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<H1><SPAN style="COLOR: rgb(0,0,0)"><SPAN
style="FONT-SIZE: medium; COLOR: rgb(0,0,0)">Global Call for
Action</SPAN></SPAN></H1>
<H1><SPAN style="COLOR: rgb(0,0,0)"><SPAN
style="FONT-SIZE: medium; COLOR: rgb(0,0,0)">On the 30th Anniversary of the Alma
Ata Declaration</SPAN></SPAN></H1>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR></SPAN></P>
<DIV align=center>
<H2><SPAN style="COLOR: rgb(0,0,0)">Comprehensive Primary Health
Care</SPAN></H2>
<H2><SPAN style="COLOR: rgb(0,0,0)">remains an Essential Tool to Achieve “Health
for All”</SPAN></H2>
<P></P></DIV>
<DIV align=left><SPAN style="COLOR: rgb(0,0,0)"><EM><STRONG>In 1978, at the
Alma-Ata Conference, ministers from 134 countries in association with WHO and
UNICEF called for 'Health for All by the Year 2000' and identified Primary
Health Care as the strategy to achieve it. </STRONG></EM>
<P><EM><STRONG>Unfortunately, that dream never came true. The health status of
many people in low and middle-income countries has not improved. Currently, we
are facing a global health crisis, characterized by growing inequalities within
and between countries. New threats to health are continually emerging. This is
compounded by negative forces of globalization which prevent the equitable
distribution of resources necessary for people's health, particularly the poor.
Within the health sector, failure to implement the principles of Primary Health
Care as set out in the Alma-Ata Declaration, has significantly aggravated the
global health crisis.</STRONG></EM></P>
<P><EM><STRONG>Governments and the international community are fully responsible
for this failure.</STRONG></EM></P>
<P><EM><STRONG></STRONG></EM></P></SPAN>
<DIV align=right><SPAN style="COLOR: rgb(0,0,0)"><EM><STRONG>People’s Charter
for Health 2000.</STRONG></EM> </SPAN></DIV></DIV>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR>The <A
href="http://www.phmovement.org/cms/files/Alma-Ata_Declaration.pdf"
target=_blank>Declaration of Alma-Ata</A> <SPAN
style="COLOR: rgb(0,0,255)"><SPAN
style="COLOR: rgb(0,0,255)"><SUP>[1]</SUP></SPAN></SPAN> urged world
governments, health and development workers, and the international community to
protect and promote the health of the world’s population. It identified Primary
Health Care (PHC) as the best strategy to achieve the goal of “Health for
All”.<BR></SPAN></P>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR>On the thirtieth anniversary of the
Declaration of Alma-Ata, the role of the United Nations’ organizations,
including the World Health Organization, has been increasingly
marginalized.</SPAN></P>
<P>The People’s Health Movement (PHM)<BR></P>
<P><SPAN style="COLOR: rgb(0,0,0)"><STRONG>affirms that</STRONG></SPAN> </P>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>'Health for All' is an achievable goal and resources were and are still
available to achieve it;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>'Comprehensive Primary Health Care' remains an essential tool to achieve
'Health for All';
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>'Health for All' means that powerful interests have to be challenged, that
neoliberal globalization <A
href="http://www.phmovement.org/cms/en/node/867#Footnote%202"><SUP><SPAN
style="COLOR: rgb(0,0,255)">[2]</SPAN></SUP></A> has to be challenged, and
that political and economic priorities have to be drastically changed (<A
href="http://www.phmovement.org/cms/en/resources/charters/peopleshealth"
target=_blank>People’s Charter for Health</A> 2000).
<P></P></LI></UL>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR>And <STRONG>calls upon</STRONG></SPAN>
</P>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>individuals, families, communities, people’s organizations, civil society
organizations and networks, and social movements to continue struggling for
their fundamental right to health and health care;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>governments to urgently adopt health sector reform policies that
<P></P></LI></UL>
<BLOCKQUOTE>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>promote the principles of equity, universal access, comprehensiveness,
adequate public financing and community participation;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>use comprehensive primary health care as the core strategy to achieve
Health for All; and
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>address the structural determinants of ill-health.
<P></P></LI></UL></BLOCKQUOTE>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>WHO to return to its constitutional mandate “to act as the directing and
co-ordinating authority on international health work” <SUP><SPAN
style="COLOR: rgb(0,0,255)">[3]</SPAN></SUP>; and to unequivocally identify
the emerging threats to people’s health and boldly advise member states how
they must be addressed; ensure that innovation in medicines and health
technology are protected as public goods;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>the Bretton Woods institutions to cease undermining people’s health and
stop protecting and promoting private-for-profit interests in the provision of
health care.
<P></P></LI></UL>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR>On the anniversary of the Alma Ata
Declaration, the PHM will continue struggling for 'Health for All'
through<BR></SPAN></P>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>developing position paper(s) that critically analyse the implementation of
CPHC over the three decades since the Alma Ata Declaration, focusing on the
continually emerging threats to HFA. Such position papers will be part of the
mobilization processes at country level;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>organizing events that advocate for the fundamental right to health,
challenging the commercialization and privatization of health care, exposing
the structural determinants of ill-health and, above all, making the voices of
the unheard heard;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>studying and disseminating country-based alternatives that ensure
universal access and equity and address the structural determinants of
ill-health.
<P></P></LI></UL>
<P><A title="Footnote 1" name="Footnote 1"></A><SPAN
style="COLOR: rgb(0,0,255)">[1]</SPAN> Declaration of Alma-Ata was signed by 134
states as a final statement of the International Conference on Primary Health
Care, Almaty (formerly Alma-Ata), Kazakhstan, 6-12 September 1978.</P>
<P><A title="Footnote 2" name="Footnote 2"></A><SPAN
style="COLOR: rgb(0,0,255)">[2]</SPAN> We mostly refer to the current global
economic order and dominant neo-liberal policies.</P>
<P><A title="Footnote 3" name="Footnote 3"></A><SPAN
style="COLOR: rgb(0,0,255)">[3]</SPAN> WHO constitution, chapter 2, article 2a.
Read the WHO constitution in <A
href="http://www.phmovement.org/cms/files/WHO-Constitution-EN.pdf"
target=_blank>English</A>, <A
href="http://www.phmovement.org/cms/files/WHO-Constitution-ES.pdf"
target=_blank>Spanish</A>, <A
href="http://www.phmovement.org/cms/files/WHO-Constitution-FR.pdf"
target=_blank>French</A> and <A
href="http://www.phmovement.org/cms/files/WHO-Constitution-AR.pdf"
target=_blank>Arabic</A>.<BR></P>
<P></P>
<HR>
<H1><SPAN style="COLOR: rgb(0,0,0)"><A title="Position paper"
name="Position paper"></A></SPAN></H1>
<H1 align=center><SPAN style="COLOR: rgb(0,0,0)"><SPAN
style="FONT-SIZE: medium; COLOR: rgb(0,0,0)">Comprehensive Primary Health Care
remains an Essential Tool to Achieve “Health for All”</SPAN></SPAN></H1>
<H2 align=center><SPAN style="COLOR: rgb(0,0,0)"><SPAN
style="COLOR: rgb(0,0,0)">Interim Position of the People’s Health Movement (PHM)
October 2008.</SPAN></SPAN></H2>
<P><SPAN style="COLOR: rgb(0,0,0)">The Comprehensive Primary Health Care (CPHC)
approach articulated in the Alma Ata Declaration in 1978, remains as relevant
today as it was 30 years ago. It recognized the need for a <STRONG>new
international economic order</STRONG> if inequities in health were to be
successfully addressed.</SPAN></P>
<P>A PHC policy in 2008 needs renewed commitments that should affirm and
consolidate Alma Ata and also take into account new realities.</P>
<P>PHM insists that PHC should be take account of but also influence the
political, economic and social processes in each specific context CPHC should
also be based on the fundamental concept that all citizens have rights to the
conditions that create health. It must:<BR></P>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>include not only the primary level of care, but also a working referral
system to secondary and tertiary levels of care;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>be adequately financed through public sources;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>ensure systems of health care provide equitable access and care according
to need;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>through action across sectors public health interventions and health
promotion address the social, political, economic and environmental
determinants of health and not just be limited to health care;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>empower communities, especially the most disadvantaged and marginalized,
so that they can act as protagonists in improving their health and their
livelihoods;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>use technology in a manner that is sensitive to local needs and contexts;
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>combine traditional and modern medicine to maximize benefits to patients;
and
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>embed policies and interventions in the human rights framework with a
special focus on the rights of vulnerable groups
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>PHM has identified new challenges that have emerged in the last 30 years
and which <STRONG>should be incorporated in a renewed commitment to
PHC.</STRONG>
<P></P></LI></UL>
<P><SPAN style="COLOR: rgb(0,0,0)"><BR>PHM notes that:<BR></SPAN></P>
<UL>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>Neoliberal globalization brings new threats to health such as; the
increase in trade in unhealthy commodities, international trade agreements
that: promote the penetration of transnational corporations into the health
sector, enforce patent rights that are used against the interests of poor
people, and apply unfair rules in the international trade of agricultural
products that devastate the livelihood and health of poor farmers.
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>Selective, vertical health care programs remain dominant, and not only
fragment wider health systems, but also draw away scarce resources from public
health systems, treating patients as passive recipients of care and ignoring
the ever-present socioeconomic and political determinants of health.
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>In light of the looming health staffing crisis, the role of paid community
health workers should be revisited; not only to extend coverage at the local
level, but also to act as social mobilizers in the empowerment of communities.
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>Increasing privatization and commercialization of health systems has
undermined the role of the public sector and has often eroded standards of
care among health workers whose activities may be influenced more by the
profit motive than the health needs of the communities they serve.
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>Poor countries have continued to lose their health workers under the
current unregulated health workers’ labor market. Regulation must ensure an
adequate human resource base for the health systems of all countries
--including compensating poor countries for their losses as a consequence of
migration (i.e., costs of training and opportunity costs of losing skilled
staff).
<P></P>
<P><SPAN style="COLOR: rgb(0,0,0)"></SPAN></P>
<LI>Intellectual property rules continue to make new life-saving medications
unavailable and unaffordable to the people who need them the most. PHC
requires universal access to essential (mostly generic) medicines.
<P></P></LI></UL>
<P><SPAN style="COLOR: rgb(0,0,0)"><STRONG>PHM reiterates the core principles of
Alma Ata. PRIMARY HEALTH CARE IN 2008 AND BEYOND, must, in addition, address
these new challenges at local, national, regional and global levels. PHM
reasserts its commitment to putting the health of marginalized groups as the
focus of its call for ‘Health for All Now’ – a call made by the PHM in 2000 in
its <A
href="http://www.phmovement.org/cms/en/resources/charters/peopleshealth">People's
Charter for Health</A>.</STRONG></SPAN></P></FONT></DIV></BODY></HTML>