What would the Ottawa Charter look like if it were written today?

The Ottawa Charter has been a phenomenal influence guiding the development of the concept of health promotion, and in shaping public health practice in the past 20 years. The world has changed somewhat since 1986 in many ways that could not have been anticipated by those drafting the Charter. Substantial social and economic changes have occurred, and continue to occur. These include the globalization of trade, the invention and development of the internet and mobile communications, as well as the emergence of new threats to health such as HIV/AIDS. Such profound changes require adaptations to established health promotion strategies and the development of new strategies. This paper considers the origins, describes changes and suggests adaptations to the five strategies of the Ottawa Charter - build healthy public policy; create supportive environments for health; strengthen community actions; develop personal skills; and reorient health services - that now routinely provide the framework for consideration of any major public health challenge.