion workforce. Hosting the conference is the latest development of that professionalrelationship with IUHPE. But there are other developments such as having our Deputy Executive Director, Trevor Simpson, as the Chair of the International Network for Indigenous Health Promotion Professionals (INIHPP) of IUHPE. HPF is also leading the work for New Zealand health promotion to become part of the global accreditation framework for health promotion, recently established by IUHPE. IUHPE has a standing work relationship with WHO, which is a partner of the conference, along with the Secretariat of the Pacific Community (SPC), being led by Dr Colin Tukuitonga, and the Australian Health Promotion Association. (Taking time out for a photo with Professor Ilona Kickbusch, one of the architects of the Ottawa Charter, 1986.) You have years of working as a journalist in Tonga and the Pacific, then retrained as a teacher and taught at some of the tertiary educational institutions here in New Zealand. Why did you later choose to work in health? And what has the experience been like for you? Health and education are two important and related determinants of the wellbeing and prosperity of Pacific peoples, in fact, all people. Good education means not only you are enlightened, but you also have a decent income which enables you to afford a healthy life, and be in control of your future. I learned these things early on through my family experience, especially from my grandparents and parents. They were humble folk from humble beginnings in Tonga, but education, being prudent, hard work and serving others were central values and goals. My mass communication, teaching, and strategic capacity-building experience were very handy when I was invited to set up a Pacific team at the Auckland Regional Public Health Service some 20 years ago. At the time I was starting to build the Pacific capacity of Massey University. I saw the invitation as an opportunity to do the same strategic work for Pacific peoples in the health sector as well. I was later seconded to build the Pacific capacity of HPF, which led to where I am today. For more than 10 years, I shared my time between Massey University and HPF, until I decided recently to focus on my health work, for now. And your strategic outcomes for the conference? There are at least three strategic outcomes. And the conference is a platform to enhance those long-term outcomes: Strengthen our co-leadership in health promotion at the global level, such as our work with IUHPE, which not only elevates the prestige of HPF, but more importantly, helps to build the capability and capacity of the health promotion workforce and sector in NZ and the world, for the wellbeing of society. Enhance our leading contribution to the world in Indigenous health promotion; Ensure the sustainable strength and longevity of HPF and the health promotion sector in New Zealand.
- Ms Osnat Lubrani, UN Resident Coordinator and UNDP Resident Representative, UNDP Pacific Office,
- Dr Viliami Puloka, HPF Pacific Leader and Otago University Research Fellow,
- Rt Hon Helen Clark, UNDP Administrator and former Prime Minister of New Zealand,
- Ms Leanne Eruera, HPF Business Manager and 2019 Conference Project Manager,
- Mr Sione Tu’itahi, HPF Executive Director and IUHPE Vice-President.
- Such campaigns do not address the primary causes of inequalities such as poverty and deprivation and
- There is greater likelihood that the approaches would be taken up by the more literate and financially-able middle classes than those living in poverty.
- Measures through the taxation and benefits system;
- Agencies collaborating to work effectively on related policies such as housing and education;
- NHS to provide better access to primary health services for the poorest and most vulnerable.
Highlights from the International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion– “Best Investment for Health” IUHPE President Michael Sparks took time out of his busy schedule to present the highlights of the conference for HPF. The 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion in Pattaya Thailand was noted for its truly global focus. More than 2,000 delegates, from over 80 countries attended the event this August. The theme – ‘Best Investment for Health” – provided many opportunities to discuss and debate this crucial question, as well as to share good practice, network and socialise. It was the first time the conference was held in a developing Asian nation. This gave participants from the region an unprecedented opportunity to participate. In turn, it afforded a greater understanding among all participants of the varying levels of investment in health promotion across countries and of the broad range of issues affecting the practice of health promotion across the different contexts.
|Highlights of the 21st International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion:
New Zealand contributionOf particular interest was the work done by the IUHPE’s Indigenous Health Promotion Network. Work done in the South West Pacific region with Māori and Indigenous Australian populations is often viewed as cutting edge and sessions were well attended by conference participants from other countries. Presentations from the region included a well-received one by HPF’s Deputy Executive Director Trevor Simpson. Another development of particular interest to health promoters of Aotearoa New Zealand was the shifting of the leadership in the South West Pacific region of the IUHPE to this country. The Health Promotion Forum of New Zealand Executive Director, Sione Tu’itahi, has been elected Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research Unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health, Otago University is its Regional Director. Until now these positions have been drawn from Australia for many year.
Delegates weighed in to support local battle to improve tobacco control in ThailandDuring the conference there were also interesting developments in relation to local tobacco controls. The tobacco Giant Philip Morris challenged in court the Thai Ministry of Public Health’s legislation to increase health warnings on cigarette packages to 85% of the outer surface. The country’s lower court issued an injunction against the Public Health Ministry to suspend enforcement of the regulations. Informed of these developments, conference delegates took action: developing a letter of support to the minister and petitioning the IUHPE General Assembly to write to the minister. Delegates also participated in a local media event to publicise the global support for tobacco control clearly evident at the conference. Following the conference The Ministry, encouraged by the support from the global health promotion community, has appealed against the injunction to the Supreme Court. A ruling is expected late this year or early in 2014.
New awards createdTwo new awards were created this year: the “most liked” daily poster session and the “Health Promotion Practice” awards. Recipients of the latter were three distinguished practitioners:
- Dr. Gene R.Carter, the Executive Director and CEO of ASCD (formerly the Association for Supervision and Curriculum Development)
- Prof.Prakit Vathesatogkit, Executive Secretary, The Action on Smoking and Health Foundation
- Dr. Don Eliseo Lucero-Prisno III, Lecturer, University of Liverpool
HPF – and New Zealand – is making a significant contribution to world health agendas. Its most recent input was to the scientific programme of the 16th World Congress on Tobacco or Health. As a member of the board of the International Union for Health Promotion and Education (IUHPE), HPF’s Executive Director Sione Tu’itahi ensured the needs of indigenous peoples and ethnic minorities were included in the recommendations invited from the global organisation.
“This is a big step for New Zealand, the HPF and for Maori and all other indigenous peoples,” says Sione. Smaller countries and ethnic minorities are often overlooked and vulnerable to the driving force of large companies and countries. “Having a voice at this level is a wonderful opportunity to advocate for the rights of these less-represented peoples.”
Recommendations about the conference from the IUHPE included:Discussions about the post-2015 development agenda to ensure health, including non-communicable diseases and social determinants are given the appropriate attention. Discussion around support for politicians in the battle with tobacco industry on initiatives such as plain packaging. Seeing outputs and outcomes of the WHO Europe NCD ministerial event focussing primarily on tobacco.
- Focussing on ‘how to do’ as much as ‘what to do’
- Including the health needs of indigenous peoples and ethnic minorities in all strategies.
Sione is the first indigenous person from the Pacific region to hold an official post with the IUHPE. He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.
IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world. Its headquarters are in Paris. For the next three years (2013-2016) its South West Pacific Region office will be co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.
Sione recently attended a meeting of the IUHPE’s Global Executive Board in Paris. Read more about the trip here.
The HPF is a national umbrella organisation for health promotion organisations and teams in New Zealand.