The Political Economy of Implementing Primary Health Care: Key Policy Shifts

Background:

The Declaration of Alma-Ata (1978) established primary health care (PHC) as the cornerstone of health equity and human development. Four decades later, the Declaration of Astana (2018) reaffirmed PHC as fundamental to achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs). These two global milestones position PHC not only as a foundation for resilient health systems and equitable access to health services but also as a catalyst for inclusive economic development, societal cohesion, and population well-being.

In October 2023, the Global Conference on PHC in Astana, Kazakhstan celebrated the 45th anniversary of Alma-Ata and the 5th anniversary of the Astana Declarations. The President of Kazakhstan launched the Global Coalition on PHC, a country-led initiative endorsed by the World Health Organization (WHO) and its several Member States. The Coalition reflects a shared global commitment to reorient health systems around PHC principles to advance UHC and accelerate progress toward the SDGs.

The Coalition operates through three key pillars: political commitment and pledges by encouraging decision makers to prioritize and make national pledges for PHC; policy advocacy by tackling systemic challenges to PHC implementation and transformation; and knowledge exchange by sharing experiences and innovations to accelerate PHC-focused reforms. By aligning with the WHO, the Coalition strengthens national, cross-regional and cross-country partnerships to build PHC capacity and scale up locally grounded and globally informed reforms.

Essence: The establishment of the Global Coalition marks a significant step in the journey towards PHC, with 19 countries already having joined: Armenia, Belarus, Bhutan, Brazil, Canada, Egypt, Finland, France, Kazakhstan, Kyrgyzstan, Luxembourg, Mongolia, Myanmar, Palestine, Qatar, Russia, Thailand, Uruguay, Malaysia. The event will delve into the Coalition’s aims and objectives, its three main activity areas, and future directions and milestones. Emphasis will be placed in the Coalition’s role in driving reorientation of health systems towards PHC.

PHC is inherently a holistic and integrative approach, naturally intersecting with a broad range of health topics. To ensure event’s relevance, visibility and influence, strategic cross-linkages will be drawn with key themes under discussion at UNGA 80. These include: NCDs and mental health, linked through disease integration; social participation, aligned with community engagement and empowerment; and WASH, underlining the critical need to physical infrastructure improvements.

Future Direction: The high-level event will conclude with a clear narrative on what the Global Coalition will do between this UNGA and the next. It will define success metrics to inform the trajectory and ensure that the Coalition’s efforts are impactful.

Speaker will include Presidents, Prime Ministers, Ministries of Foreign Affairs, Ministers of Finance, Ministers of Health, representatives of UN Agencies, key international partners, and of youth and civil society will be invited as panelists.