The International People’s Health Council (IPHC) is a worldwide coalition of people’s health initiatives and socially progressive groups and movements committed to working for the health and rights of disadvantaged people. The vision of the IPHC is to advance toward health for all — viewing health in the broad sense of physical, mental, social, economic, and environmental well being. If you want to learn more about IPHC, become part of the coalition, or communicate with the regional IPHC coordinator in your area, contact either David Werner at HealthWrights, or the global coordinator of IPHC, Maria Zuniga, at CISAS, Apartado 3267, Managua, Nicaragua (Fax: 505-2 661662; e-mail: <>).

Alma Ata: Revisited After 20 Years

In 1978 the World Health Organization and UNICEF called an International Meeting in the Central Asian city of Alma Ata, now Almaty in the Republic of Kazakhstan. That meeting gave birth to the ALMA ATA DECLARATION in which the world’s nations affirmed HEALTH AS A UNIVERSAL HUMAN RIGHT and approved the ambitious goal of HEALTH FOR ALL BY THE YEAR 2000. The goal was to be approached through a comprehensive, potentially revolutionary strategy known as PRIMARY HEALTH CARE (PHC). This called for multi-sectoral cooperation to construct a NEW ECONOMIC ORDER based on EQUITY, to be achieved through STRONG COMMUNITY PARTICIPATION.

This year, in November 1998, on the 20th ANNIVERSARY OF ALMA ATA, the WHO held another big meeting in Almaty. Its purpose was to assess how the health of the world’s people has changed since the Declaration, to analyze why we are still so far from Health for All, and to formulate a plan for HEALTH FOR ALL IN THE 21st CENTURY.

A Stronger Role for Civil Society.

The 1998 Almaty Conference was attended by many more voluntary and non-government organizations than was the 1978 Alma Ata meeting. This reflects the growing realization that non-profit and community organizations often are more in touch with the people’s needs and try to take a more holistic and sustainable approach to meeting those needs than do many governments and international agencies. Indeed, it was agreed that in planning and implementing a strategy for “HFA-21” (Health for All in the 21st Century) “civil society” (NGOs and people’s organizations) should play a much more prominent role.

IPHC Well Represented

Three leaders in the IPHC were asked to take part in HFA-21. These were David Sanders and David Werner (authors of our book Questioning the Solution, the Politics of Primary Health Care and Child Survival) and Fran Baum, president of the Australian Public Health Association. These speakers helped to gain a consensus that a major obstacle to Health for All is the globalized market economy which is widening the gap between rich and poor. Pursuit of economic growth (of the rich) has led to privatization of health services, cuts in wages and welfare, and growing poverty, hunger, crime, violence and social unrest. This has undermined PHC.

Strategy for the 21st Century

At the time of this writing, the final statement and agenda for action resulting from Almaty 1998 have not yet been completed. (Participants’ comments on the drafts are still being integrated.) We will include a follow-up on this report in our next Newsletter.

In brief, the proposal for action for “PHC-’21” calls for a model of social development based on human needs and greater equity. To move toward Health for All, the market system must be regulated to put sustainable human and environmental well-being before unchecked corporate profits. For this, civil society must take a united stand.

For a copy of the talk, “Health and Equity: Need for a People’s Perspective in the Quest for Health for All,” by David Werner at the ‘98 Almaty Conference, send US$4 to


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