The Pan American Health Organization Re-affirms the importance of primary health care.

We have recently been informed by Dr. María Magdalena Herrera that the Pan American Health Organization (PAHO) has decided to re-emphasize the principles of primary health care in a new position paper that appears to be close to being completed and adopted. This document, the Regional Declaration about Primary Health Care and can be found at the following address:

<http://www.paho.org/english/ad/ths/os/PHC-orientation-Lybrary.htm>

It is available in both in Spanish and English.

While the term “primary health care” may not sound either revolutionary or especially controversial, it does, in fact, advocate for a number of principles that, if implemented, would radically improve the access to and the quality of health care services in a large number of countries.

The basic principles of primary health care were spelled out in the Alma Ata agreement sponsored by the United Nations in 1978. This agreement affirmed the right of all people to a decent level of health. This by itself, was a point of controversy for some people who felt that we should provide health care only to those who can afford it. In addition the Alma Ata accord stated that the underlying social, economic and political circumstances that are the root causes for preventable ill health should be addressed. This was a serious sticking point for the wealthy elites of the world who feared health services might have to by paid for through a progressive tax, and for multinational corporations who feared it might cut into their profit margins. So in various ways the radical edge of the Alma Ata blunted. A good description of this process can be found in David Werner’s article Alma Ata and the Institutionalization of Primary Health Care.

In view of the more or less systematic undermining, over a period of years, of the goals established at Alma Ata, we are very pleased to see that the Pan American Health Organization is determined to re-instate the aims and principles of Primary Health Care.

According to the current draft of the Regional Declaration about Primary Health Care (PHC) there are several important reasons for putting the principles of PHC back into operation as the central guidelines for the development of health care systems in the Americas:

1. Throughout the extensive consultation process that formed the basis for this paper, it was found that PHC represents, even today, a source of inspiration and hope, not only for most health personnel, but for the community at large.
2.Due to new challenges, knowledge, and contexts, there is a need to renew and reinvigorate PHC in the region that also strengthens the PHC approach so that it can realize its potential to meet today s health challenges and those of the next quarter-century.
3. Renewal of PHC entails recognizing and facilitating the role of PHC as an approach to promote more equitable health and human development.
4. PHC renewal will need to pay increased attention to structural and operational needs such as access, financial fairness, adequacy and sustainability of resources, political commitment, and the development of systems that assure high quality care.

We have included some of our discussion of this matter on the forum (See “The Pan American Health Organization and primary health care.”) Please feel free to add your own comments to the discussion. The PAHO is interested in the reactions of our readers. At the same time it should be kept in mind that this is still a draft and has not been been finalized, and it is not meant for general distribution.

HealthWrights staff