The Relevance and Importance of Promoting Health in National SDG Responses
– Keynote Address at the 9th Global Conference on Health Promotion
Dr. Margaret Chan, Director-General of the World Health Organization
21 November 2016
His Excellency Li Keqiang, Madame Liu Yandong, Vice Premier of the State Council of China,
Excellencies, Honourable Ministers, Distinguished Participants, Ladies and Gentlemen,
I thank Shanghai, China, for hosting this event and thank Premier Li for gracing this very important Global Conference on Health Promotion.
The 9th GCHP in Shanghai is a watershed event, not withstanding 30 years ago, when the first ever meeting on health promotion was held, in Canada. In this complex world we are living in, we will learn the solutions, during this Conference, to support the health of the people living in a very complex world.
I commend Minister Li Bin and Mr. Ying Yong, Executive Vice Mayor of Shanghai, for making this event a success. Want to thank your leadership.
Another important measure taken by the Shanghai Authorities, which is very important and appreciated by this meeting, is the decision to make the airport terminals, railway stations and hotels smoke-free.
It goes without saying that China has done a lot in tobacco control, led by Beijing and Shanghai.
This is the first conference on health promotion being held under the Sustainable Development Agenda 2030, leaving no one behind.
At both the national and international levels, the Sustainable Development Goals formally embrace the need for multisectoral collaboration. Working tougher is important to deliver on these Goals.
What they do is to recognize that today’s complex health challenges can no longer be addressed by the health sector acting alone.
Curbing the rise of antimicrobial resistance requires policy support from agriculture. Abundant evidence shows that educated girls and mothers have the healthiest families.
Access to clean green energy is also important. Green energy drives economic growth, but it also reduces millions of deaths from respiratory and cardiovascular disease associated with air pollution.
The inclusion of a target for reaching universal health coverage, which is included in Sustainable Development Goal No.3, and includes financial risk protection, gives health the power to build fair, stable, and cohesive societies while also furthering the overarching objective of ending poverty.
Health is an end-point that reflects the success of multiple other goals. Because the determinants of health are so broad, progress in improving health is a reliable indicator of progress in implementing the overall Sustainable Development Agenda.
In the final analysis, the ultimate objective of all development activities, whether aimed at improving food and water supplies or making cities safe, is to sustain human lives in good health.
We welcome the attention being given to healthy cities, to good governance that follows a whole-of-society approach, and to health literacy as an enabling factor in promoting health.
City mayors hold the power for implementing the SDGs. Mayors can introduce health-promoting measures more easily across all sectors than at the national level.
The 2030 Agenda for Sustainable Development provides the platform for a whole-of-society approach.
Health literacy must extend from the personal to the political and policy levels.
Health promotion is essentially about delivering messages that change human behaviours. For example no smoking, healthy diet and more physical activities, and there is nothing harder to do in all of public health.
Some of the most successful strategies use population-wide interventions to reshape the environments in which people make their lifestyle choices.
At national and municipal levels, legislative and fiscal measures are among the most effective interventions, but often face stiff and well-funded resistance from powerful industries that market unhealthy products.
This is why we need health literacy at the political level, in the interest of policy coherence spanning multiple sectors.
Ministries of health nearly always have their facts and evidence straight, but ministries of finance, trade, agriculture, and foreign affairs are susceptible to persuasion by industry arguments.
The use of plain packaging to reduce tobacco consumption provides a good example. Industry’s first argument is: plain packaging does not work. This argument is not supported by the facts.
Plain packaging is a measure, under the WHO Framework Convention on Tobacco Control, pioneered in Australia. Following implementation of the country’s plain packaging law, as part of a comprehensive approach to tobacco control, smoking rates fell to historical lows.
No wonder governments like that France and the United Kingdom have begun implementing plain packaging laws, and New Zealand and Hungary have recently passed laws. Many other countries are close behind.
The tobacco industry tells ministries in non-health sectors a different story.
As industry argues, plain packaging fuels the black market, funds organized crime, and supports international terrorism. Such arguments sound terrifying, but not a shred of evidence supports them.
This example underscores my principal advice to you. Changing the environment in which people make their lifestyle choices requires extraordinary government commitment, courage, and persistence, even when we have all the facts on our side.
We cannot let health be sacrificed in what looks increasingly like a post-fact, post-truth world.
Tobacco use kills around 6 million people each year. That’s a fact.
Every single one of those deaths is an entirely avoidable tragedy. That’s the truth.
Ladies and gentlemen,
In October, WHO urged governments to introduce taxes on sugar-sweetened beverages to reduce their significant contribution to obesity, diabetes, and dental decay. This is in line with the recommendation of the WHO Commission on Ending Childhood Obesity.
Industry’s reaction has been swift, making two predictable arguments. First, soda taxes do not work, despite evidence to the contrary. Second, soda taxes are regressive as they punish the poor.
This argument ignores the fact that it is precisely the poor who suffer most greatly from diet-related diseases.
Across the world, noncommunicable diseases are the No.1 killers, and if we are talking about health for all people, we must address this very important subject. I urge governments to accept their responsibility to protect children. The argument that lifestyle behaviours are a matter of personal choice does not apply to children. Obesity in children is society’s fault, not theirs.
I wish you a fruitful conference and I certainly wish the 9th Global conference on health promotion a great success.