Milestones :: Perspectives
Declaration of Astana
Global Conference on Primary Health Care
From Alma-Ata towards universal health coverage and the Sustainable Development Goals
Astana, Kazakhstan, 25 and 26 October 2018
12 pages :: pdf: https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf
We, Heads of State and Government, ministers and representatives of States and Governments1, participating in the Global Conference on Primary Health Care: From Alma-Ata towards universal health coverage and the Sustainable Development Goals, meeting in Astana on 25 and 26 October 2018, reaffirming the commitments expressed in the ambitious and visionary Declaration of Alma-Ata of 1978 and the 2030 Agenda for Sustainable Development, in pursuit of Health for All, hereby make the following Declaration.
Governments and societies that prioritize, promote and protect people’s health and well-being, at both population and individual levels, through strong health systems;
Primary health care and health services that are high quality, safe, comprehensive, integrated, accessible, available and affordable for everyone and everywhere, provided with compassion, respect and dignity by health professionals who are well-trained, skilled, motivated and committed;
Enabling and health-conducive environments in which individuals and communities are empowered and engaged in maintaining and enhancing their health and well-being;
Partners and stakeholders aligned in providing effective support to national health policies, strategies and plans.
We strongly affirm our commitment to the fundamental right of every human being to the enjoyment of the highest attainable standard of health without distinction of any kind. Convening on the fortieth anniversary of the Declaration of Alma-Ata, we reaffirm our commitment to all its values and principles, in particular to justice and solidarity, and we underline the importance of health for peace, security and socioeconomic development, and their interdependence.
We are convinced that strengthening primary health care (PHC) is the most inclusive, effective and efficient approach to enhance people’s physical and mental health, as well as social well-being, and that PHC is a cornerstone of a sustainable health system for universal health coverage (UHC) and health-related Sustainable Development Goals. We welcome the convening in 2019 of the United Nations General Assembly high-level meeting on UHC, to which this Declaration will contribute. We will each pursue our paths to achieving UHC so that all people have equitable access to the quality and effective health care they need, ensuring that the use of these services does not expose them to financial hardship.
…Promotive, preventive, curative, rehabilitative services and palliative care must be accessible to all. We must save millions of people from poverty, particularly extreme poverty, caused by disproportionate out-of-pocket spending on health. We can no longer underemphasize the crucial importance of health promotion and disease prevention, nor tolerate fragmented, unsafe or poor-quality care. We must address the shortage and uneven distribution of health workers. We must act on the growing costs of health care and medicines and vaccines. We cannot afford waste in health care spending due to inefficiency….
- Build sustainable primary health care
PHC will be implemented in accordance with national legislation, contexts and priorities. We will strengthen health systems by investing in PHC. We will enhance capacity and infrastructure for primary care – the first contact with health services – prioritizing essential public health functions. We will prioritize disease prevention and health promotion and will aim to meet all people’s health needs across the life course through comprehensive preventive, promotive, curative, rehabilitative services and palliative care. PHC will provide a comprehensive range of services and care, including but not limited to vaccination; screenings; prevention, control and management of noncommunicable and communicable diseases; care and services that promote, maintain and improve maternal, newborn, child and adolescent health; and mental health and sexual and reproductive health2. PHC will also be accessible, equitable, safe, of high quality, comprehensive, efficient, acceptable, available and affordable, and will deliver continuous, integrated services that are people-centred and gender-sensitive. We will strive to avoid fragmentation and ensure a functional referral system between primary and other levels of care. We will benefit from sustainable PHC that enhances health systems’ resilience to prevent, detect and respond to infectious diseases and outbreaks…
New global commitment to primary health care for all at Astana conference
Declaration of Astana charts course to achieve universal health coverage, 40 years since declaration on primary health care in Alma-Ata
25 October 2018, Astana, Kazakhstan
Countries around the world today agreed to the Declaration of Astana, vowing to strengthen their primary health care systems as an essential step toward achieving universal health coverage. The Declaration of Astana reaffirms the historic 1978 Declaration of Alma-Ata, the first time world leaders committed to primary health care.
“Today, instead of health for all, we have health for some,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). “We all have a solemn responsibility to ensure that today’s declaration on primary health care enables every person, everywhere to exercise their fundamental right to health.”
While the 1978 Declaration of Alma-Ata laid a foundation for primary health care, progress over the past four decades has been uneven. At least half the world’s population lacks access to essential health services – including care for noncommunicable and communicable diseases, maternal and child health, mental health, and sexual and reproductive health.
“Although the world is a healthier place for children today than ever before, close to 6 million children die every year before their fifth birthday mostly from preventable causes, and more than 150 million are stunted,” said Henrietta Fore, UNICEF Executive Director. “We as a global community can change that, by bringing quality health services close to those who need them. That’s what primary health care is about.”
The Declaration of Astana comes amid a growing global movement for greater investment in primary health care to achieve universal health coverage. Health resources have been overwhelmingly focused on single disease interventions rather than strong, comprehensive health systems – a gap highlighted by several health emergencies in recent years.
“Adoption of the Declaration at this global conference in Astana will set new directions for the development of primary health care as a basis of health care systems,” said Yelzhan Birtanov, Minister of Health of the Republic of Kazakhstan. “The new Declaration reflects obligations of countries, people, communities, health care systems and partners to achieve healthier lives through sustainable primary health care.”
UNICEF and WHO will help governments and civil society to act on the Declaration of Astana and encourage them to back the movement. UNICEF and WHO will also support countries in reviewing the implementation of this Declaration, in cooperation with other partners.
Notes to editors:
The Global Conference on Primary Health Care is taking place from 25-26 October in Astana, Kazakhstan, co-hosted by WHO, UNICEF and the Government of Kazakhstan. Participants include ministers of health, finance, education and social welfare; health workers and patient advocates; youth delegates and activists; and leaders representing bilateral and multilateral institutions, global health advocacy organizations, civil society, academia, philanthropy, media and the private sector.
The Declaration of Astana, unanimously endorsed by all WHO Member States, makes pledges in four key areas: (1) make bold political choices for health across all sectors; (2) build sustainable primary health care; (3) empower individuals and communities; and (4) align stakeholder support to national policies, strategies and plans.