DECLARATION
OF ALMA-ATA
International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September
1978The International Conference on Primary
Health Care, meeting in Alma-Ata this twelfth day of September in the year Nineteen
hundred and seventy-eight, expressing the need for urgent action by all governments, all
health and development workers, and the world community to protect and promote the health
of all the people of the world, hereby makes the following Declaration:
I
The Conference strongly reaffirms that health, which is a state of complete physical,
mental and social wellbeing, and not merely the absence of disease or infirmity, is a
fundamental human right and that the attainment of the highest possible level of health is
a most important world-wide social goal whose realization requires the action of many
other social and economic sectors in addition to the health sector.
II
The existing gross inequality in the health status of the people
particularly between developed and developing countries as well as within countries is
politically, socially and economically unacceptable and is, therefore, of common concern
to all countries.
III
Economic and social development, based on a New International
Economic Order, is of basic importance to the fullest attainment of health for all and to
the reduction of the gap between the health status of the developing and developed
countries. The promotion and protection of the health of the people is essential to
sustained economic and social development and contributes to a better quality of life and
to world peace.
IV
The people have the right and duty to participate individually and collectively in the
planning and implementation of their health care.
V
Governments have a responsibility for the health of their people which can be fulfilled
only by the provision of adequate health and social measures. A main social target of
governments, international organizations and the whole world community in the coming
decades should be the attainment by all peoples of the world by the year 2000 of a level
of health that will permit them to lead a socially and economically productive life.
Primary health care is the key to attaining this target as part of development in the
spirit of social justice.
VI
Primary health care is essential health care based on practical, scientifically sound and
socially acceptable methods and technology made universally accessible to individuals and
families in the community through their full participation and at a cost that the
community and country can afford to maintain at every stage of their development in the
spirit of self-reliance and self-determination. It forms an integral part both of the
country's health system, of which it is the central function and main focus, and of the
overall social and economic development of the community. It is the first level of contact
of individuals, the family and community with the national health system bringing health
care as close as possible to where people live and work, and constitutes the first element
of a continuing health care process.
VII
Primary health care:
- reflects and evolves from the economic conditions and
sociocultural and political characteristics of the country and its communities and is
based on the application of the relevant results of social, biomedical and health services
research and public health experience;
- addresses the main health problems in the community, providing
promotive, preventive, curative and rehabilitative services accordingly;
- includes at least: education concerning prevailing health problems
and the methods of preventing and controlling them; promotion of food supply and proper
nutrition; an adequate supply of safe water and basic sanitation; maternal and child
health care, including family planning; immunization against the major infectious
diseases; prevention and control of locally endemic diseases; appropriate treatment of
common diseases and injuries; and provision of essential drugs;
- involves, in addition to the health sector, all related sectors
and aspects of national and community development, in particular agriculture, animal
husbandry, food, industry, education, housing, public works, communications and other
sectors; and demands the coordinated efforts of all those sectors;
- requires and promotes maximum community and individual
self-reliance and participation in the planning, organization, operation and control of
primary health care, making fullest use of local, national and other available resources;
and to this end develops through appropriate education the ability of communities to
participate;
- should be sustained by integrated, functional and mutually
supportive referral systems, leading to the progressive improvement of comprehensive
health care for all, and giving priority to those most in need;
- relies, at local and referral levels, on health workers, including
physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as
traditional practitioners as needed, suitably trained socially and technically to work as
a health team and to respond to the expressed health needs of the community.
VIII
All governments should formulate national policies, strategies and plans of action to
launch and sustain primary health care as part of a comprehensive national health system
and in coordination with other sectors. To this end, it will be necessary to exercise
political will, to mobilize the country's resources and to use available external
resources rationally.
IX
All countries should cooperate in a spirit of partnership and service to ensure primary
health care for all people since the attainment of health by people in any one country
directly concerns and benefits every other country. In this context the joint WHO/UNICEF
report on primary health care constitutes a solid basis for the further development and
operation of primary health care throughout the world.
X
An acceptable level of health for all the people of the world by the year 2000 can be
attained through a fuller and better use of the world's resources, a considerable part of
which is now spent on armaments and military conflicts. A genuine policy of independence,
peace, détente and disarmament could and should release additional resources that could
well be devoted to peaceful aims and in particular to the acceleration of social and
economic development of which primary health care, as an essential part, should be
allotted its proper share.
The International Conference on Primary Health Care calls for
urgent and effective national and international action to develop and implement primary
health care throughout the world and particularly in developing countries in a spirit of
technical cooperation and in keeping with a New International Economic Order. It urges
governments, WHO and UNICEF, and other international organizations, as well as
multilateral and bilateral agencies, non-governmental organizations, funding agencies, all
health workers and the whole world community to support national and international
commitment to primary health care and to channel increased technical and financial support
to it, particularly in developing countries. The Conference calls on all the
aforementioned to collaborate in introducing, developing and maintaining primary health
care in accordance with the spirit and content of this Declaration.
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