Universal Health in the 21st Century: 40 Years of Alma-Ata.” Report of the High-Level Commission. Revised edition.


To mark the 40th anniversary of the Declaration of Alma-Ata, the Pan American Health Organization (PAHO) convened the Regional Forum “Universal Health in the 21st Century: 40 Years of Alma-Ata” on December 11-12, 2017, in Quito, Ecuador. As part of this regional movement, PAHO Director Dr. Carissa F. Etienne convened a High-Level Commission: Universal Health in the 21st Century: 40 Years of Alma-Ata, chaired by Dr. Michelle Bachelet and Ambassador Néstor Mendez, and made up of an interdisciplinary group of regional experts, including representatives from communities and academia, as well as political actors, such as former health ministers, trade union leaders, and representatives of different social movements.

The objective of the Commission was to develop recommendations for the PAHO Director on how to give effect to the right to health as a fundamental human right, based on an analysis of the progress and challenges faced by health systems in the Region of the Americas.

This document reflects the Commission’s position regarding primary health care (PHC), the search for solutions to ensure the right to health, and the approach taken in discussions, analysis, and recommendations on how to guarantee this right. It is based on reports prepared by the five thematic groups addressing: a) health care model, b) institutional model, c) financing model, d) health and social protection, and e) human resources for health (see annexes to the present report). The thematic groups were led by members of the Commission, bringing together a great number of academic experts and social movements from different countries in the Region. In this report, the Commission presents 10 recommendations for achieving health for all in the Region of the Americas in the 21st century.