In Correspondence published early Online on thelancet.com Margaret Chan, director-general of WHO, receives the unequivocal support of her six regional directors for her quest to revitalise the vision set out in the 1978 Alma-Ata Declaration on Primary Health Care1.
The six regional directors* wrote in to express their support following a Lancet Editorial** on May 31 which, while welcoming Chan's drive on the issue, asked whether the six regional directors had given it their full backing. The directors say: "Dr Chan's commitment to primary health care is in itself an expression of the unequivocal support from the six regional directors and of the unanimity of views among the senior management of the organisation with regard to primary health care. Despite the wide variation across and within regions with respect to health challenges and the responses required to address these, there is mutual agreement that primary health care will continue to be central to WHO's strategy to strengthen health systems towards the vision of 'Health for All'."
The regional directors refer to the series of regional conferences held throughout 2007 and early 2008 specifically focused on the need for well-performing health systems based on primary health care, and their current initiative with Dr Chan to present a common document on primary health care to encourage debate at upcoming regional meetings.
They conclude: "Learning from the post-Alma Ata experience, WHO's commitment to Health for All and primary health care strategy has to be long term and unwavering over the coming decades. And while a decade from now there will be a different director-general and regional directors, the onus is on the current leadership of WHO, under the guidance of the 193 member states, to ensure that primary health care does not remain an approach driven by motivated individuals but is enmeshed in the fibre that binds the organisation's strategic objectives together and to its three levels."
Lancet editor Dr Richard Horton adds: "Many critics of WHO point to divisions between the director-general and the six regional directors as one reason why the agency sometimes fails to make the impact it should. In this 30th anniversary year of the Alma-Ata Declaration, and at a moment of deep concern about how the international community can work with countries to strengthen health systems, the alignment and combined advocacy of WHO's global leadership is an unprecedented moment in WHO's history. Revitalising primary health care is the single most important action that countries and donors can do to save lives and avoid disability. WHO is now perfectly poised to lead this new movement for primary health care as we approach a critical G8 meeting in July when Japan will mobilise global efforts still further to scale up the world's response to preventable disease."
In September, the Lancet will produce a special themed issue dedicated to the 30th anniversary of Alma Ata and will be jointly organising a two-day conference on the future of primary health care with the London School of Hygiene and Tropical Medicine. In March 2008 The Lancet also published a Comment on a proposal for global action for health systems for the forthcoming G8 summit in Japan.***
Notes to editors:
1 The International Conference on Primary Health Care was convened in Alma-Ata, in what is now Kazakhstan, in 1978, and was attended by virtually all member nations of WHO and UNICEF. The Alma-Ata Declaration was a landmark event in the field of public health and it identified primary health care as the key to the attainment of the goal of health for all.
*The six regional directors at WHO are: Hussein A. Gezairy, Eastern Mediterranean; Shigeru Omi, Western Pacific; Marc Danzon, Europe; Mirta Roses Periago, Americas; Plianbangchang Samlee, South-East Asia; Luis Gomes Sambo, Africa
**The Editorial and Comment are attached to the e-mail of this press release as one pdf, along with the complete letter
For the six regional directors, please contact Dr Mohamed A. Jama, Deputy Regional Director, Eastern Mediterranean Region, T) +202 22 765 027 / +20 10 33 33 401 E) jamam@who.int
Lancet Press Office: T) +44 (0) 20 7424 4949 E) pressoffice@lancet.com
http://www.eurekalert.org/jrnls/lance/chanlettereop.pdf
http://www.eurekalert.org/jrnls/lance/chaneditorialcomment.pdf
Journal
The Lancet