PHM calls on WHO to recommit to ‘Health for All’
18 May 2007
The People's Health Movement (PHM), a global coalition of health activists, has welcomed the World Health Organization’s (WHO) renewed focus on primary health care (PHC) and called on it to again pursue the goal of ‘Health for All’ as described in the 1978 Declaration of Alma Ata.
At a round table meeting on primary health care at the 60th World Health Assembly in Geneva, civil society, government and WHO representatives from around the world discussed the obstacles to implementation of the Declaration along with new challenges that have emerged since 1978.
"We must reclaim the fire of Alma Ata before we are only left with its ashes", said Dr Halfdan Mahler, former Director General of the WHO and architect of the Alma Ata Declaration. He said the declaration was the high point of collaboration between WHO and NGOs.
Dr Mahler also cautioned those at the meeting to remember that there were two aspects to the Declaration – primary care and “health for all”. “Health is politics”, said Dr Mahler, adding that recommitting to primary health care must address new challenges and not merely be a technical exercise.
Health workers from all continents of the world spoke at the round table about their experiences and the challenges they faced. Despite a long history of PHC in Palestine, Dr Jihal Mashal said, “the current conflict has severely reduced access to and quality of health care for Palestinians.” Other participants, including from Sudan, Iraq, Nigeria, Thailand, New Zealand and Norway, said that there was much rhetoric about community participation in primary health care but that this has been hard to put into practice. This had led to the alienation of ordinary citizens from public health systems and the proliferation of expensive private health services.
Participants also shared experiences of progress and solutions in their countries. Dr Thelma Narayan said that in India, “a ‘public-public’ partnership between civil society and government was bringing about change to respect the right to health.”
According to the PHM, the WHO should define the concept of Primary Health Care to reflect the broad vision of the Alma Ata declaration. For this it must incorporate the following principles:
* A systems-wide approach that includes public health interventions, health promotion activities and hospital services.
* A health system that is progressively financed, inclusive and equitable.
* Address the social, political and economic determinants of health and implement multi-sectoral action to improve health – not just healthcare.
* A community empowerment approach which enables people to act towards improving their health and the conditions they live in.
* A health system based on the 'Right to Health' recognising the entitlements of citizens.
* The appropriate use of technology sensitive to local contexts and people's traditional culture.
New challenges in the implementation of primary health care programs include:
The proliferation of selective health care programmes
Global public-private partnerships
The new market economy in health
Dominance of patent rights over patient rights
“Any renewal of primary health care, while reiterating the core principles, must address these new challenges at local, national, regional and global levels, and bring the health of marginalised groups to the centre of the commitment to 'Health for All’” the PHM said.