A renaissance in primary health care
Publisher/Journal: The Lancet Volume 372, Number 9642
Publication date: 13 September 2008
Language: English
Overview
30 years ago, in the midst of the Cold War, health experts and policy makers from 134 WHO member states convened in the former USSR to attend a conference on international primary health care. On Sept 12, 1978, the Alma-Ata Declaration was signed, with the ambitious target of achieving “Health for All by 2000”.
Now is the right moment to proclaim the urgent need for a renaissance in primary health care. The continuing relevance of this 30-year-old Declaration is remarkable. Many of the challenges faced in 1978 remain, such as infectious diseases (eg, the ongoing threat of H5N1 avian influenza and HIV/AIDS), political instability and conflict (most recently seen in Iraq and Zimbabwe), and worsening poverty (the World Bank last month estimated that 1·4 billion people now live in poverty).
In recognition of this timely reawakening of interest in primary health care, this week's Lancet revisits, updates, and relaunches the key messages from Alma-Ata. A series of eight papers begins with an analysis of modern primary health care, and issues such as implementing cost-effective interventions in low-resource settings and tackling the growing burden of chronic diseases. We publish an analysis of individual country progress since 1978, with possible lessons for those who have shown the least advance. Involvement of communities in planning and implementation of health care (one of the main tenets of the Alma-Ata Declaration) is explored in the context of maternal, newborn, and child health, as are the roles of national policies and effective service integration, all foundations of a successful primary health care service. The final paper in the series looks to the future and provides a series of action points to revitalise primary health care, both nationally and globally.