Press Release WHO/89 27 November 1998 PRIMARY HEALTH CARE IN THE 21ST CENTURY IS EVERYBODY'S BUSINESS Meeting in Almaty, Kazakhstan on 27-28 November 1998 to commemorate the 20th anniversary of the Alma-Ata Declaration, delegates from government, international organizations, nongovernmental organizations and the private sector are taking stock of primary health care (PHC) achievements and exploring how new partnerships at local, national and international levels can further improve people's health and social wellbeing through PHC. PHC is a comprehensive health systems approach which is developed in partnership with the communities themselves. It encompasses sectors and activities which influence health and it includes prevention, health promotion, cure and rehabilitation. "Health for All through PHC is an eminently sound, ethically founded and cost-effective way to improve the quality of life of individuals and communities alike," said Dr Jo Asvall, WHO's Regional Director for Europe. Inspired by the Alma Ata Declaration in 1978, country after country the world over embraced PHC as an explicit priority and this has resulted in both significant and quantifiable improvements in people's health status. Since the PHC approach was enshrined, the worldwide infant mortality rate has decreased from 90 per 1000 live births in 1975 to 59 in 1995 - a decrease of 34% - while immunization coverage for children under one year of age has risen from 20% to 80% between 1980 and 1990. In the mid 1970s, only 38% of the people in developing countries had access to safe drinking water and 32% to adequate sanitation, whereas those figures had risen to 66% and 53%, respectively, by 1990. But the world 20 years on from the Alma Ata Declaration is vastly different from that which saw the signing of the Declaration. Economic instability, globalization and the triumph of the free market credo have meant more pressure to produce profits and a greater move to private health systems, while transnational media and marketing have also increased their influence on the way people conduct their lives. These trends have all resulted in increased inequities. Against this background, this week's meeting aims to identify key directions for the development of local, national and international health systems. Future action will call on the cooperation of many actors. Mechanisms will be needed for strengthened collaboration across government ministries and various sectors of society, including the private sector. Only then will health be everybody's business; only then will the world have a realistic chance of achieving the goal set out in the original Alma Ata Declaration of Health For All. WHO consists of 191 Member States. Its world headquarters are in Geneva, Switzerland, and it has six Regional Offices: in Harare, Zimbabwe (for Africa), Washington, USA (for the Americas), Copenhagen, Denmark (for Europe), Alexandria, Egypt (for the Eastern Mediterranean), New Delhi, India (for Southeast Asia) and Manila, the Philippines (the Western Pacific). For further information, journalists can contact Gregory Hartl, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.int