• by IPS Correspondents (penang, malaysia)
• Friday, December 30, 1994
• Inter Press Service

PENANG, Malaysia, Dic 30 (IPS) - A drastic shift in global health strategy has been silently taking place in the past few years, away from the principle of state responsibility for providing health care for all people.

In many countries worldwide, public health budgets have been cut, health-related fees have shot up, and the health situation, especially of the poor, has deteriorated.

And according to health experts, problems such as malnutrition and child deaths and the resurgence of cholera, tuberculosis, malaria, and plague will worsen if such policy trends continue.

David Werner, author of 'Where There Is No Doctor', the best- selling primer on community-based health practice, perhaps explains best why the public should be worried about the shift in global and national health strategies.

Werner, who works with the U.S.-based Healthwrights group and is a consultant for the World Health Organisation (WHO), recalled at a recent meeting of experts here how the concept of primary health care was adopted by virtually all governments at the 1978 global health conference that endorsed the Alma Alta Declaration.

To achieve 'Health for All by the Year 2000', the Declaration promoted the principles that all people are entitled to basic health rights and that the state is responsible for meeting the people's health needs, regardless of gender, race and class.

The declaration's centrepiece was a comprehensive strategy that included an equitable, consumer-centred approach to health services and also addressed social factors that influence a person's physical and mental well-being.

At the international meeting on health strategies held here in early December, Werner said these high expectations have not been fulfilled. He added: "It is painfully evident that the goal of 'Health For All' is growing more distant not just for the poor but for humanity."

During the 1980s, child mortality rates dropped, but undernutrition and morbidity rates rose. In the early l990s, the decline in child mortality rates slowed or stopped. Now, child mortality rates are rising, especially in Africa.

Werner says three factors have undermined primary health care.

First, instead of adopting a comprehensive health and social programme, the U.N. Children's Fund (UNICEF) compromised and opted for selective primary health care aimed at limited reducing child mortality through selected interventions like oral rehydration therapy (ORT) and immunisation.

© Inter Press Service (2014) — All Rights Reserved. Original source: Inter Press Service

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