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Since 1978, life expectancy has increased 10 years in the region. But inequities continue to impede access to health for millions of people. PAHO’s Director called for renewed commitment to health for all

Washington, D.C., 25 September 2018 (PAHO/WHO) – Back in 1978, when countries around the world recognized primary health care as the key to “health for all” at Alma-Ata, Kazakhstan, average life expectancy in the Americas was 67 years. Forty years later, a baby born in the Americas can today expect to live 10 years longer, that is, to age 77.

At the historic International Conference on Primary Health Care, leaders from around the world committed to achieving “health for all” by the year 2000 and reaffirmed the fundamental values of the right to health, equity and solidarity.

“Alma-Ata gave the world PHC as an approach and a strategy for health and well-being."

“Health for all was an ambitious goal that has still not become a reality,” said the Director of the Pan American Health Organization (PAHO), Carissa F. Etienne, during a side event at the 56th PAHO Directing Council, which is taking place this week in Washington, D.C. “Unacceptable levels of health inequities continue to leave many people behind.”

Nevertheless, despite that unmet goal, many countries have expanded access to health and health coverage by strengthening the first level of care, establishing integrated health networks, and addressing segmentation and fragmentation of their health systems.

“We have eliminated many diseases, expanded vaccination coverage, and addressed diseases that had long been neglected,” said Etienne. She enumerated a number of health milestones achieved over the past four decades that are documented in a book launched during the side event, Alma-Ata 40: From Alma-Ata to Universal Health.

The Primary Health Care (PHC) strategy refers to much more than the first level of care, Etienne noted. It calls for the creation of integrated health services that not only are curative but that also include health promotion, prevention, rehabilitation and treatment for common diseases. “Alma-Ata gave the world PHC as an approach and a strategy for health and well-being,” she said, adding, “It clearly established that it is governments’ responsibility to provide health services for their populations.”

Changing the course of history

Etienne said that to achieve health for everyone, everywhere in the 21st century, “We need to change the course of history. We need a regional mass movement for universal health. We need all voices saying that now is the time” to reach health for all.

“We are in the 21st century, with scientific and technological advancements that were unimaginable in 1978,” said Etienne. “We know what has worked and what has not worked in the quest for health equity. We know that focusing only on selective and minimal packages of services will not get us there. We know that we have to eliminate financial barriers to guarantee access and coverage for all.”

Moreover, “we know that it’s not just about financing; we need the right combination of human resources, infrastructure and equipment, medicines and health technologies. We need a strong first level of care backed up by an integrated health service delivery network. And we must involve everyone, including those who have until now been left behind.”

Etienne also highlighted the need for strong commitment from governments as well as across different government and social sectors in order to make health for all a reality. “Without action by the state, there is no right to health, especially for those living in conditions of vulnerability,” she said, adding that health for everyone, everywhere “is possible and necessary. The time is now.”

During the side event, Etienne inaugurated a new photo exhibit showing the contributions of PHC to health in the Americas. She also presented a special edition of PAHO’s scientific journal dedicated to “Primary Health Care: 40 Years after Alma-Ata.”