By Carmel Williams
In 1978 when the Alma-Ata Declarationcalled on urgent action by all governments to protect and promote the health of all, primary health care was described as ‘essential health care, based on practical, scientifically sound and socially acceptable methods and technology made universally accessible … and at a cost that the community and country can afford to maintain…’. It was also, in the first paragraph, acknowledged as a fundamental human right.
Forty years ago, achievement of primary health care for all was seen to be dependent upon a “New International Economic Order”. The Declaration twice referenced the UN declaration adopted in 1974 that aimed to rebalance power (and trade) by restructuring some fundamentals in the world economy, and providing greater benefits and participation to poorer countries. In comparison, the Astana Declaration on primary health care, due to be released in October 2018, shies away from such bold comments and instead states its commitment to ‘enabling people and communities to pursue the knowledge, skills and resources needed to take care of their own health, including the use of digital technologies.’
Predating neo-liberalism, Alma-Ata made no mention of the private sector, or partnerships with business. Rather, it proclaimed that ‘Governments have a responsibility for the health of their people which can be fulfilled only by the provision of adequate health and social measures.’ In contrast, the 2015 founding document of the Sustainable Development Goals(SDGs), identifies universal health coverage(not care) as an SDG, and stresses the importance of the private sector in the achievement of it, and in all other goals. “We recognize that we will not be able to achieve our ambitious Goals and targets without a revitalized and enhanced Global Partnership…bringing together Governments, civil society, the private sector…”. Similarly, the Astana Declaration states, ‘We have more partners and more stakeholders, both public and private, working toward common goals…’ downplaying the essential role of government in achieving primary health care for all, and not acknowledging human rights obligations of states. Continue reading →
