The call to action: health promotion in The Gambia - closing the implementation gap?

This paper discusses the difficulties facing the development of health promotion in The Gambia, and in 'closing the implementation gap' noted by the WHO 7(th) Global Conference on Health Promotion (2009, Nairobi). The Gambia has achieved a great deal so far, but health promotion as a discipline has not really informed the development of its approach to health. There is not a central concern with determinants of health and tackling health inequalities and there is no well-developed health promotion infrastructure. The difficulties facing sub-Saharan Africa generally can be extrapolated from the paper, with the conclusion that sub-Saharan Africa faces many disease and health challenges not experienced by richer countries and thus not only does the discourse of health promotion need to take this into account, but also the basic needs of Africa need to be placed at the forefront.