Statement on the 70th anniversary of the International Union for Health Promotion and Education

Congratulations to the International Union for Health Promotion and Education (IUHPE) on 70 years of service to the health promotion community! Let me personally attest to the gratification it was to serve as Vice-President for Scientific Affairs (2004–2007; 2013–2016) and President of IUHPE (2007–2010). In particular I enjoyed working over many years with the competent and wonderful staff based in Paris. In addition, it was a real pleasure to work with many of the dedicated individual members of IUHPE. Memories of that time linger and remain as a highlight of a 50-year career in public health. Many of those I worked with at IUHPE remain close friends to this day.

It has not always been easy for a non-governmental organization (NGO) in health promotion. Global health promotion itself has had a long and tortuous path in the public health arena. It has always had an uphill struggle to be seen as a critical component of public health by the established public health profession, somewhat analogous to how public health has been regarded as a secondary choice in medicine. Make no mistake, health promotion has been and remains a marginalized field of public health. The he extent to which this unfortunate situation has improved over the years can be attributed to IUHPE and other NGOs motivated by a determination to change public health to a social science-based field addressing the health of the public. Causality is a difficult concept, but I have little doubt that such key ideas as concern with the health of marginalized peoples, concern with health as an area of policy and advocacy in sectors outside the biomedical sector, and a general concern with those socio-economic factors that underlie the health of the public significantly emerged from the work of IUHPE and other key global health organizations. Of course, direct evidence of such an organizational impact is not easily proven, but the continuing and persistent efforts of IUHPE, its officials, its staff and its members to emphasize a broader concept of public health is revealed in its 70 years of work. Furthermore, IUHPE is particularly challenged due to its global emphasis, because global membership-based organizations have special financial challenges to sustain their influence and viability. Nonetheless, the organization has survived and continues to work at the global level.

Predicting the future of IUHPE, or public health for that matter, may be a fool’s errand. Nonetheless, over many years IUHPE managed to keep its emphasis on the broad global goals of health promotion. Current times appear to be a challenge to this mission especially as we witness a rising anti-globalism and return to crass nationalism. Hopefully, the long-term trend will be in the direction of IUHPE’s global interests. In fact, the pandemic of 2020 has revealed with great clarity the necessity and key role of global health promotion in the future of the public’s health. The helplessness of clinical medicine to address the pandemic was revelatory. Further, across much of the globe and most notably in the world’s most advanced economies, traditional public health was found wanting in dealing with the pandemic. What was revealed was the role of health literacy, politics, policy, confusion, complexity, communication, racism and prejudice in the pandemic – all areas that are profoundly at the center of health promotion’s remit and relate to the discourse on what promoting the public’s health is really about. In other words, the need for work that is basic to IUHPE’s global mission was revealed. The challenge for an organization like IUHPE is to continually address the fundamental issues that drive health promotion as a concept and to convey the message of health promotion to the public at large, but most importantly to the field of public health. The field and practice of public health exist particularly in institutions: schools of public health, government departments of public health, and global organizations of public health. A survey of most of these institutions across the globe would reveal, in my opinion, a paucity of the health concerns shared by IUHPE and many other health-related NGOs. For the future of IUHPE and health promotion, this must change and IUHPE should play a significant role in addressing this needed change. For example, for at least the past 150 years we have known the role of poverty in fostering poor health in the public sphere. This role is not well addressed by traditional epidemiology, despite good efforts by many practitioners to develop a meaningful social epidemiology, and yet epidemiology with its bio-medical base is still seen by many as the ‘science’ of public health. The ‘science’ of public health is not really found in the biomedical sciences, it is in the social sciences. It is the challenge of organizations like IUHPE to make this point, over and over, until the public’s health changes.