Trade, foreign policy, diplomacy and health

Global Health Declarations

For at least the past 30 years, there has been an increasingly global response to health problems. In 1978, 134 health ministries signed the Alma Ata Declaration. The Declaration set a deadline of the year 2000 for achieving a level of health that would enable all of the world's people to lead a socially and economically productive life. The strategy to achieve this goal was focused on primary healthcare with the emphasis on community participation and tackling the underlying causes of disease such as poverty, illiteracy and poor sanitation. Many now argue that globalization has become an additional threat to the achievement of the health-for-all principle contained in the Declaration, with an estimated 800 million people still lacking access to even the most basic health services. However, those who see greater benefits from globalization feel that it can, in fact, make the health-for-all principle a reality.

In 1998, a new global health policy “Health for All in the 21st Century”, incorporated additional elements not considered in Alma Ata. The importance of a gender perspective and the need to see health as central to sustainable human development are both emphasized. Also included is a recognition of the growing importance of civil society in health governance. The new policy confirmed the goals of Health for All as:

  • To attain health security for all
  • To achieve global health equity
  • To increase healthy life expectancy
  • To ensure access for all to essential health care of good quality.

The first International Conference on Health Promotion, held in Ottawa in November 1986, presented a Charter for Health Promotion, which supported the achievement of health for all by the year 2000 and beyond. This conference was primarily a response to growing expectations of a new public health movement around the world. Discussions focused on needs in industrialized countries, but took into account similar concerns in all other regions. It built on the progress made through the Declaration on Primary Health Care at Alma Ata and WHO's “Targets for Health for All”.

More recently, and as a reflection of civil society's stronger influence on and participation in global health issues, the People's Health Assembly has produced a People's Health Charter. Based on an analysis of world health problems, as well as existing policies and programme, the Charter makes a set of recommendations to governments as well as international organizations, the business sector, and nongovernmental organizations. The Charter asserts that health is a human right and that “health and human rights should prevail over economic and political concerns” and calls for the provision of “universal and comprehensive primary health care, irrespective of people's ability to pay”.