Revisiting Alma-Ata: what is the role of primary health care in achieving the Sustainable Development Goals?

The Sustainable Development Goals (SDGs) are now steering the global health and development agendas. Notably, the SDGs contain no mention of primary health care, reflecting the disappointing implementation of the Alma-Ata declaration of 1978 over the past four decades. The draft Astana declaration (...

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Bibliographic Details
Published in:The Lancet (British edition) 2018-10, Vol.392 (10156), p.1461-1472
Main Authors: Hone, Thomas, Macinko, James, Millett, Christopher
Format: Article
Language:English
Subjects:
Education
Employment
Empowerment
Global Health
Health care
Health care policy
Health services
Health Services Accessibility - standards
Humans
Medical research
Mortality
Primary care
Primary Health Care - standards
Public health
Social justice
Steering
Sustainable development
Universal Health Insurance
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Summary:The Sustainable Development Goals (SDGs) are now steering the global health and development agendas. Notably, the SDGs contain no mention of primary health care, reflecting the disappointing implementation of the Alma-Ata declaration of 1978 over the past four decades. The draft Astana declaration (Alma-Ata 2·0), released in June, 2018, restates the key principles of primary health care and renews these as driving forces for achieving the SDGs, emphasising universal health coverage. We use accumulating evidence to show that countries that reoriente their health systems towards primary care are better placed to achieve the SDGs than those with hospital-focused systems or low investment in health. We then argue that an even bolder approach, which fully embraces the Alma-Ata vision of primary health care, could deliver substantially greater SDG progress, by addressing the wider determinants of health, promoting equity and social justice throughout society, empowering communities, and being a catalyst for advancing and amplifying universal health coverage and synergies among SDGs.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(18)31829-4