Declaration of Alma-Ata
International Conference on Primary Health Care
Alma-Ata, USSR, 6-12 September 1978
Alma-Ata, USSR, 6-12 September 1978
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
selfreliance 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 s
ystem 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:
1.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;
2.addresses the main health
problems in the community, providing promotive, preventive, curative and
rehabilitative services accordingly;
3.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;
4.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;
5.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;
6.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;
7.relies, at local and
referral levels, on health workers, including physicians, nurses,
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 ofthe 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, 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 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, nongovernmental 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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