By Dr Linda Lovell-Roberts
Forty-five years ago, in September 1978, the Assembly of the World Health Organization adopted the Alma Ata declaration. The essence of this declaration is that health is a basic human right which governments should strive to provide for all citizens. The slogan” Health for All by 2000 “was coined at the Alma Ata meeting.
Health was defined as “complete, physical, mental and social well-being, not merely the absence of disease”. The vision was for every person to live a socially and economically productive life, limited only by their natural endowment. Participation in planning and implementation of health care delivery is the right and duty of every individual. The declaration articulated the concept that primary care, encompassing preventive measures and population screening, is the most important component of the health system.
The aspiration was that where necessary, social infrastructure and amenities would be developed. The overarching aim was, as far as possible, to keep persons out of hospital. Services in homes and communities would be emphasised.
Despite the fact that this extremely broad agenda has not been achieved, there has been progress in eradicating disease and in meeting the challenges of wars and pandemics. In 1978, the life expectancy worldwide was 65 years; in 2021 it was 74years. The increase has been in all countries of the world. In Canada, which has consistently had one of the longest expectancies, it moved from 74 years to 83 years. In Chad, which has one of the shortest, it moved from 44 to 53 years. In Antigua and Barbuda, it moved from 68 to 78 and in the United States from 70 to 77.
Health for all remains an ideal which all countries should work towards. Social problems become medical problems. Many studies show that illness is more prevalent in lower socio-economic groups. Adequate shelter, water and electricity are prerequisites for a healthy life. The availability of nutritious food is also very important.
In most countries, conditions caused by an unhealthy lifestyle are the common causes of death. Work needs to be done on providing more exercise programmes and increasing the availability of fresh fruits and vegetables.
All cancers are curable if diagnosed and treated in the early stages. More intensive and focused screening programmes would reduce suffering and deaths from cancer.
There has been significant progress in immunisation coverage worldwide. Poliomyelitis, a vaccine preventable disease, has been almost eradicated. Many formerly prevalent childhood infections are now very uncommon.
The practical benefit of focusing on primary health care is that there will be a reduction in the need for hospitalisation and medication, and the money saved can be used for preventive action in the community. In addition, the population will be healthier, and therefore more able to contribute to society.
The call of “Health for All” is as relevant as it was 45 years ago. The declaration of Alma Ata is a vision of a better world which the human family should work to make a reality.
Thoughts and views expressed in Observations do not necessarily reflect the opinion of Observer Newsco, its management or staff.