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The International Conference
on Primary Health Care, meeting in Alma-Ata this twelfth day of September
in the year Nineteen hundred and seventy-eight, expressing the need
for urgent action by all governments, all health and development workers,
and the world community to protect and promote the health of all the
people of the world, hereby makes 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 fundamental 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 action 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 economically 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 and social
development and contributes to a better quality of life and to world
peace.
IV
The people have the right and duty to participate individually and collectively
in the planning and implementation 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 decades 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 families 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 central 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 of a continuing health care process.
VII
Primary health care:
- reflects and evolves
from the economic conditions and sociocultural and political characteristics
of the country and its communities and is based on the application
of the relevant results of social, biomedical and health services
research and public health experience;
- addresses the main health
problems in the community, providing promotive, preventive, curative
and rehabilitative services accordingly;
- 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 diseases; prevention and control of locally endemic
diseases; appropriate treatment of common diseases and injuries; and
provision of essential drugs;
- involves, in addition
to the health sector, all related sectors and aspects of national
and community development, in particular agriculture, animal husbandry,
food, industry, education, housing, public works, communications and
other sectors; and demands the coordinated efforts of all those sectors;
- 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;
- should be sustained by
integrated, functional and mutually supportive referral systems, leading
to the progressive improvement of comprehensive health care for all,
and giving priority to those most in need;
- relies, at local and
referral levels, on health workers, including physicians, nurses,
midwives, auxiliaries and community workers as applicable, as well
as traditional practitioners as needed, suitably trained socially
and 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 primary health care as part of a comprehensive
national health system and in coordination with other sectors. To this
end, it will be necessary to exercise political will, to mobilize the
country's resources and to use available external resources rationally.
IX
All countries should cooperate in a spirit of partnership and service
to ensure primary health care for all people since the attainment of
health by people in any one country directly concerns and benefits every
other country. In this context the joint WHO/UNICEF report 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 fuller 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, d�tente
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 care, as
an essential part, should be allotted its proper share.
The International Conference
on Primary Health Care calls for urgent and effective national and international
action to develop and implement primary health care throughout the world
and particularly in developing countries in a spirit of technical cooperation
and in keeping with a New International Economic Order. It urges governments,
WHO 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 introducing,
developing and maintaining primary health care in accordance with the
spirit and content of this Declaration.
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