At the International Conference on Primary Health Care (PHC) held in Almaty (formerly Alma-Ata, USSR) on September 12, 1978, the Health-For-All (HFA) Alma Ata Declaration was launched. The declaration reaffirmed the WHO Constitution that health included physical, mental and social well-being, but that “large numbers of people and even whole countries, were not enjoying an acceptable standard of health.” From then on primary health care was to be the key to attaining the goal of health for all by the year 2000. Which “enshrined community-based healthcare as the core of decision-making”. [1, 2, 3, 5]
“As stated in the Declaration of Alma-Ata adopted in 1978, the key to attaining the goal of health for all by the year 2000 is primary health care.” Since primary health care “services reflect and evolve from the local economic conditions and social values, they vary in different countries and communities…but should include at least education concerning prevailing health problems and the methods of preventing and controlling them… including family planning; immunization against the major infectious diseases;prevention and control of locally endemic diseases…”
Out of this declaration global targets for health were established and measured. The strategy of health-for-all has been endorsed at the highest political level, but a gap remained between what is preached and what is practised. In 1995 the HFA for the 21st Century was launched.
WHO’s dependence on private foundations and pharmaceutical companies for funding began in 1993, as such private influence to grown and “the balance of power has shifted away from populations, represented by nation states.” It “has coincided with a growing reliance on [vested-intrests] vaccine-based strategies” as the primary solution for public health. “This top-down approach represents an abandonment of the community-based healthcare principles enshrined in the Alma Ata Declaration and in the founding charter of WHO. History has come full circle” catalysed by COVID-19. [4, 6]
By 1998 it was recognised “Changes in the economic and political situation in the 1980s proved to be a major obstacle to the implementation of the health-for-all strategy…. WHO continued to support the principles of health for all, but organized itself in such a way as to deal with prevalent diseases in developingcountries. It pushed the medical approach as far as it could go, even in prevention, by giving greater emphasis to vaccinations and vertical programmes.” [7, 8]