Alma Ata 40 yrs on, half the world can’t access primary healthcare

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In his piece for The Lancet, WHO DG talks of inadequate political leadership

Forty years after the Alma Ata declaration that resolved to make primary health care accessible to everybody, half of the world’s population still do not have access to essential health care.

A Lancet special issue to mark 40 years of the landmark 1978 declaration, highlights the gaps that still remain in primary healthcare. Alma Ata was the first international declaration on primary health care.

“Primary health care is in crisis. It is underdeveloped in many countries, underfunded in others, and facing a severe workforce recruitment and retention challenge. Half the world’s population has no access to the most essential health services. Yet 80–90% of people’s health needs across their lifetime can be provided within a primary health-care framework—from maternity care and disease prevention through vaccination, to management of chronic conditions and palliative care. As populations age, and multimorbidity becomes the norm, the role of primary health-care workers becomes ever more important,” the Lancet sums up.

“Realisation of the vision and values set forth in the Declaration of Alma-Ata has been hampered by inadequate political leadership…”

India’s flagship health programme Ayushman Bharat has a primary health component. The country is currently in the process of rolling out 1,53,000 health and wellness centres.

Dr Tedros Adhanom

In his piece for the issue, World Health Organisation Director-General Dr Tedros Adhanom Ghebreyesus has written: “40 years later, that (Alma ATA) vision has gone largely unfulfilled. Realisation of the vision and values set forth in the Declaration of Alma-Ata has been hampered by inadequate political leadership and circumstances beyond the health sector (eg, economic crises and political instability) and within the health sector (eg, global epidemics, vertical disease-specific approaches, unregulated private health care, and overinvestment in specialised curative care). The 40th anniversary of the Declaration of Alma-Ata is a time to reaffirm the principles of the original declaration and underline the importance of primary health care for achieving health and wellbeing for all.”

Forty years since the Alma-Ata Declaration, global leaders will convene in Astana (Kazakhstan) on 25-26 October to renew their commitment to primary health care.