Leaders from governments and United Nations organisations, heads of city authorities, and health experts from around the world have promised to promote public health and eradicate poverty through the signing of two landmark commitments.

Held in Shanghai on 21–24 November, the ‘9th Global conference on health promotion’, co-organised by the World Health Organization (WHO) and the National Health and Family Planning Commission of the People’s Republic of China, was the stage for the signing of the Shanghai Declaration on Health Promotion and the Shanghai Healthy Cities Mayors’ Consensus.

The former agreement strengthens the links between health and wellbeing and the United Nations 2030 Agenda for Sustainable Development and its Sustainable Development Goals. The latter agreement, meanwhile, commits more than 100 mayors of cities all over the world to advance health through improved management of urban environments.

The Declaration underlines the need for people to be able to control their own health and be in a position to make healthy lifestyle choices. Noting the need for political action across many different sectors and regions, it highlights the role of good governance and health literacy in improving health, as well as the critical role played by city authorities and communities.

Governance-related commitments include protecting health through public policies, strengthening legislation, regulation and taxation of unhealthy commodities, and implementing fiscal policies to enable new investments in health and wellbeing. The Declaration also stresses the importance of universal health coverage and the need to better address cross-border health issues.

Health literacy pledges include the development of national and local strategies to improve citizens’ awareness of how to live healthy lives, and increasing citizens’ ability to control their own health and its determinants by using digital technology. The Declaration also sets out a commitment to ensure that environments support healthy consumer choices; for example, through pricing policies, transparent information and clear labelling.

The Mayors’ Consensus, meanwhile, recognises the growing importance of focusing on urban environments, with two-thirds of the world’s population expected to live in cities by 2030. The agreement comprises 10 action areas that will be integrated into participating cities’ plans, and which align with the UN’s 2030 Agenda for Sustainable Development.

The Consensus commits city chiefs to:

• integrate health as a core consideration in all city policies;
• promote community engagement through multiple platforms, including schools, workplaces and modern technology, to advance health; and
• reorient municipal health and social services towards equity and universal health coverage.

Action areas also include addressing pollution, gender-based violence, child development, and making cities smoke-free.

WHO director-general Dr Margaret Chan warned that these commitments will matter little unless they are backed by government action that protects people from health risks, gives access to healthy choices, and spreads awareness of how to be and stay healthy.

She added: “Legislative and fiscal measures are among the most effective interventions that governments, national and city, can take to promote the health of their citizens – from tobacco control and taxing sugary drinks to ensuring people can breathe clean air, bike home safely, and walk to school or work without fear of violence.”