Mayors Preforum, Road to Shanghai
–Chile, July 25 and 26, 2016–
VISION, STRATEGIC DIRECTIONS, AND ACTION COMMITMENTS FOR THE HEALTHY MUNICIPALITIES NETWORKS IN THE AMERICAS
We, the mayors and senior political representatives of cities, municipalities, towns, and territories, gathered at the Mayors Preforum in Santiago, Chile, convinced of the increasing relevance and the significant contribution the Healthy Municipalities movement can make to the health and well-being of our citizens, confirm our commitment to action that will inspire and guide our work in the years to come.
This Declaration is meant to provide political impetus and legitimacy to strengthen the Healthy Municipalities movement in the Americas, building on our past investments and achievements and better tuning to and connecting with twenty-first century approaches to health, social development and sustainable development.
The Santiago Declaration outlines our rationale, the values and the principles, as well as the renewed strategic objectives and approaches of the Healthy Municipalities movement in our region in the light of emerging priorities, scientific evidence on solutions that work, lessons learnt from our work, and the work of the global Healthy Cities movement to date and the relevant regional and global strategies and plans.
The Declaration is structured around four main sections:
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Health and sustainable development and the key role of local governments
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Healthy Municipalities movement: values, principles, and approaches
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A renewed, reinforced agenda and important themes for the Healthy Municipalities movement in the Americas
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Declaration of Santiago, Chile (Political Statement for the Global Conference on Health Promotion, Shanghai, China, November 2016)
Health and Sustainable Development and the key role of local governments
We recognize that:
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Health is a fundamental human right and every human being is entitled to the enjoyment of the highest attainable standard of health.
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Health is a core value and goes hand in hand with the social, economic, human and sustainable development of our cities, municipalities and territories.
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The health status of our people and that of our communities is profoundly affected by the conditions in which individuals are born, live and work.
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The knowledge and experience of the social, environmental, urban, cultural, commercial and political determinants of health provide the basis for how we should understand and deal with health in our cities, municipalities and territories. The public health challenges of the twenty-first century to be addressed effectively require the full engagement of local (municipal) governments.
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Local (municipal) governments can provide effective leadership and capacity for intersectoral work for health and sustainable development and they can promote and enable community involvement and empowerment. Local authorities are in a better position than the health authorities to enlist the participation of a wide variety of social actors.
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Local governments generally have primary responsibility for planning and/or delivering services critical for influencing the social determinants of health (SDH) (e.g., education, transportation, housing, urban planning) and often they have responsibility for health service delivery and public health.
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Local (municipal) governments have a key and central role to play in the implementation of all the sustainable development goals (SDGs) and in particular address the strong links between SDG 3 (Good Health for All) and SDG 11 (Make Cities and Human Settlements Inclusive, Safe, Resilient and Sustainable).
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The well-being, health and happiness of our citizens depends on our willingness to give priority to the political choices that address equity and the determinants of health.
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Ultimately health is a political choice that should match our values and aspirations for protecting and constantly improving the health and well-being of all our citizens.
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This means creating supportive social and physical environments and conditions for enabling all people to reach their maximum health and well-being potential.
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In the complex world of multiple tiers of government, numerous sectors and both public and private stakeholders, local governments have the capacity to influence the determinants of health and well-being and inequities. They are well positioned to have such influence through whole-of-local government and health in all policies, regulation, integrated strategies and plans and partnerships across society
Healthy Municipalities movement: values, principles and approaches
We are very conscious of the fact that:
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The aim of the Healthy Municipalities movement is to put health high on the social and political agenda of cities, municipalities and territories by promoting health, equity and sustainable development through innovation and change.
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The Healthy Municipalities movement was created on the recognition of the importance of action at the local and urban level and the key role of local governments.
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The Healthy Municipalities movement is a political, strategic, cross-cutting and intersectoral initiative. “Healthy Cities/Healthy Municipalities” is a strong global movement because of its local political connection.
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Healthy Municipalities represents “a real-world laboratory” to generate good practices, evidence and knowledge, methods and expertise that can be used to promote health in all cities, municipalities and territories in the region of the Americas.
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Healthy Municipalities is a value-based initiative which offers the opportunity to whole-city governments and societies to promote health and well-being for all, using the very best evidence available and innovative ideas at any time.
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It represents a channel of connecting with the urban public health conditions on the ground across the region of the Americas.
The values, principles and approaches of the Healthy Municipalities movement are deeply rooted in the Constitution and key strategies and resolutions of the Pan American Health Organization (PAHO), the World Health Organization (WHO) headquarters, and other agencies as well as in the best available evidence and experience from practices from our Region and beyond.
In this context, we acknowledge the importance and relevance of the:
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Regional Plan of Action on Health in All Policies
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Rio Political Declaration on Social Determinants of Health (2011) and Resolution WHA65.8 (2012) of the World Health Assembly “Outcome of the World Conference on Social Determinants of Health”
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Health Promotion documents: Cuenca Declaration (1978), Ottawa Charter (1986), Declaration of Santa Fé de Bogotá (1992)
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The Curitiba Declaration and the La Granja Declaration
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Political Declaration of the United Nations High-level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases (2011)
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The Zagreb (2008) and Athens (2014) Healthy Cities Declarations of the European Healthy Cities movement
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The framework of the Sustainable Development Goals of the 2030 Agenda for Sustainable Development
We stress that:
Healthy Municipalities is a dynamic concept which should be continuously enriched with new developments and emerging priorities and scientific evidence. This is essential for Healthy Municipalities to maintain its relevance and credibility. The agenda, themes and goals of each phase of the Healthy Municipalities movement in the Americas should therefore reflect global and regional priorities and strategies and issues emerging from the urban (health, social, environmental) conditions in our Region.
We declare our constant commitment: -
To the promotion of action to put health high on the social and political agenda of our cities, municipalities, towns and territories
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To the fundamental values of the Healthy Cities-Healthy Municipalities movement since its inception, namely the right to health and well-being, equity and social justice, gender equality, solidarity and social inclusion, universal coverage and sustainable development
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To the following principles and approaches that should underpin all Healthy Cities-Healthy Municipalities policies, strategies and plans: addressing the determinants of health and root causes of ill-health and inequalities; promoting intersectoral action and partnership-based approaches; promoting health and equity in all local policies; supporting community participation, empowerment and democratic governance; and using the life-course approach.
Community participation is essential for the success of the Healthy Municipalities movement
The Ottawa Charter (1986) defined health promotion as “the process of enabling people to increase control over, and to improve, their health.” Giving a voice to individuals and communities and creating the pre-conditions for empowerment and meaningful engagement are at the core of the Healthy Municipalities approach. More than ever before and in the face of the fast changing social landscapes of cities and towns there is a need to create inclusiveness and social cohesion. Empowered communities will have the knowledge, the skills and the means to participate in decisions that affect their health and well-being and also navigate and access resources that can improve their health and quality of life. There is increasing evidence that socially inclusive and cohesive communities are healthier and happier.
We declare our commitment to the following critical issues:
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To investing in our cities, municipalities, and territories and our people striving to create cities for all our citizens.
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To fully using and integrating in our health development work, twenty-first century evidence-based public health and health promotion approaches and solutions that work.
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To ensuring that our policies and plans are comprehensive, systematic and strategic aiming at delivering best outcomes and maximum impact.
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To integrating health and sustainable development considerations in how we plan, design, maintain, improve and manage our cities, municipalities and territories and neighborhoods and use new technologies.
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To valuing social diversity and investing in building trust and cohesion amongst our communities.
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To employing whole-of-local government and whole-of-society and Health in All policies approaches in our efforts to reaching out to different partners (public and corporate) and civil society.
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To focusing in engaging with other sectors on what they can do for health and what health can do for them identifying win-win, synergistic and co-beneficial outcomes.
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To promoting policy coherence, synergies and better coordination as well as systems enabling joint planning and accountability.
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To investing in creating adequate capacity for steering, managing, and implementing our Healthy Municipalities initiatives and programs.
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To putting in place the resources and mechanisms for systematically assessing the health and the conditions that affect health in our cities, municipalities and territories as well as for monitoring our Health in All policies and reducing health inequality efforts.
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To publishing regularly a city health profile as a basis of identifying priorities and accountability for health in our cities, municipalities and territories.
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To increasing our investments in disease prevention and health promotion applying the social determinants of health (SDH), equity and economic lens and aiming at creating social and physical environments that are conducive to health and well-being as well as increasing health literacy.
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To promoting awareness about individual responsibility and social responsibility for health through SDH and equity perspective.
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To developing strategies and plans that are framed on population-based and life-course approaches.
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To developing an intersectoral integrated strategic framework and plan for health development in the city with commonly agreed goals.
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To making sure that local Healthy Municipalities plans and activities are aligned and connected with the main city development strategies.
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To developing local and national platforms, networks and fora that promote social dialogue and broad civic engagement.
A renewed, reinforced agenda and important themes for the Healthy Municipalities movement in the Americas
The Health Municipalities approach provides an adaptable and practical framework for delivering Health for All at the local level. It provides an exceptional platform for joint learning and sharing of expertise and experience between cities, municipalities and territories within and between our national networks in the Region.
We endorse the fact that:
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Every city is unique and distinctive and within the frame of the overarching goals and themes of Healthy Municipalities approach, cities, municipalities and territories have the flexibility to identify and give weight to areas that are of particular relevance to local realities.
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A big strength of the Healthy Cities/Healthy Municipalities movement is its diversity.
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Our commitment to Healthy Municipalities will not be wholehearted and comprehensive without being true in our actions to its fundamental values and principles.
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The transformative potential of a Healthy Municipalities strategy for local health promotion/development can only be made alive through joint efforts by the different stakeholders in our cities, municipalities, towns and territories.
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The future prosperity of urban populations depends on our willingness and ability to seize new opportunities to enhance the health and well-being of present and future generations.
We are fully convinced that the time is right to reinforce and expand our Healthy Municipalities movement in the Americas and commit to initiate a new phase of Healthy Municipalities in the Americas.
This phase should be shaped on the basis of six strategic priorities:
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To strengthen the political, strategic and operational capacity of our national networks
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To revisit, update and expand the goals, commitments and action agenda of Healthy Municipalities in our Region
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To agree on a minimum number of common goals that will be shared and pursued by all national networks and member cities, municipalities, towns and territories
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To introduce five-year cycles (phases) in the development of the Healthy Municipalities program in the Americas that will provide the opportunity to regularly renew its action agenda and evaluate the outcomes and lessons learned from each phase
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To establish the International Healthy Municipalities Network of the Americas comprised of our national and local networks, and develop a common strategy with principles, priorities, and standards
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To actively seek to connect with the global Healthy Cities movement and key international networks of cities and municipalities that are concerned with aspects of urban development
We recognize that:
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Strengthening leadership and governance for health and well-being is fundamentally crucial, and for this reason we will join our efforts to promote better awareness and dialogue about the principles and added value of Healthy Municipalities; the political determinants and capacity required for change and innovation; and methods for reaching out to other sectors and engaging civil society
We declare our commitment to a comprehensive Healthy Municipalities framework that covers six action domains:
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Promoting local leadership and intersectoral governance for health/working together for the health of our city
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Addressing the needs of people of all ages and vulnerable groups/caring for our people and community and promoting equity
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Creating supportive physical and social environments for healthy living/making the healthy choices, the easy choices and healthy settings
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Promoting healthy physical and built environments/making the city clean, safe, attractive and sustainable
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Strengthening community resilience and health literacy/engaging and empowering our people with knowledge and skills for health and well-being
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Strengthening public health services and community care services/making high-quality services accessible to and for all
We declare our commitment to including in our strategies a minimum set of seven common goals:
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To ensure that the HiAPs and SDG agendas are explicitly and fully integrated in our vision and plans
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To give high priority to community participation and empowerment and community resilience
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To measure and systematically and comprehensively address health inequalities
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To give all our children a healthy start in life with the active involvement of different sectors (such as health, social services, education, housing and planning), families and communities
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To create conditions for healthy and active living for all with emphasis on physical activity, healthy and sustainable nutrition, reduction of obesity and mental stress, controlling the use of alcohol and creating smoke- and drug-free cities.
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To increase health literacy among individuals, communities and institutions
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To invest in healthy environments and healthy urban planning and design, creating safe and clean neighborhoods with access to green areas and space for social interaction and good facilities for all and creating age- and child-friendly settings
We finally declare our commitment to:
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Increasing our capacity for effective leadership and intersectoral action through whole-of-government, whole-of-society and HiAP approaches
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Working together as city leaders and as national networks promoting solidarity, sharing experiences and shaping our future visions and strategies
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Generating policy and practice expertise, good evidence, knowledge and methods that can be used to promote health in all cities, municipalities, towns and territories in the Americas Region
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Establishing working links between cities, municipalities and territories and networks of local authorities in the Americas and partnerships with agencies concerned with urban issues
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Increasing the accessibility of the Healthy Municipalities movement in the Americas to all member states in the Region
Declaration of Santiago, Chile
This is our moment!
We, the mayors and city managers of Chile, Ecuador, Peru, Guatemala, Cuba, Brazil, Argentina, Mexico, Haiti, Colombia, Guyana, and Paraguay, present at the Mayors Preforum of the Americas, Road to Shanghai 2016, held July 25–26, 2016, in Santiago, Chile, hereby declare that:
The Global Conference on Health Promotion, to be held in Shanghai, China, in November 2016, offers a unique opportunity to strengthen political commitment to health promotion and the Healthy Cities, Municipalities, Towns, and Territories Movement worldwide.
This is our moment to promote policies and action to address health determinants, human rights, and inequities through health in all policies and intersectoral approaches, within the framework of Sustainable Development Goals.
As local leaders, we are convinced that we have the power to make a real difference in the health and quality of life of the citizens of our territories.
We are determined to improve the development and performance of local and national healthy cities networks.
We are convinced that national policies must recognize the importance of the role of municipalities in health development and actively promote healthy cities networks.
It is our conviction that working together, we can create synergies and platforms for sharing our local experiences and innovations. We have therefore decided to create an International Network of the Americas and develop a common strategy with principles, priorities, and standards.
We call on the international community and international agencies, such as the Pan American Health Organization (PAHO/WHO), to join us in this effort and assume this commitment.
In witness whereof, we, the participating mayors and city managers of the Americas, sign the Declaration of Santiago in La Granja Municipality, Santiago, Chile, on 26 July 2016.