Advancing the Geneva Charter for well-being—Practical strategies for change
The Geneva Charter—realising the potential of a wellbeing society1 highlighted concepts and ideas relevant to policymaking, arising from discussions of a group of global leaders. This second editorial presents the challenges and opportunities in bridging the concepts with policy and political realities.
1 WHAT IS THE PROBLEM?
The Geneva Charter for Well-being expresses ‘the urgency of creating sustainable well-being societies, committed to achieving equitable health now and for future generations without breaching ecological limits’.2 Addressing this challenge requires sophisticated and holistic responses involving multiple sectors and actors from across society. This editorial provides examples of how three countries (Finland, Thailand and United Arab Emirates—see Boxes 1–3) and a non-government organisation (Wellbeing Economy Alliance—see Box 4) are working towards building and supporting well-being societies.
BOX 1. Finland case study
Dr Taru Koivisto, Director General, Ministry of Social Affairs and Health
Finland's determined efforts to promote the Economy of Wellbeing involve action within Finland as well as multiple international forums.2
Finland has a long history of Health in All Policies action.12 Building on this experience, a national steering group is preparing a national action plan to integrate the economy of well-being into knowledge-based decision-making and government processes. Intersectoral, and including civil society, the focus of the plan will be practical approaches to implementation, decision-making supports, concrete indicators and measurement tools across social, economic, environmental and health domains.
Complementing national action, Finland is also committed to working with other countries and partners to support the economy of well-being agenda.
BOX 2. Thailand case study
Dr. Weerasak Putthasri, Deputy Secretary-General, National Health Commission, Thailand
Thailand included the concept of well-being in their definition of health—the state of human being, which is perfect in physical, mental, spiritual and social aspects, all of which are holistic in balance13—as part of their Health Act in 2007.
A third National Health System Charter has been approved by Cabinet and acknowledged by Parliament. It aims to achieve an equitable, resilient, sustainable and inclusive health system, leaving no one behind and underpinned by Universal Health Care and a right to health. Further, the intention is to strengthen action towards Health in All Policies concepts and frameworks including participatory governance and to promote and support healthy environments and address social determinants of health towards a well-being society.
A critical part of Thailand's Health Act facilitates participatory public policymaking where civil society is actively involved in the entire policymaking process.
BOX 3. United Arab Emirates case study
Dr Hussain Abdulrahman Al Rand, Assistant Undersecretary of Public Health Sector, Ministry of Health and Prevention, UAE
- Flourishing country encompassing: a nation of opportunities; government that serves, protects and empowers; liveable cities and communities; sustainable living to protect the environment and natural resources and vibrant culture.
- Connected communities including stable, supportive families and homes; cohesive communities living together and positive places to work and study.
- Thriving citizens including living actively and well for better health, good mental health and positive emotions and fulfilment.
The nine strategic objectives include health, social, economic and environmental well-being as well as digital, education and organisation aspirations. A National Wellbeing Council coordinates the integration of efforts between different entities and sectors to enhance well-being along with 90 supporting initiatives including policies and programs to achieve desired outcomes.
The health component of well-being within the National Wellbeing Strategy 2031 consists of four pillars, namely: physical well-being that entails promotion of healthy lifestyles; mental well-being; establishing healthy communities of well-being in settings, particularly in schools, and at workplaces; and raising the level of satisfaction with health care services.
BOX 4. Wellbeing Economy Alliance case study
Michael Weatherhead, Development Lead, Wellbeing Economy Alliance
The Wellbeing Economy Alliance (WEAll) is the leading collaboration of organisations, alliances, movements and individuals working towards a Wellbeing Economy, delivering human and ecological well-being.15 A well-being economy is one where the economy is in the service of society and nature.
WEAll identifies five core dimensions of a well-being economy that unite us in our need for dignity, fairness, purpose, nature and participation.
The broad remit of the well-being economy means engaging and connecting people from diverse interests (e.g. climate, biodiversity, social affairs, social justice) and with diverse roles (politicians, businesspeople, activists and academics). Support structures including hubs around the world, the Wellbeing Economy Governments partnership, the Policy-makers Network as well as multiple narrative and knowledge resources and case studies.
2 WHAT ARE THE SOLUTIONS?
2.1 Governance and leadership
As the Geneva Charter notes, ‘well-being forms a new social contract and provides a compass for public policy’1 and stronger governance arrangements can support the changes required. All three countries have, or are finalising, national high-level plans setting directions for well-being, as well as committees typically involving representatives from different sectors (e.g., finance, human services, environment and health). Partnerships with civil society, such as those in Thailand, and non-government organisations, such as Wellbeing Economy Alliance (WEAll), are also critical. High-level country leadership is a vital characteristic.
2.2 Working nationally and globally
There is emerging international support for the movement towards well-being and the well-being economy. As noted by Finland, the International High-Level Group on the Economy of Wellbeing is sharing expertise, knowledge and articulating ambitions to support change.3 This is complemented by a Wellbeing Economy Governments (WEGo) partnership comprising Scotland, Iceland, New Zealand, Wales, Finland and Canada4: all countries that have implemented practical measures to promote the well-being economy approach. And the 75th World Health Assembly unanimously approved a UAE proposal for the setting up of a comprehensive framework for promoting the quality of life and well-being of individuals and societies in various countries.5
2.3 Acting locally
The complexity of building a well-being society requires widespread action. In an era where well-being targets are spread across all Sustainable Development Goals (SDGs),6 civil society plays a significant role in the intersection between political power and knowledge power. As a result of supportive legislation and a long history of engagement, civil society in Thailand is trusted and credible; such enabling environments can support communities to play a meaningful role in solving national and local well-being challenges and empowering communities at the same time.7
2.4 Resources and capabilities
Alliances across countries and organisations help to share expertise and collaborate on practical support for building well-being and assist countries become a well-being society.
There is a need for a common language and knowledge base about well-being and the well-being economy such that it can be applied across different disciplines and settings.8 Decision-making frameworks and processes are being developed to support this application, and the development of concrete indicators and measurement tools across social, economic, environmental and health domains is important. Policy labs allow practical exchange on specific policy areas. Upskilling the workforce is also important as is publication of evidence on the practical action that can be taken.
2.5 Health care
As recognised in the Geneva Charter,1 an equitable, accessible and resilient health system, based on Universal Health Coverage, ‘leaving no one behind’,9 is also important for well-being and the achievement of the SDGs. UAE and Thailand both noted that a well-being mindset helped them deal with COVID, including the use of digital solutions.
The health and well-being of people are influenced by complex social and environmental challenges including climate change, NCD risk factors, poverty and COVID.10 This requires an urgent rethink of the social and economic models in place and the importance of partnerships between sectors, with communities and countries to solve issues and protect people and the planet.
3 THE WAY FORWARD
Common to all country examples is a commitment to addressing the broad determinants of health; this is core business for people working in health promotion. Inequity underpins the problems of living within the boundaries of the planet; well-being forms a new social contract and provides a compass for better outcomes for individuals, communities and societies. The concept of well-being resonates across multiple disciplines and societal actors, and this breadth and ability to speak to diverse audiences can provide a powerful platform encouraging multiple groups from across society to unify behind it. For the health promotion sector, the Geneva Charter for Well-being1 provides a compass for the future.
- It is important to build a common language and good understanding about well-being, ensuring it can be applied across many different disciplines and settings.
- Secondly, boundary objects such as briefing documents and practice examples are important in building skills and solutions.
- Thirdly, understanding of the problem is growing but information about interventions—successes and challenges—must be published.
- Fourthly ‘boundary spanners’—individuals within an innovation system who have, or adopt, the role of linking the organisation's internal networks with external networks and sources of information11—must be encouraged, trained and supported. They need skills and knowledge in research, practice and policy.
- Finally, reflexivity is vital. We need to reflect on what we do and learn from others including Indigenous communities.
CONFLICT OF INTEREST STATEMENT
Michele Herriot received funding as a consultant from the Centre for Health in All Policies Research Translation, SAHMRI to support the writing of this article.
