Primary health care, the Declaration of Astana and COVID-19

Overview

Introduction

In 2018, the global health community came together in Astana, Kazakhstan to celebrate the 40th anniversary of the 1978 International Conference on Primary Health Care and the ensuing Declaration of Alma-Ata.1 The Declaration has influenced a generation of public health workers towards health for all through the strategy of primary health care. Among the primary tenets of the Declaration were: health as a human right; communities driving decisions that influence their health; health care close to where people live; and coordinated efforts across society to create health, including fairer social and economic arrangements. The Declaration also emphasized the importance of primary care services. Primary care serves as a person’s first point of contact when people seek health care, engaging their family and community context, dealing with most problems, and acting as the fulcrum of the health system, referring patients onward to other services when necessary.2 None of these principles have lost their relevance over time.3 The Alma-Ata Declaration’s influence and canonical status in public health are unmatched by almost any other text, and certainly in comparison with the many declarations, statements and resolutions issued each year by the global health community.