One month after world leaders committed to redouble action on universal health coverage (UHC) at the United Nations General Assembly, 70 countries convened to step up primary health care investments by 2030.
The International Conference on “Primary health care policy and practice: implementing for better results” marked the 45th anniversary of the Declaration of Alma-Ata and 5th anniversary of the Declaration of Astana on primary health care. The conference, which brought together over 600 health policy-makers and partners from countries, took place in Kazakhstan—the birthplace of the historic primary health care (PHC) declarations. It was co-hosted by the Government of Kazakhstan, the World Health Organization (WHO), and UNICEF.
More than half of the world’s population is still not covered by essential health services. Two billion people face severe financial hardship due to healthcare costs. Participants called for greater investments in primary health care, making the most of digital innovations, ensuring protection from catastrophic out-of-pocket health costs, and investing in the health and care workforce to address the projected 10 million health worker shortage by 2030.
“We have seen during the pandemic that the poor, the most vulnerable, and the most marginalized people paid the highest cost. Equity cannot and must not wait,” Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said in his opening address. “WHO is committed to working with governments, international financing institutions, partners, young people and civil society to radically change course, through prioritizing action and investments into a primary health care approach.”
An additional investment of at least US$ 200–328 billion per year, or approximately 3.3% of national gross domestic product, is required to globally scale-up the PHC approach in low- and middle-income countries and to meet commitments made in the second United Nations Political Declaration on UHC adopted on 5 October 2023.
PHC ensures good quality, more affordable and equitable access to essential health services. It is the most inclusive, effective and efficient path to UHC. Implementing PHC requires enhanced collaboration to increase and improve political commitment, governance, financing and engagement. It also requires a paradigm shift, from building health systems that focus on treating diseases to co-creating systems that look after the totality of health and well-being of people, so that communities can be healthier and better protected from diseases.
Radically scaling up PHC in countries could save over 60 million lives. It can also deliver 75% of the projected health gains from the Sustainable Development Goals.
WHO’s work in primary health care
The WHO Special Programme on PHC’s (SP-PHC) objective is to support countries in reorienting their health systems towards PHC and to ensure robust normative guidance to track progress for accountability and impact. The WHO UHC Partnership is key to the implementation of this work. With a network of more than 150 health policy advisers deployed in 125 countries and six WHO regional offices, the UHC Partnership is WHO’s largest platform for international cooperation on UHC. The UHC Partnership organized a pre-conference workshop in Astana on 22 October 2023, for over 250 delegates from ministries of health, development partners and WHO country offices from all over the world. The workshop provided an opportunity for countries to examine the connections between primary health care and UHC, the political dynamics surrounding health system reforms, and success factors that enabled innovation and investment for primary health care for better implementation in the immediate future.
Through the Primary Health Care-Accelerator of the Global Action Plan for Healthy Lives and Well-being (SDG3 GAP), WHO, UNICEF and partners are also working together and creating synergies across sectors, to better support countries in delivering on their UHC commitments through primary health care. WHO and UNICEF have been strong partners in primary health care for decades. Together, WHO and UNICEF have developed the Operational Framework for PHC, providing a clear compass for action by any country on our planet.
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Alma-Ata Declaration
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Back to the future: harnessing the power of primary health care to transform our health systems