A renaissance in primary health care.

摘要

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". In 1978, 2000 million people were estimated to have no access to adequate health care. There were vast inequalities between rich and poor countries, and between rich and poor populations within countries. The Alma-Ata Declaration revolutionised the world's interpretation of health. Its message was that inadequate and unequal health care was unacceptable: economically, socially, and politically. Unfortunately, the goal of "health for all", while a rallying call to action, was not met. Theories for this failure abound: the vision for primary health care was politically unacceptable to some nations and so was marginalised; emerging health threats took precedence (no one imagined the global disease burden that HIV/AIDS would bring); and health priorities shifted (to the Millennium Development Goals [MDGs]).