PHA-Exchange> PHC:More Action Less Words please! Revive the spirit of Alma Ata! Press release from the PHM

[Aviva]

22 May 2003 03:12:57 -0700

        People's Health Movement 
URGENT                                          PRESS RELEASE 
Primary Health Care: More Action Less Words please!
Revive the spirit of Alma Ata !
Geneva, May 21: The People's Health Movement welcomes the proposed
adoption of a resolution affirming the Alma Ata vision of Primary
Health Care (PHC) as the cornerstone of national health systems by
member states of the World Health Organization. 

PHM however believes that the WHO, as well as many member states, while
paying lip service to the PHC approach have been in practice promoting
a completely different route, often detrimental, to public health. The
Who's current approach is highly selective and disease focused and
driven by donor initiatives at the expense of people-centred and
holistic approaches. 

PHM therefore calls upon the WHO to return to the original Alma Ata
vision that promised `Health for All` by providing primary health care
while at the same time tackling the underlying socio-economic and
political causes of disease. Health, according to the PHM is a basic
human right and neither charity nor a mere input to economic growth. 

The PHM also warmly welcomes the statements made by the New Zealand,
South African, Nigerian and Thai delegations to WHA, 2003 that
variously called upon the WHO to address inequalities in access to
health care and not to reduce the PHC concept to a set of 'nice words'.
The statement of one of these delegations pointing out that PHC is not
just about diseases and technology and requires a comprehensive
approach is also to be applauded. The delegations have welcomed the WHO
resolution on PHC but called for it to be strengthened in a number of
ways. 

'There is little point in constructing a perfect building if the
foundation is weak. Primary Health Care is the foundation of health
systems globally'' said the delegate from New Zealand.   

'We need to set specific targets for Primary Health Care funding' said
a representative of the Nigerian delegation suggesting that 40 % of the
health budget be set aside for Primary Health Care. 

According to the PHM, the proposed resolution on PHC to be adopted at
the World Health Assembly, 2003 while talking about the health needs of
the disadvantaged ignores the following factors that affect public
health, especially of the very poor:

·         Increasing global inequities - the gap between developing and
developed countries is growing

·         Increasing inequities within countries 

·         Declining life expectancy in many African countries where
HIV/AIDS offers new challenges for PHC which are not acknowledged in
the resolution

·         The absolute number of people living in poverty has increased
world wide and sharply in some regions. 

According to the PHM the major cause of the growing inequities, both
within and among countries, is the increasingly unipolar world economic
order and its impact on the lives and livelihoods of people around the
world.  Neither the Who's global report nor the resolutions acknowledge
this impact. Until the world is characterised by fair economic and
trade relationships the promise of Health for All cannot be achieved. 

Neo-liberal economic policies and World Bank/IMF inspired `health
reforms` being pushed through in developing countries have resulted in:

·         Privatisation of public health services

·         The introduction of user fees for patients

·         Lack of public investment in state-run primary health care
systems 

·         Lack of attention to leadership and management development
for PHC

Sharp reductions in basic vaccination coverage since 1990 are stark
evidence of this.

All this has obviously also resulted in the overall deterioration in
quality and equitable delivery of public health services and had a
devastating effect on the ability of the poor to access health care. 

PHM calls for wider consultation between WHO and civil society members
to revive the goal of Alma Ata!

'Governments have a fundamental responsibility to ensure universal
access to quality health care, education and other social services
according to people's needs, not according to their ability to pay'
People's Charter For Health. The Charter, the guiding spirit of the PHM
is the largest consensus document on health in the world.

Dr Ravi Narayan                                   
Prof. David Sanders
Co-ordinator- PHM Secretariat            
International People's Health
Council & PHM

Dr. Armando De Negri 
ALAMES (Latin American Association for Social Medicine) & PHM

For media enquiries, please call: May 15th till May 24th

Geneva: Local mobile: 078- 876 5437 (dial +41 78 876 5437  from abroad)
 France : Mobile : +33 660 839 448

For PHM media enquiries (permanent contacts) :

India: Dr. Unnikrishnan PV , +91 (0) 98450 91319     :  
unnikru at yahoo.com 

London: Andrew Chetley, London : +44 20 7539
1591chetley.a at healthlink.org.uk

Thailand: Satya Sivaraman (E-mail: satyasagar at yahoo.com )   

+++++++++++++++++++++++++++++++
Dr. Unnikrishnan PV , India
E-mail: unnikru at vsnl.com; Ph (m): +91 (0) 98450 91319
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