25 October 2018: UN Member States renewed their commitment to primary health care as the foundation for achieving universal health coverage (UHC) and other health-related targets of the SDGs at the Global Conference on Primary Health Care in Astana, Kazakhstan. The Declaration of Astana will feed into discussions at the UN General Assembly’s (UNGA) 2019 high-level meeting on universal health care.

The Global Conference on Primary Health Care took place from 25-26 October 2018, organized by the World Health Organization (WHO), the UN Children’s Fund (UNICEF) and the Government of Kazakhstan. A high-level session on the first day adopted the Declaration of Astana and discussed a whole-of-government approach to improving primary health care. Yelzhan Birtanov, Minister of Health, Kazakhstan, anticipated that the adoption of the Declaration of Astana will set “new directions” for developing primary health care as the basis of health care systems.

The Declaration commits to strengthening national health care systems and making health for all a reality, 40 years after the first commitment to primary health care was made in the 1978 Declaration of Alma-Ata. SDG target 3.8 calls for achieving UHC, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.

UNICEF calls for health resources to focus on building strong comprehensive health systems, rather than focusing on single-disease interventions.

UNICEF notes that progress since 1978 has been uneven, with at least half the world’s population lacking access to essential health services, and almost six million children dying from preventable causes before reaching the age of five. The agency calls for health resources to focus on building strong comprehensive health systems, rather than focusing on single disease interventions.

The Declaration acknowledges that, despite “remarkable progress” over the past 40 years, many people around the world still have unmet health care needs. It calls for action to counter the growing costs of health care, medicines and vaccines, and avoid waste and inefficiency in health care spending, acknowledging the impact of disproportionate out-of-pocket spending by patients and their families in causing poverty.

Other issues highlighted in the Declaration include the challenge of antimicrobial resistance, the burden of lifestyle-related and non-communicable diseases (NCDs), and the impact of environmental factors, such as extreme climate events, that affect people’s health. The Declaration commits to applying both scientific and traditional knowledge in primary health care, providing decent work and appropriate compensation for health professionals, and investing in education and training of the primary health care workforce. [WHO Press Release] [UNICEF Press Release] [Conference Website] [WHO Webpage on Declaration] [Full Text of Declaration]