Assesses the extent to which the social goal of health for all, formalized a decade ago at the historic Alma-Ata conference, has produced measurable changes in both the orientation of health services and the welfare of humanity. Future-oriented in its purpose, the book takes a hard look at the complexities behind this simple slogan, the reasons for its successes and failures, and the main problems facing the coming decade. Throughout, an effort is made to cast the humanitarian potential of this movement against the realities of a world political and economic order that rarely gives priority to health. The book opens with a brief introduction to the Alma-Ata conference, followed by a reproduction of key statements that have shaped the health for all movement. Against this background, readers are given a detailed, critical assessment of what the vision of health for all has achieved during its first decade of practical application. Drawing upon material prepared for a 1988 conference held in Riga, the author first explains the component principles of health for all and then questions whether the widespread formal adoption of these principles has made any difference in public health. While noting major gains in a number of industrialized and developing countries, the book concentrates on the plight of the poorest countries, where health conditions have either remained the same or deteriorated. Readers are reminded that the development process has done little to relieve the suffering of the world's most vulnerable groups, that efforts to improve health now face a new set of solution-resistant problems, and that socioeconomic progress will stagnate unless these problems are quickly and effectively addressed. To this end, the chapter concludes with a series of proposals for securing the necessary motivation and support, followed by ten detailed lines of action that must be followed in order to address these problems in the spirit of health for all through primary care. Proposed lines of action are presented in the second main chapter, which records highlights from the Forty-first World Health Assembly, including an assessment of the future of the health for all strategy, a round table on the tenth anniversary of Alma-Ata, and resolutions concerning the need to develop leadership for health for all. The book concludes with a critical review of the main tasks to be faced in the coming years and a compelling reminder that successes and failures will be measured in terms of human lives and deaths.

eng fre spa.

WHODOC

WHO monograph

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