Thirty years after Alma-Ata declaration: international. Marc Sprenger, Director-General RIVM. collaboration needed forever. November 26, 2008, Paris

Transcription

1 Thirty years after Alma-Ata declaration: international collaboration needed forever Journees de veille sanitaire, InVS 10 ans November 26, 2008, Paris Marc Sprenger, Director-General RIVM

2 Visionary thinkers 1. En chantant, Michel Sardou 2. Alma Ata declaration

3 Declaration of Alma-Ata 1978 Shift in focus from ill, health and hospital to a focus on communities and families controlling their own health, putting the public into public health New revolutionary hollistic approach

4 Alma-Ata: translation into 10 articles I Health: state of complete physical, mental and social wellbeing: action of many other social and economic sectors II Inequality health status: within countries unacceptable III Promotion of health essential to sustained economic and social development IV People have the right participate planning and implementation of their health care V Health for all 2000 primary health care is the key VI Primary health care based on practical, scientifically sound first level of contacts with health system

5 Alma-Ata: Primary health care (VII) 1. Addresses the main health problems in the community, providing promotive, preventive (2) 2. Includes education, promotion of proper nutrition (3) 3, Involves agriculture, animal husbandry, housing demands the coordinated efforts (4) 4. All countries should cooperate in a spirit of partnership 5. Health by people in any one country directly concerns and benefits every other contry (IX)

6 Evaluation 2008: Now More Than Ever (WHO) Striking inequities Health system have lost focus on fair access Return to primary health care: better performance Specialists GP Health as commodity Fragmented care (vertical) Primary health care: smart way Deliberate policy decisions are needed

7 New start for primary health care Today more evidence effectiveness and efficiency PHC Countries with strong PHC: better outcomes at low cost Evidence is robust across time and place (all countries) Essential feature PHC: accessibility, a person focus over time Vertically services: interfere with responsibility of the State World wide plan needed: WHO should set the agenda! Role of National Public Health Institutes? Salman Rawaf et al Thelancet 1365, October 18, 2008

8 Questions after Alma-Ata 1. Are the topics still relevant? 2. Do the Nat PH Institutes play a role? Check annual report of InVS 3. Is international collaboration important

9 Health: state of complete physical, mental and social wellbeing: action of many other social and economic sectors

10 Inequality health status: within countries unacceptable August 2008 Commission on Social Determinants of Health

11 Promotion of health essential to sustained economic and social development

12 People have the right participate planning and implementation of their health care

13 Primary health care plays a keyrole

14 Primary health care based on practical, scientifically sound first level of contacts with health system

15 PHC: Includes at least: education, promotion of proper nutrition (3)

16 PHC: Involves agriculture, animal husbandry, housing demands the coordinated efforts (4)

17 PHC: All countries should cooperate in a spirit of partnership

18 PHC: Health by people in one country directly concerns and benefits every other country

19 Conclusions 1. Alma-Ata: very visionary! 2. InVS works in the spirit of Alma-Ata 3. Alma-Ata needs InVS & NPHI 4. International collaboration needed forever Congratulations InVS 10 years! 19