Health leaders from around the world are gathering in Port Moresby this week for the APEC High-Level Meeting on Health and the Economy. The theme is Transforming Primary Health Care through Investment, Innovation, and Collaboration, and never has the need been more pressing.
From the World Health Organization (originally written August 18, 2018)
There is an outbreak of polio in Papua New Guinea today that is putting children, families, and the economy at risk. This is a perfect example of the need to keep investing in primary health care to ensure that every man, woman and child can easily get essential services like immunization.
Forty years ago, health leaders from around the world came together at the first International Conference on Primary Health Care. The Declaration of Alma-Ata, adopted then, called for urgent action by governments and the health and development community to protect and promote health—with primary health care the key to achieving this goal. This was a watershed moment in public health history—the first time that the world had united around the idea of primary health care to deliver better health for all.
The past 40 years have seen tremendous successes in public health—advances in medical science and technology, increased life expectancy in most countries, great reductions in rates of many deadly diseases, and the eradication of smallpox. There have also been profound shifts in global geopolitics and the world economic order.
And somewhere along the way, the vision of primary health care as the key to health for all was lost. It was replaced with more of a global focus on disease-specific programmes provided on a selective basis.
Today, the world is united around a new vision—the Sustainable Development Goals. Universal health coverage is central to achieving those Goals. This means ensuring all people can access quality health services when and where they need them, without financial hardship. Primary health care—people’s first point of contact with the health system—is essential to universal health coverage.
But many challenges stand in the way of realizing this vision.
Right now, at best, only half the world’s population is covered. Hundreds of millions of people cannot access the services they need to stay healthy, manage a chronic condition, or recover from illness. Primary health care also plays a critical role in keeping countries safe from health security threats like outbreaks of diseases such as polio and drug resistant TB, and in responding to natural disasters and other health emergencies.
There is also a shortfall of people trained to deliver those services. Right now, the world is short of 7.2 million health workers, with the largest shortages in the APEC region, including here in Papua New Guinea.
People’s ability to pay for primary health care also hinders access in some places. This leads many to delay seeking care, and high out-of-pocket medical expenses create a spiral of poverty. Kids have to abandon school and dreams of a career so tuition money can pay a family member’s medical bills. Adults leave jobs—or cannot get jobs—because they have to care for a sick family member.
We must work towards strengthened primary health care services in every country. The impact will not only be on people’s health. Primary health care and universal health coverage have the power to improve not only the overall health of the people, but also the development and economic prospects of entire nations.
With the rise in noncommunicable diseases, ageing populations, and outbreaks of old and new diseases and other health emergencies, the need for more investment in primary health care is urgent.
With primary health care as part of universal health coverage, everyone will be protected—no matter who they are or where they live. People will be able to get the health services they need without financial hardship. Kids will continue to learn and workers will earn.
I know that governments have many competing priorities, and health may not always seem the most urgent. But strengthening primary health care is a guaranteed return on investment. The dividends will continue for years. It may be the best investment you will ever make.