Primary Health Care
    25 Years of the Alma-Ata Declaration

Statement of Senator Edward M. Kennedy
Commemoration of the 25th Anniversary of the Alma-Ata Declaration of 1978

September 7, 2004

It was a privilege to participate in the first international conference on primary healthcare, held in Alma-Ata, in 1978. Delegates from 134 countries and 67 international organizations met and agreed that it is unacceptable that the vast majority of the world's people lack basic primary health care. The sad truth of modern life is that children in developed nations are able to live healthy and productive lives, while vast numbers of children in developing nations suffer and often die too early from treatable diseases.

At Alma-Ata, we declared that health care is not just another commodity. The wealth of a nation should not determine the health of its people. Good health is not a gift to be rationed based on ability to pay. Quality, affordable health care for all people is a matter of basic fairness. Health care should be a fundamental right of every man, woman and child. At Alma-Ata, we urged the governments of the world to guarantee this right by the year 2000.

Although we have yet to fulfill this commitment, we must not forget or abandon it. More than ever today, the cooperation of governments, international organizations, and health professionals is essential to provide the basic care to narrow the gap between developing and developed nations. The mapping of the human genome-a task that once seemed impossible-has immensely advanced our understanding of human biology. Treatment for diseases once thought incurable have the potential to save the lives of millions of persons suffering from Parkinson's and Alzheimer's disease, diabetes, and many other illnesses. Paralysis from spinal cord injury may one day be reversed, and those now living in wheelchairs may one day walk again.

Breakthroughs in the biotechnology and pharmaceutical industries are bringing remarkable new discoveries from the laboratory to the bedside of patients. Many miracle drugs more than pay for themselves in better health, and also in lower costs for physicians and hospitals.

Along with these scientific advances, we have also made progress in improving public health systems. The SARS epidemic produced an impressive global response. Health agencies around the world responded effectively. Scientists labored day and night, with extraordinary results. They deciphered the complete DNA sequence of the virus thought to cause SARS, and they are developing sensitive new tests to identify the infection and cure the disease. Cooperative initiatives between governments and health organizations have demonstrated that effective international efforts can curb global epidemics.

Clearly, many difficult challenges lie ahead. Forty-two million people were living with HIV/AIDS at the end of 2002, and millions were children under the age of 15. Each day, twelve thousand more persons around the world are infected with HIV. Eight thousand people a day die from AIDS in Africa alone, and many of them are children. Only 50,000 receive the drugs that can turn this deadly disease into a chronic one. Surely, we can do better.

It is estimated that out of 100 children born, 30 will suffer from malnutrition in the first five years of life; 26 will not be immunized against the basic childhood diseases; 19 will not have access to safe drinking water and 40 will lack adequate sanitation; 17 will never go to school. 11 million children each year-30,000 a day-die before reaching their 5th birthday.

As we look ahead to the future of global health care, the nations of the world have a solemn obligation to live up to, the declaration made at Alma-Ata. Millions of lives are at stake. Decent health care is a fundamental right of all people, everywhere, and this new century of the life sciences gives us all a unique opportunity to achieve that long-sought goal.

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