Empowering people for sustainable development: the Ottawa Charter and beyond

In November 1986, 212 participants from 38 countries convened in Ottawa, Canada, at the first International Conference on Health Promotion organized by the World Health Organization (WHO), Health and Welfare Canada, and the Canadian Public Health Association. Although not representative of the entire globe, these participants adopted the Ottawa Charter on health promotion as “the process of enabling people to increase control over, and to improve, their health”. The five action areas identified were to: build healthy public policy; create supportive environments; strengthen community action; develop personal skills; and re-orient health care services, toward prevention of illness and promotion of health [1–3]. The Charter laid the foundation for subsequent efforts in advancing global health over the next 30 years, including development of the Millennium Development Goals (MDGs). The MDGs have given way to a more robust and comprehensive agenda, the Sustainable Development Goals (SDGs) [4], underpinned by the principles of reducing inequities and universal health coverage (UHC).Thus the vision of the Charter is foundational to progress in health care over the last 30 years. Here, we review the progress made and discuss the unfinished agenda of the Charter as well as opportunities to accelerate its objectives in the context of UHC and the SDGs, through collaborations of international and local health organizations.