Making a political choice: The Trondheim Declaration

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What does the Norwegian city of Trondheim have in common with Ottawa, Adelaide, Sundsvall, Jakarta, Mexico, Bangkok, Nairobi and Helsinki? Answer: until last year – nothing. Now: They are all associated with health promotion statements.

By Tone Poulsson & Øyvind Giæver

 

LogoTrondheimThe Nordic Health Promotion Conferences have a long tradition starting in 1987, much inspired by the global health promotion conference and the “Ottawa Charter for Health Promotion” from the previous year. However, the tradition from the global conferences of making statements and declarations has not had a counterpart in the Nordic conferences – until last year.
After an extensive process involving an editorial group, three plenary presentations, two workshops, e-mail inputs, and a mail box for suggestions, 747 participants agreed on a four page-declaration on the last day of the conference, 29th August 2014.

The title of the declaration – Equity in health and well-being is a political choice – affirms that equity in health and well-being is a political choice. Inequity is not inevitable or given by nature. The inequities are created in the shaping of our societies. And societies have the power and means to reduce those inequities.

Bosse Pettersson of Sweden drafting a structure for the declaration
Bosse Pettersson of Sweden drafting a structure for the declaration

The Trondheim declaration clearly states that the right to health is at heart of all our actions. Resources and opportunities must be distributed so that people can shape their lives according to their own desires and ambitions. In order to achieve equity in health and well-being, the Trondheim declaration points out four requirements:

  • The first addresses the fundamental causes of health and well-being through universal welfare and action on the social determinants of health. Society oriented efforts to reduce NCD must be based on an understanding of the political and commercial driving forces.
  • The second is about interactive governance and genuine commitment to implementation.  Only real and accountable implementation can give value to policies and plans. We must seek mutual benefits and synergies on equal terms through partnerships across sectors, but also identify potential conflicts and negotiate solutions accordingly.
  • The third concerns comprehensive evidence and knowledge. The declaration calls for a broad conception of evidence. We need to recognize knowledge from many disciplines and sectors, and use various methods and broad participation.
  • Fourth and finally – socially sustainable communities and healthy community development is key. Local and regional actors are closest to the population. Local and regional participation and commitment are the backbone of public health. They need sufficient resources and capacity.
A local volunteer with the mailbox for decalartion suggestions
A local volunteer with the mailbox for decalartion suggestions

The Trondheim Declaration points out the critical success factors of action on social determinants of health: solidarity, participation, universal welfare and good governance through democratic institutions that are transparent and accountable. In the last paragraph, the 747 participants commit themselves to spread the message to decision-makers; take an active role in achieving these shared ambitions; contribute to increased Nordic cooperation for equity in health and well-being in the Nordic countries and reduced health inequalities globally.

Tone Poulsson
+ posts

Tone has a master in Health Policy, Planning and Financing from the University of London (2001). She is currently senior advisor in the Public Health Division in the Directorate of Health, working mainly with strategies to reduce social inequalities in health.

Øyvind Giæver
+ posts

Øyvind holds a ph.d. in philosophy from the University of Oslo on expert input in health policy decision procedures (2004). He is currently senior advisor in the Public Health Division in the Directorate of Health, working mainly with strategies to reduce social inequalities in health.

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