DOCSLIB.ORG

From Alma-Ata to the Year 2000: Reflections at the Midpoint

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
From Alma-Ata to the Year 2000: Reflections at the Midpoint The World Health Organization is a specialized agency of the United Nations with primary responsibility for international health matters and public health. Through this organization, which was created in 1948, the health professions of some 165 coun­ tries exchange their knowledge and experience with the aim of making possible the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life. By means of direct technical cooperation with its Member States, and by stimulating such cooperation among them, WHO promotes the development of comprehensive health services, the prevention and control of diseases, the improvement of en­ vironmental conditions, the development of health manpower, the coordination and development of biomedical and health services research, and the planning and im­ plementation of health programmes. These broad fields of endeavour encompass a wide variety of activities, such as developing systems of primary health care that reach the whole population of Member countries; promoting the health of mothers and children; combating malnutrition; controlling malaria and other communicable diseases, including tuber­ culosis and leprosy; having achieved the eradication of smallpox, promoting mass immunization against a number of other preventable diseases; improving mental health; providing safe water supplies; and training health personnel of all categories. Progress towards better health throughout the world also demands international cooperation in such matters as establishing international standards for biological substances, pesticides, and pharmaceuticals; formulating environmental health criteria; recommending international nonproprietary names for drugs; administering the International Health Regulations; revising the International Classification of Diseases, Injuries, and Causes of Death; and collecting and disseminating health statistical information. Further information on many aspects of WHO's work is presented in the Organiza­ tion's publications From Alma-Ata to the Year 2000: Reflections at the midpoint World Health Organization Geneva 1988 ISBN 92 4 156124 6 © World Health Organization 1988 Publications of the World Health Organization enjoy copyright protection in accord­ ance with the provisions of Protocol 2 of the Universal Copyright Convention. For rights of reproduction or translation of WHO publications, in part or in toto, applica­ tion should be made to the Office of Publications, World Health Organization, Geneva, Switzerland, The World Health Organization welcomes such applications. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omis­ sions excepted, the names of proprietary products are distinguished by initial capital letters. Printed in Switzerland 88/7791-Phototypesetting-7000 Contents Preface by Dr John H. Bryant v Alma-Ata: the beginning The background to Alma-Ata 3 Address by Dr H. Mahler, Director-General of WHO, to the International Conference on Primary Health Care, Alma-Ata, 6 September 1978 4 Declaration of Alma-Ata 7 Riga: Alma-Ata revisited The background to Riga 13 From Alma-Ata to the year 2000: reflections at the midpoint on progress and prospects 14 Introduction 14 Health for all-principles and imperatives 15 Health for all-wistful dream or living reality? 18 Health for all-successes and failures, gains and losses 20 Looking ahead-priority choices 29 Fresh strategies for a new era 34 Dr Mahler's eight questions asked at Alma-Ata 60 Conclusions 62 Alma-Ata reaffirmed at Riga 72 Preface 72 Introduction to the actions at Riga 72 The permanence of health for all 74 Intensifying social and political action for the future-Agenda 2000 75 Accelerating action for health for all-Agenda 2000 81 Special priority initiative in support of the least developed countries by WHO and the international community 86 Forty-first World Health Assembly The significance of the Forty-first World Health Assembly 89 World health-2000 and beyond 91 Address by Dr H. Mahler, Director-General, to the World Health Assembly, 3 May 1988 91 iii From Alma-Ata to the Year 2000 Remarks by Dr H. Mahler, Director-General, to the World Health Assembly on the fortieth anniversary of WHO, 4 May 1988 98 Remarks by Dr H. Nakajima, Director-General Elect, to the World Health Assembly, 4 May 1988 101 Technical Discussions on Leadership Development for Health for All, 5-7 May 1988 104 The background of the Technical Discussions 104 Report of Dame Nita Barrow, General Chairman of the Technical Discussions, to the World Health Assembly, 9 May 1988 (extracts) 106 Round table debate on the tenth anniversary of Alma-Ata, 9 May 1988 (extracts) 110 Farewell remarks by Dr H. Mahler, Director-General, to the World Health Assembly, 9 May 1988 126 To the year 2000 and beyond The tasks before us 131 Actions recommended at Riga: focal points for future concern and action 133 Special priority initiative by WHO and the international community in support of the least developed countries 143 A twofold agenda for the year 2000 and beyond 145 A new form of international dialogue? 148 References 149 Annex 1. Resolution WHA41.34: Strengthening primary health care 152 Annex 2. Resolution WHA41.26: Leadership development for Health for All 155 iv Preface The International Conference on Primary Health Care, held in Alma-Ata, USSR, in 1978, was convened in response to an international sense of despair over the widespread inequities in health and health care that afflicted all nations of the world, developed as well as developing. The conference responded with a call for radical change in both the content and design of health services, so that there would be equity in health services through primary care, thus giving rise to the highly symbolic goal of WHO - Health for All by the Year 2000. The pronouncement from Alma-At a had an immediate effect on the global strategies of WHO and has dominated its policies and programmes ever since. There was a somewhat delayed but nevertheless substantial impact on the health policies of the Member nations, other international organizations and nongovernmental organizations. What has been less certain is whether or not there have been improvements in health following these policy changes. What in fact has been the effect of Alma-Ata on the health of the people of the world? Have the pronouncements of Alma-Ata, the strategies of WHO, and the commitments to health for all of the Member States had a significant impact on health? Or has there been more rhetoric than reality, more ceremony than commitment? This is far more than academic questioning. The health conditions of the poor and deprived, who exist in virtually all countries, and the costs in terms of human suffering and national underdevelopment are so extreme that the ques­ tion of whether the global public health movement that began in Alma-Ata is viable or not is of the highest international significance. The year 1988, ten years after Alma-Ata, is roughly half-way to the turn of the century. WHO, UNICEF and other interested parties decided that it was an appropriate time to review what has happened since Alma-Ata and what the prospects appear to be for the year 2000 and beyond. The Government of the Soviet Union agreed to host a return meeting, this time in Riga, capital of the Latvian Republic of the USSR. The meeting at Riga was undertaken as an assessment: "From Alma-Ata to the Year 2000 - a midpoint perspec­ tive". That meeting was held in March 1988, and its conclusions were forward­ ed to the World Health Assembly in May of that year. The Forty-first World Health Assembly, to which all the Member countries of WHO were invited to send delegates, took place in May 1988 and included several relevant events: v From Alma-Ata to the Year 2000 • The document from Riga was received and considered by the Assembly. • The Assembly celebrated the fortieth anniversary of the World Health Organization. • A round table debate took place on the tenth anniversary of Alma-Ata, bringing together a distinguished group of people to make their obser­ vations on issues that followed from that historic meeting. • The Technical Discussions held during the World Health Assembly were on the subject of Leadership for Health For All, a question close­ ly related to the principles and the prospects of Alma-Ata. The outcome of these discussions together with background materials form a substantial documentation of the views of many countries, organizations and individuals, as well as of the staff of WHO, UNICEF and other organizations within the United Nations system. The purpose of this publication is to bring together the relevant papers, ideas, comments and questions pertaining to Alma-Ata and the problems and pros­ pects associated with it. Efforts have been made to identify key ideas, problems and trends that might help those committed to the spirit of Alma-Ata not only to understand what has been happening but also to look ahead to the prospects for health for all through primary health care. Many people within and outside WHO assisted the development of this publication. It found its roots in Riga, grew to maturity during the Forty-first World Health Assembly, and developed further in the weeks thereafter. The inspiration and the source of many of the most important ideas described here was, of course, Dr Halfdan Mahler, Director-General of WHO from before Alma-Ata to 1988.
Load more

Recommended publications
  • Primary Health Care Research and Development 2004; 5: 284–288
    Primary Health Care Research and Development 2004; 5: 284–288 Primary health care: a global overview John Macdonald Men’s Health Information and Resource Centre, University of Western Sydney, Australia Central to the original Alma Ata declaration was the notion of a system, which included the fostering of health through multisectoral collaboration. This aspect often gets referred to as comprehensive health care, in counter distinction to a selec- tive primary health care model, which emerged immediately following the confer- ence, as the former, though laudable in intent, was argued to be unworkable. Indeed from a global perspective, comprehensive primary health care, if noticed at all in the culture of western medicine, was relegated to being of relevance in ‘other’ places: so-called developing countries. Nevertheless, at the beginning of a new century, in a vastly different world to that of the 1970s, it is the central contention of this paper that it is still possible to assert that the primary health care model is still relevant À in all countries of the world. The work on the ‘social determinants of health’ increas- ingly adds weight to the arguments against the irrationality of an overemphasis on medical technical interventions to the neglect of the health-enhancing or health- threatening contexts in which people live out their lives. Consequently it is now becoming possible to think and plan the management of health, not just the management of disease. Keywords: Alma Ata; primary health care; social determinants of health Essential to the primary health care approach other conference, on health promotion, for the launched at the Alma Ata conference was the ‘reorientation’ of health services towards a more denunciation of the ‘gross inequality in the health health and less disease focus (WHO, 1986).
    [Show full text]
  • Review of 40 Years of Primary Health Care Implementation at Country Level
    Review of 40 years of primary health care implementation at country level December 2019 WHO Evaluation Office Acknowledgements The review team would like to thank all the participants in the online survey for Member States. Their insights and perspectives on primary health care implementation at country level were an essential element of this review. In addition, the work of the reference group constituted for this review, in providing feedback on the concept note and the draft report, was greatly appreciated. The purpose of publishing reports produced by the WHO Evaluation Office is to fulfil a corporate commitment to transparency through the publication of all completed evaluations. The reports are designed to stimulate a free exchange of ideas among those interested in the topic and to assure those supporting the work of WHO that it rigorously examines its strategies, results and overall effectiveness. The analysis and recommendations of this report are those of the independent review team and do not necessarily reflect the views of the World Health Organization. This is an independent publication by the WHO Evaluation Office. The text has not been edited to official publication standards and WHO accepts no responsibility for error. The designations in this publication do not imply any opinion on the legal status of any country or territory, or of its authorities, or the delimitation of frontiers. Any enquiries about this evaluation should be addressed to: Evaluation Office, World Health Organization Email: [email protected] Table
    [Show full text]
  • Health in All Policies As Part of the Primary Health Care Agenda on Multisectoral Action
    SOCIAL DETERMINANTS OF HEALTH ACCESS TO POWER, MONEY AND RESOURCES AND THE CONDITIONS OF DAILY LIFE — THE CIRCUMSTANCES IN WHICH PEOPLE ARE BORN, GROW, LIVE, WORK, AND AGE Social Determinants of Health Discussion Paper no. 11 [energy] [investment] [community/gov.] [water] [justice] [food] [providers of services, education, etc.] [accessible & safe] [supply & safety] Health in All Policies as part of the primary health care agenda on multisectoral action ISBN 978 92 4 151502 3 WORLD HEALTH ORGANIZATION AVENUE APPIA 1211 GENEVA 27 SWITZERLAND DEBATES, POLICY & PRACTICE, CASE STUDIES WWW.WHO.INT/SOCIAL_DETERMINANTS/EN/ B HEALTH IN ALL POLICIES AS PART OF THE PRIMARY HEALTH CARE AGENDA ON MULTISECTORAL ACTION Michele Herriot and Nicole B Valentine Health in All Policies as part of the primary health care agenda on multisectoral action/ Michele Herriot, Nicole B Valentine (Discussion Paper Series on Social Determinants of Health, 11) ISBN 978-92-4-151502-3 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence.
    [Show full text]
  • Statement of the Civil Society Workshop “40 Years of Alma-Ata: Translating ‘Health for All’ Into the Present and Future”, Geneva, Ecumenical Centre, 18 May 2018
    Consultation statement of the civil society workshop “40 Years of Alma-Ata: Translating ‘Health for All’ into the Present and Future”, Geneva, Ecumenical Centre, 18 May 2018 Summary Translating “Health for All” into the Present and Future Health is a fundamental human right – enshrined in the WHO constitution and the declaration of Alma Ata. However, after 40 years, inequality, poverty, exploitation, violence and injustice are still keeping one Billion people from accessing health care. To achieve health for all, inequities have to be overcome, powerful interests to be challenged, and political and economic priorities must be transformed. Realising the vision of Alma Ata is more urgent than ever: • Applying the principles of Primary Health Care as declared at Alma Ata 1978 is critical in achieving health for all by 2030. • Community engagement and ownership is the key to health for all and essential for building resilient health systems that allow all people to access the health care they need. • A skilled and motivated health workforce is at the centre of health systems at all levels. It must be recognized that community health workers play an essential part in realising universal health coverage and health for all. • Strong people’s organisations and movements are fundamental to strong health systems. • Access to essential medicines of good quality at an affordable price is part of health for all. Policies must ensure that research costs are delinked from the price of drugs and everyone has the right to access essential medicines. • Health for all demands inter-sectoral collaboration and must provide access to prevention, promotion, treatment, care, rehabilitation and palliative care to everyone within a sustainable framework.
    [Show full text]
  • The Impact of Vertical Public Health Initiatives on Gendered Familial Care Work: Public Health and Ethical Issues
    University of Rhode Island DigitalCommons@URI Philosophy Faculty Publications Philosophy 2021 The impact of vertical public health initiatives on gendered familial care work: public health and ethical issues Zahra Meghani Follow this and additional works at: https://digitalcommons.uri.edu/phl_facpubs The University of Rhode Island Faculty have made this article openly available. Please let us know how Open Access to this research benefits you. This is a pre-publication author manuscript of the final, published article. Terms of Use This article is made available under the terms and conditions applicable towards Open Access Policy Articles, as set forth in our Terms of Use. Meghani Cite as Meghani, Z. (2021). The Impact of Vertical Public Health Initiatives on Gendered Familial Care Work: Public Health and Ethical Issues. Critical Public Health. https://www.tandfonline.com/doi/full/10.1080/09581596.2021.1908960 The impact of vertical public health initiatives on gendered familial care work: Public health and ethical issues1 Introduction There is a growing body of research on the impact of vertical public health initiatives on low-income countries. This essay argues that projects that examine the impact of vertical public health ventures on the national health systems of low-income countries should also evaluate their effect on the familial caregiving responsibilities of women and girls from poorer households. By making that case, this paper aims to foster conversation between researchers who study vertical public health schemes and scholars who examine the impact of gendered care work norms, institutions, policies, and practices on women and girls from low-income households. Health and disease status at the individual and population level are partially determined by socio-political-economic factors (WHO 2020).
    [Show full text]
  • Technical Paper Primary Health Care
    REGIONAL COMMITTEE FOR THE EM/RC50/8 EASTERN MEDITERRANEAN August 2003 Fiftieth Session Original: Arabic Agenda item 8 (d) TECHNICAL PAPER PRIMARY HEALTH CARE: 25 YEARS AFTER ALMA-ATA EM/RC50/8 CONTENTS EXECUTIVE SUMMARY......................................................................................................... I 1. INTRODUCTION.............................................................................................................1 2. LOCATING AND DEFINING PRIMARY HEALTH CARE...........................................1 3. ACHIEVEMENTS OF PRIMARY HEALTH CARE.......................................................2 3.1 Global vision............................................................................................................2 3.2 Reorientation of health care institutions and provision............................................3 3.3 Democratization of health through community-based initiatives ............................4 3.4 Highlighting intersectoral collaboration for health development ............................5 3.5 Paving the way for new initiatives...........................................................................5 3.6 Creation of a critical mass........................................................................................5 3.7 Health as a human right............................................................................................6 4. REASONS FOR UNSUCCESSFUL IMPLEMENTATION OF PRIMARY HEALTH CARE................................................................................................................6
    [Show full text]
  • Invitation for Public Comment Global Action Plan for Healthy Lives and Well-Being for All
    INVITATION FOR PUBLIC COMMENT GLOBAL ACTION PLAN FOR HEALTHY LIVES AND WELL-BEING FOR ALL Accelerator Discussion Paper 2: Primary Health Care (PHC) Developed by: UNICEF and WHO Contributions from: UNFPA, UNAIDS, GFF, UNDP, The Global Fund, Gavi, World Bank Disclaimer: These documents are working papers and subject to change. They do not necessarily reflect the views of the 12 Global Action Plan signatory agencies. Key elements of the accelerator discussion papers will be used as inputs to the Global Action Plan. BACKGROUND Health systems anchored in primary health care (PHC) are associated with better health outcomes, improved equity and better cost efficiency. The renewed concept of PHC towards universal health coverage (UHC) adopted in the Declaration of Astana maintains the central tenets of the 1978 Alma Ata Declaration and was acknowledged as the foundation of health and wellbeing for all. Paradoxically, despite this broad support, PHC remains inadequately translated into the policies, actions and services required to generate optimal health and wellbeing, particularly for those most in need. Accordingly, the key objective of this Accelerator is to relentlessly focus on the elimination of inequity and the progressive achievement of UHC, health and wellbeing through a PHC approach, supported by the development and implementation of concrete plans and actions that combine, as appropriate, multi-sectoral action, community engagement and integrated primary care services. These approaches should promote universal access to accessible, quality, effective and essential health care in all countries, beginning with the poorest and most marginalized communities. PHC is a whole-of-society approach to health as a construct.
    [Show full text]
  • Ten Years After Alma-Ata by John H
    Ten years after Alma-Ata by John H. Bryant he International Conference have been the problems and pro­ volved in the HFA movement, cen­ on Primary Health Care gress in pursuing HFA since Alma­ trally at times, peripherally at T (PHC), sponsored by WHO and Ata?" is immensely complex. The others, but always with interest. UNICEF, took place in Alma-Ata, question has social, economic, eco­ What follows, then, is an effort to USSR, in 1978, just 10 years ago. logical, political, biomedical and or- look broadly over the complex ter­ Decisions by the Member States at rain that we call Health for All, try­ the World Health Assembly in ing to pick out salient features of 1977, and the subsequent Declara­ Professor John H. Bryarit, the topography: problems that are tion of Alma-Ata launched the Professor and Chairman of the most serious and widespread, ob­ movement toward Health for All Department of Community stacles that are most intractable, (HFA) by the Year 2000. The re­ Health Sciences at the Aga and possibilities that are most sults have since found their place in Khan University, Pakistan, was hopeful. the history of global public health the author of a 60-page work­ The first guiding principle of movements. ing document prepared for a HFA is that primary health care What has happened since Alma­ meeting in Riga, USSR, in (PHC) is seen as the key to achiev­ Ata? What has been the progress? March. The meeting marked ing HFA. The original description The success stories? The failures? the midpoint between the De­ of PHC in the Declaration of Alma­ Where does HFA stand? Is the con­ claration of Alma-Ata in 1.978 Ata is splendid and succinct (see cept still alive and being worked a!,ld .
    [Show full text]
  • Almaty Acclamation of Mayors
    ALMATY ACCLAMATION OF MAYORS: CITIES AT THE FRONTLINE OF HEALTH AND WELL-BEING FOR ALL WHO European Healthy Cities Network Summit of Mayors Almaty, Kazakhstan, 2324 October 2018 1 Reaffirming the commitment 1. We, the participants of the WHO Healthy Cities Summit of Mayors, through this Almaty Acclamation of Mayors, on 24 October 2018, forty years later, reaffirm our commitment to the definition of health in the WHO constitution, the values and principles of a primary health care approach as enshrined in the Alma Ata Declaration (1978), and the notion that health and well- being of the people is one of the most important social goals requiring engagement from all sectors. We recognize that of the utmost importance is the role of cities, urban places, and local governments in achieving them. Leading by example 2. We acknowledge that cities contribute to this pursuit in many ways, including, by creating the physical, social, cultural, and economic places and environments that facilitate improved health and well-being; by supporting primary health care and local services, including social and education services, that contribute to the development of human capital; and by growing and nurturing thriving, empowered, and resilient communities that are engaged and involved in the decisions that affect them and their future. We will lead by example. Defending social justice and sustainable development 3. We uphold the need to promote and defend equity, social justice, gender equality and to leaving no one behind as called for in the United Nations 2030 Agenda for Sustainable Development, and its 17 global goals (SDGs). These cannot be achieved without cities and local governments.
    [Show full text]
  • The Declaration of Alma Ata on Its 30Th Anniversary: Relevance for Family Medicine Today
    Essays and Commentaries The Declaration of Alma Ata on Its 30th Anniversary: Relevance for Family Medicine Today Allen L. Hixon, MD; Gregory G. Maskarinec, PhD The Declaration of Alma Ata, issued on September 12, 1978, provides a moral vision for primary care that remains valuable today at a time of transformation of the specialty of family medicine. The Declara- tion asserts a comprehensive definition of health that recognizes health as a fundamental human right, argues persuasively that gross inequalities in health status are politically, socially, and economically unacceptable, and identifies primary health care as the key to improving health and reducing health status inequalities. The values of Alma Ata can guide the specialty of family medicine to lead positive health system change through renewed collaboration, addressing inequalities, efficient use of resources and appropriate technology, and advocacy in the spirit of social justice. (Fam Med 2008;40(8):585-8.) In 1978, the International Confer- national development economists of family medicine and requires ence on Primary Health Care held were calling for a “New Interna- us to work at the systems level for in Alma Ata, USSR, made an ur- tional Economic Order” in response social justice in the distribution of gent call for the world community to economic disparities between the services to those in need. to come together to improve global developed and developing worlds. The Declaration of Alma Ata also health. This was issued as the “Dec- These political and economic re- defines health comprehensively. It laration of Alma Ata,”1 a document alities helped reshape the arenas of states that health systems should that continues to be the sociopo- public health and primary care.
    [Show full text]
  • Implementing the Renewed Vision for Primary Health Care in the Declaration of Astana: Cambridge.Org/Phc the Time Is Now
    Primary Health Care Research & Development Implementing the renewed vision for Primary Health Care in the Declaration of Astana: cambridge.org/phc the time is now Hans Kluge1,2, Edward Kelley2,3, Yelzhan Birtanov4, Pavlos N. Theodorakis5,6, , , , , Editorial Shannon Barkley6 7, Serzhan Aidossov6 8 9 and Jose M. Valderas10 11 Cite this article: Kluge H, Kelley E, Birtanov Y, 1Director, Division of Health Systems and Public Health, Regional Office for Europe, World Health Organization, Theodorakis PN, Barkley S, Aidossov S, Copenhagen, Denmark; 2Co-Chair, Alma-Ata 40th Anniversary Technical Coordination Team, Geneva, Switzerland; Valderas JM. (2019) Implementing the renewed 3Director, Department of Health Systems and Safety, World Health Organization, Geneva, Switzerland; 4Ministry of vision for Primary Health Care in the Healthcare of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan; 5Senior Advisor, Division of Health Systems Declaration of Astana: the time is now. Primary Health Care Research & Development and Public Health, European Centre for Primary Health Care, Regional Office for Europe, World Health 20(e158): 6 1–2. doi: 10.1017/S1463423619000719 Organization, Almaty, Kazakhstan; Member, Alma-Ata 40th Anniversary Technical Coordination Team, Geneva, Switzerland; 7Technical Officer, Department of Health Systems and Safety, World Health Organization, Geneva, Author for correspondence: Switzerland; 8Advisor to the Ministry of Healthcare of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan; Pavlos N. Theodorakis, Division of Health
    [Show full text]
  • Basic Principles of Healthy Cities: Health for All
    Basic Principles of Healthy Cities : Health for All Basic Principles of Healthy Cities: Health for All 1 Basic Principles of Healthy Cities : Health for All The Healthy Cities (HC) projects seek to apply “Health for All” principles and health promotion strategies of the Ottawa Charter for Health Promotion through local action in urban settings. This leaflet aims to introduce the idea, origin and development of the “Health for All” principles - the cornerstones of the HC projects, so as to entrench the HC concept in the community. The Origin of the Health for All Principles In the seventies of the 20th Century, the political and economic conditions of the international community were difficult. Against the backdrop of urbanisation and political uncertainty, health disparities between developed and developing countries and even within countries became so great that people found them politically, socially and economically unacceptable. Health disparities became a common concern for everyone. In 1977, the World Health Assembly (WHA) proposed a primary social target for all governments, international organisations and the global community: “To enable all of the world’s citizens to enjoy by 2000 a level of health that would allow them to lead a socially active and economically productive life”. This social target of “Health for All ” (abbreviated “HFA”) emphasised the attainment of the highest possible level of health by societies a basic human right, and observing ethical principles in health policy making, health research and service provision. Formulation of policies and strategies should be guided by principles of equity and solidarity, and active attention should be given to gender-specific perspectives and aspirations.
    [Show full text]