Forty years after Alma Ata we reaffirm its principles and renew its call to action

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LETTER TO THE MINISTERS OF HEALTH OF THE AMERICAS REGARDING ALMA ATA’S 40TH ANNIVERSARY

" Forty years after Alma Ata we reaffirm its principles and renew its call to action"

 We, the undersigned, represent a diverse coalition of nationalities and occupations –academia, politics, technical cooperation, and public management, among others. Despite coming from different backgrounds, all of us have been permanently committed to the achievement of the right to health. ALMA ATA has been a fundamental milestone in our thinking and in our work. That is why we believe that it not only deserves to be remembered with faithfulness to its values and principles, but it should be highlighted that its implementation is still valid and urgent. For this reason, we respectfully request your support to ensure that the commemoration of this date becomes an opportunity to effectively engage governments and people in the strengthening of Primary Health Care (PHC), considering its achievements and its pending tasks, as wells as from concrete and verifiable proposals. 

The 40th anniversary of the Alma Ata Declaration –which is probably the most important global health initiative–, has led to the organization of a Global Conference that will be held in Astana next October. We hope that this global event, as well as those that will be held in other places, will strongly and clearly endorse the value of PHC as an axis to materialize and make universal the right to health.

A new and powerful call to action that derives from the spirit of Alma Ata should recognize that the world and its people have changed, and that despite of the progress that has been made profound inequities persist. Millions of human beings in the America’s are socially destined to get sick and die and are excluded from having a timely access to comprehensive and quality health services.

This 40th anniversary should invite us to inquire about the reasons that have hindered the adoption of an effective vision of health promotion and prevention, of social participation, of intersectoral work in fields related to development, and of work in territories with and for the communities. It should also summon us to think about the ways to overcome the underlying factors that relegate the first level of care in many of our countries to a "poor services for the poor", and that prevent PHC from being the strategy of development and emancipation to achieve Universal Health for everyone everywhere. Not long ago, the region of the America’s agreed to work towards the attainment of "Universal Health". That is why PHC becomes more necessary than ever and it should be translated into an explicit and clear will and commitment of the countries to prioritizing PHC; to finance it and provide the necessary resources, human talent and health technologies for its development as a public policy of the State; and to promote a genuine citizen participation as a guarantee of sustainability of said policies.

Today, 40 years after that generous and supportive Declaration, we recognize that the ambitious goal of "health for all" was not met. But we do not expect a nostalgic rhetoric and, even less, a list of complaisant speeches. We hope that, under the leadership of the ministries of health, we can have bold, politically responsible and technically based answers on what we still must do to end the great inequality in access and in the quality of the health services that persist.  It is time to face with determination the challenges that prevent health from being an effective right for everyone in the Americas. Without universal health, there will not be welfare or individual or collective prosperity, nor will we be able to honor what has been committed in the Sustainable Development Goals: "that no one will be left behind".



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