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COVID-19 has shown us clearly that the world must commit to a transformative approach that promotes health and wellbeing. Living in the Anthropocene – an epoch defined by human impact on our ecosystems – moves us into unknown territory. The challenge is to find a way of living that aims to meet the needs of all people within the means of the living planet. We will require foresight, agility and resilience to be well prepared. The global risks we face are enormous and they are interconnected – yet the opportunity to accelerate change for the better is extraordinary as well. We have models, knowledge and technologies at our disposal that could significantly improve health and wellbeing and create fairer and more sustainable societies – yet they have not been used widely to serve the public purpose and to address inequities.

The International Union for Health Promotion and Education (IUHPE) Position Statement on Health Literacy provides an overview of existing evidence and continuing debate on health literacy. Developed by the IUHPE Global Working Group on Health Literacy, including experts from around the globe, the Statement provides a basis for discussion and advocacy, by and with IUHPE, both within the health promotion community, and among stakeholders and partners in health promotion. The Statement offers a detailed introduction to the concept of health literacy, calling for global action to improve health literacy in populations. It positions health literacy as an important and modifiable social determinant of health, that plays a significant role in broadly-based strategies for health promotion. The Statement emphasises the necessity of a systems approach to health literacy, underpinned by global, national, regional and local policies. It summarises key evidence to guide practice and policy development, recognising the importance of continued investment in intervention research, in professional and consumer capacity building, and in the transfer of research findings into frontline health promotion practice. In summary, health literacy is understood as an important cross-cutting issue in health promotion throughout the lifespan, which has practical application in guiding clinical practice, public health interventions and public policy for the advancement of global health.

Communities are characterized by common interests, common ecology, and common social system or structure. These characteristics, qualities, and processes involved in the community affect both health behaviors and health outcomes during disease outbreaks. Hence, health promotion theorists and practitioners emphasize working ‘with’ rather than ‘on’ communities. They believe health promotion, with all its experiences in community mobilization, empowerment, and health literacy programs, should be part of disease prevention and control efforts from the very beginning. Health promotion knowledge needs to be fully integrated into infectious disease control, especially in the context of outbreaks.

Significant improvements in population health are likely to arise when the social determinants of health are addressed. This creates a challenge for health systems, as the policy levers to influence the determinants largely lie outside of their direct control. Health agencies have been attempting to develop responses that affect these policy levers with mixed success. Success often requires particular conditions or “windows of opportunity” to be present before even small systemic change can be made. The government of South Australia has developed a practical, policy-oriented response to address the determinants of health—Health in All Policies—and has been successfully working across government for the past five years, using a policy learning process to implement this approach. This article will focus on how the South Australian Health in All Policies initiative started and the conditions that enabled South Australia to establish a centralized governance structure, harness a group of cross-sector policy entrepreneurs, and conduct health lens projects across a range of policy issues. The authors will comment on the nature of these conditions and their relevance for other governments struggling to reduce the burden of chronic disease and growing health budgets by addressing the social determinants of health.

International health has as a rule been considered as the involvement of countries in the work of international organizations such as the World Health Organization, usually through small departments of ‘‘international health’’ in the Ministries of Health and as development aid and humanitarian assistance, more often than not handled by bilateral aid agencies linked (in most cases) to the Ministries of Foreign Affairs or to Ministries of Development. But even in these long-established areas of action there has not been enough cooperation between European countries to speak with one voice, support similar priorities, harmonize aid and cooperate at recipient country level. This division has also held back joint European action on global health. Global health refers to those health issues that transcend national boundaries and governments and call for actions on the global forces that determine the health of people [1]. It requires new forms of governance at national and international level that seek to include a wide range of actors. As in international health, in many countries as well as in the European Commission three strands of global health action generally run in parallel with little coordination or even in competition

La sante est au coeur meme de la modernite et du developpement. Elle a faconne la nature de l'etat nation moderne et de ses institutions sociales. La sante a fait avancer les mouvements sociaux, a defini les droits de la citoyennete et a contribue a la construction de l'etre moderne et de ses aspirations dans le monde developpe, tout en acquerant petit a petit un role similaire dans les pays en voie de developpement. La reussite de la sante publique a change la nature meme des societes developpees. Elles sont devenues des societes de sante, et se definissent par cinq caracteristiques majeures : - une esperance de vie elevee et des populations âgees ; - un systeme de soins medicaux et de sante expansif : - un marche de la sante qui se privatise rapidement : - la sante est un theme dominant dans le discours politique et social : - la sante est un but personnel important dans la vie. Chacune de ces cinq caracteristiques. et peut-etre encore plus leurs synergies sont en train de changer le visage de la sante publique et l'etendue de sa mission. Deux dimensions apparaissent comme des forces motrices : la faisabilite et l'expansion du territoire, et un nombre important de nouveaux acteurs de sante publique. Exactement comme aux 19 e et 21 siecles. l'action de sante publique va definir ce qu'est le progres non seulement pour la sante mais egalement pour les systemes economique et social de la societe du 21 siecle. Comment allons nous traiter les personnes âgees ? Comment allons nous payer la sante ? Qui a droit aux soins ? Jusqu'ou pousserons-nous nos capacites biologiques ? Toutes ces questions ne concernent pas uniquement la sante : elles ont trait a notre mode de vie. a la justice sociale et a la solidarite. Nous commencons seulement a comprendre la la dimension politique de cette evolution dans tout ce qu'elle implique, et son impact n'est aujourd'hui plus limite au monde developpe. De plus en plus, la sante publique doit faire lace a de nouveaux defis ; agir dans de nouvelles spheres politiques : commerce, industrie, droit international, politique etrangere, pour n'en nommer que quelques unes : ○ sortir de ses domaines d'action classiques pour entrer dans des champs comme la traitement de la toxicomanie, la genetique ou les droits humains; ○ repondre aux consequences de la privatisation et de la commercialisation toujours croissantes de la sante et des services de soins a travers le monde. Depuis l'arrivee des traitements antiviraux, par exemple, le VIH/SIDA n'est plus synonyme de peine de mort. Mais la faisabilite du traitement met alors au premier plan les questions de la disponibilite et de l'acces a celui-ci, que ce soit pour les riches comme pour les pauvres. C'est cette faisabilite de la sante qui de plus en plus conduit le debat sur la dignite humaine, l'equite et la justice sociale et pose de nouveaux defis a l'actions de saute publique. Les centres d'interet de la sante publique - l'equite, l'acces aux soins et aux services et les determinants de la sante -vont devoir prendre de plus en plus une dimension mondiale et examiner de maniere plus systematique comment les reponses de la sante publique doivent se partager entre riches et pauvres, entre communaute internationale et etats nations, entre citoyen et etat, entre secteur public et prive. Elle doit elaborer de nouveaux principes d'action dans un monde a considerer dans son entierete.

Just as new lifestyles both health promoting and health compromising are spread internationally so is disease. The influence of the media the spread of HIV/AIDS and the spread of certain patterns of behavior affect all communities to some degree. The need for health promotion health education and accurate relevant information and knowledge for building new partnerships and public policies supportive of health was therefore never greater. Significant technology communications and transport are available to exploit for the benefit of all. Active community participation plays an essential role in promoting and protecting health. There are many valuable lessons to be learned for implementation worldwide from examining how communities meet their challenges and needs. The author discusses community ownership strategies to meet existing challenges degrees of participation tools of health promotion a move toward community action the concept of community public health equity the present situation and WHO/HPRs five-year plan and international conference.