Leadership for health: developing a canny nanny state.

Health leadership comes from government, non-governmental organisations (NGOs), commercial organisations, and the community as a whole. Government has an obligation to act to protect the health of its citizens, both in respect of traditional threats to health, such as infectious diseases, and in response to newer threats, such as diet. Leadership requires the recognition and rejection of strategies that attempt to replace evidence with rhetoric. We recommend that health policy decisions have a clear evidence base and equity rationale, where the proposed interventions have been balanced against the freedom of individuals to act on their own account without undue influence from marketing. We recommend that government draws on the experience and expertise of the NGO and public health sectors, and communities to promote responsiveness to local priorities and needs. We recommend that public health practitioners strengthen their links with communities and build constituencies so public health decision-making does not occur predominantly in the bureaucratic domain.