Case Studies, Environment, Global

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.


Case Studies, Environment, Global

Rotorua Statement

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.
    This includes:
    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.


  1. 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
  2. Durie M. An Indigenous Model of Health Promotion. 18th World Conference on Health Promotion
    and Health Education. Melbourne, 2004.
  3. Durie M. An Indigenous model of health promotion. Health Promotion Journal of Australia
  4. UN General Assembly. Transforming our world: the 2030 Agenda for Sustainable Development.
    New York: United Nations 2015
  5. World Health Organization. Health in 2015: from MDGs, millennium development goals to SDGs,
    sustainable development goals. Geneva: World Health Organization, 2015
  6. 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.
  7. 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.



The Mayor of Rotorua has agreed to explore further the idea of Rotorua becoming a healthy city.

From left: IUHPE2019 co-chair and executive director of the Health
Promotion Forum (HPF), Sione Tu’itahi, Rotorua Mayor Steve Chadwick, Dr Faten ben
Abdelaziz, coordinator of Health Promotion with WHO and Dr Viliami Puloka of HPF.

Steve Chadwick told delegates at the closing of the 23 rd International Union of Health Promotion and Education’s conference that she was looking forward to seeing what was involved in the process of becoming a healthy city.

Ms Chadwick was handed the Shanghai Consensus on Healthy Cities by Dr Faten ben Abdelaziz, the coordinator of Health Promotion with the World Health Organisation. (WHO).
Ms Chadwick said as a signatory to the United Nations Global Compact – Cities Programme, which is a worldwide initiative aimed at creating sustainable societies, Rotorua was keen to see what the journey to becoming a healthy city would entail.

She thanked the conference for the Rotorua – Waiora: Promoting planetary health and sustainable development and Indigenous legacy documents.
“We’re looking forward to seeing what is in the legacy statements,” she said.
Executive Director of the Health Promotion Forum (HPF), co-host of the conference, Sione Tu’itahi thanked the mayor for her support and for welcoming delegates to the city.

HPF’s Dr Viliami Puloka thanked everyone on behalf of participants who came from all over the Pacific and presented a mural which was painted by young artists from the Solomons and New Caledonia to the people of Rotorua.

The artists who painted the mural just outside the Energy Events Centre are under the Pacific Community’s (SPC) WAKE UP! Project aimed at encouraging young Pacific Islanders to get involved in efforts to control non-communicable diseases.
“Our hearts are filled with aroha as we present this artwork to the people of
Rotorua,” said Dr Puloka.



IUHPE2019 Rotorua put Māori culture on the world stage.

Tamati Kruger and Dame Ann

Māori culture was woven through the 23 rd International Union for Health Promotion and Education World Health Promotion conference with a powhiri by Te Arawa for overseas guests and delegates setting the tone.
The theme of ‘Waiora: Promoting Planetary Health and Sustainable
Development for All’ reflected the indigenous focus of the conference, which was attended by more than 1000 delegates from around the world and New Zealand. It was the largest conference Rotorua has ever staged.

For the first time at a world conference, Te Reo Māori was an official language and at an IUHPE conference it was the first time an indigenous legacy statement was released.

An indigenous lounge was set up in the exhibition area of the event, which was co-hosted by the Health Promotion Forum of NZ (HPF), where delegates could watch women from Hapai te Hauora weaving and speak to kaumatua.

Delegates watch women from Hapai Te Hauora weaving.

Tūhoe leader Tamati Kruger’s speech was met with awe by delegates who
agreed it was powerful and inspiring. “The more we learn, the taller we get. Learning must never have the objective of knowledge. It must lead to action,” he told delegates.

Mr Kruger said it was good for our wellbeing to know who we are. It is not a protest, not a war against anyone but it was a “fight for our rangatiratanga, for our survival … that is our world today.

“Virtues are the habits that all of us need, so we may find the truths in our
culture and in our life,” he said.
“Tūhoe is Mauri ora … Tūhoe are looking for regular experiences of wehi, ihi, wana, in order to build themselves and fix themselves. Wana is a Māori term that generally depicts the thrill, joy and excitement of life and people need that to become decent and healthy people.

“Tūhoe declared Te Urewera, their land is a living being, their mother and can’t be owned. Their truth is based on their identity as Tūhoe. Being Tūhoe is their antidote to despair.”
Mr Kruger explained how Tūhoe was redesigning more appropriate spaces and buildings, criminal justice and crime prevention processes, energy and
recycling procedures and health services.

Women from Hapai te Hauora performing a Tī Rākau for delegates.

“Mauri Ora does not have an end date,” he said. He also emphasised the importance of climate change in Te Urewera. “Nature does not need people, people need nature. We don’t own the land. We live with it.

Dame Ann Salmond, Professor in Māori Studies and Anthropology at Auckland University addressed ‘Whaiora: The search for wellbeing”.
Dame Ann shared about the Christchurch shootings and said although there
was a need to acknowledge the racism and hatred that has always been with us, we can be hopeful about the emerging commitment to address these.

“New Zealanders pride themselves on tolerance but there has been much soul- searching in the wake of the Christchurch massacre. It was extraordinary to see New Zealanders reach for Māori values.
“We need to foster aroha and manaakitanga and kotahitanga,” she said.
Dame Ann said effective, accountable and inclusive governance sounded
mechanistic. “We need to look for new ways based on aroha and learn from Māori and Pacific traditions.

“The relations between and among people and other life forms are currently out of balance generating violence. Reciprocity has broken down.
“We need to strive for a state of ora: a balance between the wellbeing of the land, the wind, the sky, the ocean and all forms of life. Human wellbeing is just one element within this network of life,” she said. “If I am the river and the river is me. If the river is dying, I’m dying. It’s not poetry it’s reality, it’s public health. This is a relational theory of how reality works. We cannot separate our people from the environment.
“People are just one element in networks of kinship among all forms of life- health of people, land and oceans are but one.”

Sir Mason Durie who spoke at the launch of the conference emphasised how vital it was that indigenous approaches to planetary health and the health of people were acknowledged.
He talked about Te Pae Mahutonga, also known as the Southern Cross
together with the Matariki or Pleiades constellations to emphasise this.
Both star systems feature prominently across the Pacific as both navigational tools and as frameworks for the health of people and the environment.

He also shared his knowledge of indigenous health promotion and its intimate relationship to the natural world, the cosmos and people.
Sir Mason also reflected on the last two major health conferences held in
Rotorua, the first in 1907 when Māori Sanitary inspectors met for their first general conference. The conference took a health promotion approach.
The second was in 1937 when the Women’s Health League Te Ropu o te Ora, Tunohopu met.