Strengthening Primary Health Care

Total Signatures Collected: 1855

(View Signatures)

In 1978 the Alma-Ata declaration highlighted the importance of community-oriented comprehensive primary health care around the world. Now, 30 years later we ask the donor organizations to review again the mission of Alma-Ata, providing accessible, affordable and sustainable primary health care for all.

We call upon donor organizations like the Gates Foundation, the Global Fund to Fight AIDS, Malaria and Tuberculosis, PEPFAR, the WHO etc. to allocate 15% of their vertical disease-oriented budgets towards the support of horizontal primary health care by 2015.

In recent years, we have seen a huge increase of financial support for improving health care in developing countries. For example, from 1997 to 2002 funding increased from US$6.4 billion to US$8.1 billion. While this has been a great accomplishment, the majority of the financial support goes towards disease-specific projects (vertical programming), rather than addressing a broader range of illnesses through comprehensive primary health care and preventive measures (horizontal programming).

These disease specific programs have not met the main objective of improving the health of the whole community. Despite the large sums being donated, these projects only focus on small parts of the population. Disease specific programs underestimate the importance of access to health care services by all people. Furthermore in many countries disease specific programs lead to increased shortage of human resources in the general health care by employing local health care workers in their own projects for salaries often 2-4 times the normal salaries, creating an internal “brain-drain”.

In order to improve the health status of individuals world wide, a different strategy must be adopted. There are indications that donor organizations are becoming aware of this need for change.

General health outcomes, also for patients with AIDS, Malaria and Tuberculosis, will improve evidently when sustainable comprehensive primary health care, accessible and affordable for all, is operational. Community-oriented primary health care is a cost-effective way to integrate health care for individuals with a broader public health perspective.

We, the undersigned, call upon all donor organizations to allocate 15% of their budgets for disease oriented programs towards strengthening local primary health care systems by 2015.

(View Signatures)