<br><span class="gmail_quote">From: <b class="gmail_sendername">PHM Global Secretariat</b> <a href="mailto:secretariat@phmovement.org">secretariat@phmovement.org</a><br></span>
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<p style="TEXT-ALIGN: center" align="center"><b><span style="FONT-SIZE: 14pt">Qatar Declaration: Health and Well-being through Health Systems</span></b></p>
<p style="TEXT-ALIGN: center" align="center"><b><span style="FONT-SIZE: 14pt">based on Primary Health Care</span></b></p>
<p style="TEXT-ALIGN: center" align="center"><b><span style="FONT-SIZE: 14pt">4 November, 2008</span></b></p>
<p><b><span style="FONT-SIZE: 14pt">Preamble</span></b></p>
<p><span style="FONT-SIZE: 14pt">On the occasion of the 30th anniversary of the Declaration of Alma-Ata, the Member States of the World Health Organization in the Eastern Mediterranean Region, assembled at the First International Conference "Qatar Primary Health Care 2008: The Foundation of Health and Well-being" in Doha, Qatar, 1-4 November 2008, reaffirm that the primary health care approach is the main strategy to achieve better health and wellbeing for the people of the Region. Further, they reiterate their commitment to primary health care and its values and principles of universal access and coverage, based on equity and social justice, community involvement and health as a basic human right.</span></p>
<p><span style="FONT-SIZE: 14pt"> </span></p>
<p><span style="FONT-SIZE: 14pt">Through this declaration the Member States express their commitment to:</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Greater solidarity, cohesion and a shared responsibility in supporting one another in developing health systems based on primary health care;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Translation of the primary health care principles and values into actions that improve the health and well-being of all populations, including vulnerable groups.</span></p>
<p><b><span style="FONT-SIZE: 24pt"> </span></b></p>
<p><b><span style="FONT-SIZE: 14pt">The Challenge</span></b></p>
<p><span style="FONT-SIZE: 14pt">The Member States of the Eastern Mediterranean Region recognize that:</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Appropriate response to change in the global geopolitical, socioeconomic, informational, technological and climatic landscape is a challenge for health systems;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Several countries of the Region are caught up in longstanding complex emergency situations that have disrupted health systems and adversely affected health outcomes;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">A number of countries in the Region, particularly some low-income and middle-income countries are struggling to achieve the Millennium Development Goals;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Addressing the wider social determinants of health is critical to achieving good health outcomes;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">There are significant disparities within and between countries in the numbers, skill mix and distribution of the health workforce in the Region;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Despite prior commitment to the primary health care strategy, there have been varying levels of implementation and significant inequities exist in the financing and provision of health care and in health outcomes;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">There is an existing and increasing high burden of chronic non-communicable diseases, including mental health disorders, and associated preventable risk factors, which has high cost implications for health systems;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt; FONT-FAMILY: Symbol"><span>·<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Communicable diseases continue to pose a threat to the health of people in the Region and weak health systems are recognized as a barrier for the scaling up of health services against such diseases;</span></p>
<p><b><span style="FONT-SIZE: 14pt"> </span></b></p>
<p><b><span style="FONT-SIZE: 14pt">The Commitment</span></b></p>
<p><span style="FONT-SIZE: 14pt">The Member States express their highest level of commitment to:</span></p>
<p><span style="FONT-SIZE: 14pt"> </span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>1.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Ensure that all the principles and values of primary health care are fully integrated into the various elements of the national health system;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>2.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Strengthen solidarity through appropriate means in order to support countries of the Region to achieve universal access to quality and safe health services.</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>3.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Promote the role of leadership in health development at all levels through institutional strengthening of ministries of health;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>4.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Invest in health in order to promote national growth and development and allocate adequate resources for primary health care programmes, secure financial sustainability and improve social health protection to reduce the share of out-of pocket spending;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>5.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Tackle the wider social determinants of health and health inequities, building on the Region's experience of community-based initiatives, and promote health in all policies and programmes as well as intersectoral action;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>6.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Strengthen the decentralization of the health system through appropriate organization, management and funding;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>7.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Establish and/or scale up family practice models, ensuring the active involvement of all team members;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>8.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Ensure integration of vertical programmes for control of communicable and non-communicable diseases into the mainstream health care delivery system, particularly at primary health care level;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>9.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Promote healthy lifestyles as part of a renewed strategy for control of non-communicable diseases, including mental health disorders and injuries;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>10.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Ensure community-oriented training programmes in all educational settings which develop an adequate health workforce with appropriate skills mix; and ensure good remuneration and clear career paths to encourage the health workforce into primary health care;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>11.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Expand the role of primary health care workers as community leaders to include positive contribution to environmental protection and to promote healthy lifestyles;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>12.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Strengthen partnership for primary health care between government, civil society, community leaders, academia and the private sector;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>13.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Support the urgent revival and revitalization of disrupted health systems in countries in complex emergency situations and the removal of all barriers to access to health care;</span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>14.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Monitor and evaluate health system performance through the development and use of national health information systems and national and regional health observatories; </span></p>
<p style="MARGIN-LEFT: 0.25in; TEXT-INDENT: -0.25in"><span style="FONT-SIZE: 14pt"><span>15.<span> </span></span></span><span dir="ltr"></span><span style="FONT-SIZE: 14pt">Promote policy and health systems research, community-based participatory research and knowledge translation for evidence-based policy-making.</span></p>
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<p><span style="FONT-SIZE: 14pt">Qatar</span><span style="FONT-SIZE: 14pt"> </span><span style="FONT-SIZE: 14pt"> World Health Organization</span></p>
<p><span style="FONT-SIZE: 14pt"> </span></p>
<p><span style="FONT-SIZE: 14pt">Afghanistan Bahrain Djibouti Egypt </span></p>
<p><span style="FONT-SIZE: 14pt">Islamic Republic of Iran Iraq Jordan </span></p>
<p><span style="FONT-SIZE: 14pt">Kuwait Lebanon Libyan Arab Jamahiriya </span></p>
<p><span style="FONT-SIZE: 14pt">Morocco Pakistan Palestine Oman </span></p>
<p><span style="FONT-SIZE: 14pt">Sudan Saudi Arabia Somalia Syrian Arab Republic </span></p>
<p><span style="FONT-SIZE: 14pt">Tunisia United Arab Emirates Yemen</span></p>
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