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Declaration
of Alma-Ata
The International Conference on
Primary Health Care, meeting in Alma-Ata this twelfth day of September in t=
he
year Nineteen hundred and seventy-eight, expressing the need for urgent act=
ion
by all governments, all health and development workers, and the world commu=
nity
to protect and promote the health of all the people of the world, hereby ma=
kes
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 fundame=
ntal
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 acti=
on
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 economic=
ally
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 a=
nd
social development and contributes to a better quality of life and to world
peace.
IV
The people have the right and du=
ty
to participate individually and collectively in the planning and implementa=
tion
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 dec=
ades
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 famil=
ies
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 centr=
al
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 o=
f a
continuing health care process.
VII
Primary health care:
1.&n=
bsp;
reflects and evolves from the
economic conditions and sociocultural and polit=
ical
characteristics of the country and its communities and is based on the
application of the relevant results of social, biomedical and health servic=
es
research and public health
experience; &nbs=
p; &=
nbsp; &nbs=
p;
2.&n=
bsp;
addresses the main health proble=
ms
in the community, providing promotive, preventi=
ve,
curative and rehabilitative services accordingly; &n=
bsp; =
; &n=
bsp; =
;
3.&n=
bsp;
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 diseas=
es;
prevention and control of locally endemic diseases; appropriate treatment of
common diseases and injuries; and provision of essential drugs; =
&nb=
sp; =
&nb=
sp;
4.&n=
bsp;
involves, in addition to the hea=
lth
sector, all related sectors and aspects of national and community developme=
nt,
in particular agriculture, animal husbandry, food, industry, education,
housing, public works, communications and other sectors; and demands the
coordinated efforts of all those
sectors; &=
nbsp; &nbs=
p; &=
nbsp;
5.&n=
bsp;
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; &nb=
sp; =
&nb=
sp;
6.&n=
bsp;
should be sustained by integrate=
d,
functional and mutually supportive referral systems, leading to the progres=
sive
improvement of comprehensive health care for all, and giving priority to th=
ose
most in need; &n=
bsp; =
; &n=
bsp;
7.&n=
bsp;
relies, at local and referral levels, on health workers, inclu=
ding
physicians, nurses, midwives, auxiliaries and community workers as applicab=
le,
as well as traditional practitioners as needed, suitably trained socially a=
nd
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 pri=
mary
health care as part of a comprehensive national health system and in
coordination with other sectors. To this end, it will be necessary to exerc=
ise
political will, to mobilize the country's resources and to use available
external resources rationally.
IX
All countries should cooperate i=
n a
spirit of partnership and service to ensure primary health care for all peo=
ple
since the attainment of health by people in any one country directly concer=
ns
and benefits every other country. In this context the joint WHO/UNICEF repo=
rt
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 full=
er
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 car=
e,
as an essential part, should be allotted its proper share.
The International Conference on
Primary Health Care calls for urgent and effective national and internation=
al
action to develop and implement primary health care throughout the world and
particularly in developing countries in a spirit of technical cooperation a=
nd
in keeping with a New International Economic Order. It urges governments, W=
HO
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 introducin=
g,
developing and maintaining primary health care in accordance with the spirit
and content of this Declaration.
© 2009 World Health Organization