According to the World Health Organisation, Primary Health Care (PHC) includes physical, mental and social well-being and it is people-centred rather than disease-centred. PHC is a whole-of-society approach that includes health promotion, disease prevention, treatment, rehabilitation and palliative care. A PHC approach includes three components: 1) meeting people’s health needs throughout their lives; 2) addressing the broader determinants of health through multisectoral policy and action; and 3) empowering individuals, families and communities to take charge of their own health.
NAM Member States recognise the significance of the Alma-Ata Declaration of 1978 which stated that PHC 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 system bringing health care as close as possible to where people live and work, and constitutes the first elements of a continuing health care process.
NAM Member States also attach significance to the 2018 Astana Declaration on PHC. The new PHC declaration affirms the “commitment to the fundamental right of every human being to the enjoyment of the highest attainable standard of health without distinction of any kind”, and reaffirms the commitment to the Alma-Ata core principles. The Astana Declaration recognizes that remaining healthy is challenging for many people, particularly the poor, and states that it is “unacceptable that inequity in health and disparities in health outcomes persist”.
NAM Member States reiterated their commitments regarding PHC at the 146th session of the Executive Board (EB) of the World Health Organisation (WHC) held in Geneva from February 3-8, 2020. On the opening day, Permanent Mission of the Republic of Azerbaijan to the UN Office and other International Organizations in Geneva delivered a statement on behalf of NAM. NAM Member States expressed their readiness to continue collaborating with WHO in ensuring that the fundamental human right – the right to health is ensured for everyone on this planet and that no one is left behind. Tanzania, speaking on behalf of 47 Member States of the Africa Region welcomed the comprehensive report of the review of the 40 years of the implementation of Primary Health Care (PHC) at country level.
Tanzania highlighted that even before the Alma Ata Declaration, the Africa Region regarded health as a foundation for national development, a concept which was further reinforced by the numerous resolutions and declarations. Tanzania mentioned that limited equity in access, poor health infrastructure, shortage and poor distribution of skilled health personnel, inadequate utilization of digital health technologies, and poor access to health services for people in hard-to-reach areas were bottlenecks in providing PHC and urged the WHO to cooperate with national governments to eliminate this.
Several participating NAM Member States also mentioned their national commitments to ensure an effective PHC mechanism. India stated that it was committed to increasing India’s public health spending to sustain the pace and scale of reform towards increasing government health expenditure to 2.5% by 2025 and two-thirds of this would be spent on PHC. India firmly believed that the WHO needed to create mechanisms at regional and global levels to enable an exchange of experiences between countries on models of Primary Health Care (PHC).
Ghana said that PHC is an important tool in achieving universal health coverage (UHC). Following the Alma Ata declaration in 1978, many countries in Africa, including Ghana embraced the idea of improving PHC to enhance effective health service delivery. In Ghana, PHC delivery continued to play an important role in the wellbeing of citizens especially in deprived communities. PHC units served as the first line of service and met the basic health care needs of most vulnerable and deprived communities.
Zambia urged the WHO Secretariat to expeditiously come up with a roadmap for the development of a monitoring and evaluation framework with clear timelines as this is imperative to monitoring implementation and measuring impact particularly at country level.