The Ottawa Charter is 40 years old

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🎂🌏 40 years after the Ottawa Charter, how can we translate its ambitions into practice? A historical perspective and avenues to strengthen participation, equity, cooperation, and ethics within teams.

. 📌 Understanding the history of the Ottawa Charter, adopted in 1986, helps to give meaning to current practices: acting on living conditions, building health-promoting policies, and working with communities, rather than limiting ourselves to individual behaviours. Forty years on, this editorial questions how to realise this ambition. Drawing on Australian examples, it invites professionals to reflect on their ways of working: what place should be given to the knowledge and priorities of populations? How can we strengthen cooperation between sectors, advocacy, and ethical reflection? A resource to connect the historical foundations of health promotion to the daily choices of teams, without constituting a ready-to-use methodological guide.

1️⃣ SUMMARY

Editorial published for the 40th anniversary of the Ottawa Charter. Starting question : has the field built the workforce, ethical frameworks and governance capacity necessary to realise the vision of the Charter (p. 1)? The text addresses health in all policies, or HiAP (p. 1-2), the commercial determinants of health, including digital platforms (p. 2), then equity, social justice and the decolonisation of practices, with the example of acute rheumatic fever and rheumatic heart disease among Aboriginal and Torres Strait Islander populations (p. 2-3). It then discusses systems, the workforce and governance: ethics, advocacy, reflexivity (p. 3). It concludes with perspectives, including climate change and the World Conference on Health Promotion in 2028 in Melbourne (p. 3-4). No target audience is explicitly stated.

2️⃣ KEY TAKEAWAYS

1️⃣ Observation: a gap between ambitions and capacities. Real progress exists in workforce development, but there is a lack of a codified ethics of practice, a sustainable investment and governance frameworks suited to the social, commercial and environmental determinants (p. 1). In Australia, in many contexts, the workforce remains under-resourced and without stable funding (p. 3).

2️⃣ Observation: no globally recognised code of ethics.. According to the authors, this absence persists even though ethics is a core competency of health promotion. In practice, it is often reduced to compliance with research ethics committee procedures, rather than being viewed as an ongoing process of reflection and responsibility. The Health Promotion Ethics Project of the AHPA, trialled in 2024 with five organisations, is presented as a model response to these challenges (p. 3).

3️⃣ Authors' proposal: five priorities. Integrate HiAP across all sectors; prioritise planetary health; tackle commercial determinants; prioritise equity through a structural and systemic change; strengthen systems, workforce and governance, including ethics, advocacy, reflexivity and decolonising approaches (p. 4).

3️⃣ TO ACT

Positioning document: it does not provide a directly usable tool on the ground. The suggestions below are based on explicitly cited elements.

1️⃣ Integrate reflexivity into training (case 1: action explicitly requested by the document). The authors recommend making it a central design principle for training, both initial and ongoing (p. 3). They present reflective pedagogy, particularly in planetary health and advocacy, as a practical approach (p. 3).

2️⃣ Draw inspiration from ethical supervision frameworks The Health Promotion Ethics Project of the AHPA, trialled in 2024 with five organisations, combines a discipline-specific ethical review, adapted document templates for health promotion, and supervision provided by practitioners. The text also cites ethical supervision mechanisms at the community level in New Zealand and Canada (p. 3; refs. 34-36). It does not specify the conditions for public access to the mentioned document templates.

3️⃣ Preparing for the World Conference of 2028 (case 3: preparation for an announced action). The document presents the World Conference on Health Promotion of 2028, in Melbourne, as an opportunity to revisit the Ottawa Charter (p. 4). It does not specify the modalities or the timetable for contribution.

4️⃣ 3 PRACTICAL QUESTIONS

1️⃣ Is there a globally shared code of ethics for the practice of health promotion?

According to the authors, there is still no globally agreed ethical code for this practice, even though ethics is a core competency. This does not mean that no ethical framework or mechanism exists: the text cites ethical supervision mechanisms at the community level in New Zealand and Canada, as well as a project by the AHPA trialled in 2024 with five Australian organisations (p. 3)

2️⃣ Why do the authors emphasise reflexivity?

The critical examination of values, assumptions, and power relations is considered essential so that health promotion does not reproduce the inequalities it seeks to reduce (p. 3).

3️⃣ How do commercial actors influence health according to the document?

Through marketing, political engagement and the strategic production and use of scientific data (p. 2). Digital platforms add the algorithmic amplification of disinformation, targeted marketing and the commodification of health data (p. 2).

5️⃣ TO GO FURTHER

1️⃣ Health Practices Blog — « 40 years of the Ottawa Charter: Stephan Van den Broucke's view on health promotion in Belgium » (referenced in L’Hebdo No. 44-2025, 5 November 2025).

pratiquesensante.odoo.com/blog/pratiques-15/40-ans-de-la-charte-dottawa-…-5324

and The history of Health Promotion -  https://www.pratiquesensante.com/1-5-hisoire-promotion-sante

2️⃣ External resource — Health Promotion International (Oxford University Press), special collection « Ottawa Charter at 40 »: editorials, case studies and interviews published in 2025-2026, presented by the publisher as open access. It contains two texts cited by the editorial (ref. 21 and 32). External source; page consulted and verified on 30/10/2026.

academic.oup.com/heapro/pages/ottawa40

6️⃣ #️⃣ HASHTAGS

#pratiquesensante #ChartedOttawa #Ottawa40 #HealthPromotion #CommercialDeterminants #HealthInAllPolicies #EthicsInHealthPromotion #Reflexivity

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