Declaration of Alma-Ata
International Conference on Primary Health Care, Alma-Ata, USSR, 6-12
September 1978
The 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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