Declaration of Alma-Ata

The Declaration of Alma-Ata was adopted on September 12, 1978, at the International Conference on Primary Health Care in Alma-Ata, USSR (now Almaty in Kazakhstan). The conference was organised by the World Health Organization and United Nations Children’s Fund.

Through this 1,118-word Declaration, the Conference expressed “…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.” The Declaration also states that governments, international organisations and the world community should aim for “...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.”

Excerpts from the 10 points of the Declaration:

I. The Declaration reaffirms that health – a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity – is a fundamental human right. The attainment of the highest possible level of health is an important social goal globally. Realising this goal requires the action of many social and economic sectors in addition to the health sector. 

II. The existing gross inequality in the health status of people – between developed and developing countries, as well as within countries – is politically, socially and economically unacceptable. Therefore, it is of common concern to all countries. 

III. Economic and social development – based on a ‘New International Economic Order’ –  is important for the attainment of health for all, and for reducing the gap between the health status of the developing and developed countries. The promotion and protection of health is essential for sustained economic and social development; it contributes to a better quality of life and world peace.

IV. The Declaration affirms that “The people have the right and duty to participate individually and collectively in the planning and implementation of their health care.”

V. It states that “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. The Declaration defines primary healthcare as “…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 self-reliance and self-determination.” Primary healthcare, it says, forms an integral and central part of the country's health system, and the overall social and economic development of the community. It is the first level of contact between individuals, families and communities with the national health system – bringing healthcare as close as possible to where people live and work.

VII. Primary healthcare, the Declaration further asserts, reflects the economic, sociocultural and political characteristics of the country and its communities, and is based on the application of social, biomedical and health services research and public health experience; it addresses the main health problems in the community, providing promotive, preventive, curative and rehabilitative services, accordingly; it includes 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, immunisation against major infectious diseases, prevention and control of locally endemic diseases, appropriate treatment of common diseases and injuries, and provision of essential drugs; it involves, in addition to the health sector, related sectors such as agriculture, livestock rearing, food, industry, education, housing, public works and communications – and demands the coordinated efforts of all those sectors; it requires and promotes maximum community and individual self-reliance and participation in the planning, organization, operation and control of primary healthcare; it should be sustained by integrated and functional referral systems, leading to the progressive improvement of comprehensive healthcare for all, and giving priority to those most in need; and it relies, at local and referral levels, on health workers, including physicians, nurses, midwives, auxiliaries and community workers as applicable, as well as traditional practitioners, suitably trained to work as a health team and to respond to the expressed health needs of the community. 

VIII. The Declaration advises all  governments to formulate national policies, strategies and plans to launch and sustain primary healthcare as part of a comprehensive national health system, in coordination with other sectors. For this, it will be necessary to exercise political will, mobilise the country's resources and use available external resources rationally. 

IX. The Declaration states that “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.”

X. “An acceptable level of health for all the people of the 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” – asserts the Declaration.

Focus by Aakanksha.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.