ABSTRACT
Comprehensive Primary Health Care (PHC) is a bold vision for health systems and health promotion laid out in the World Health Organization’s 1978 Alma Ata Declaration. Comprehensive PHC emphasizes a holistic, social view of health encompassing treatment, prevention, health promotion, and inter-sectoral action on the social determinants of health. However, since its inception, comprehensive PHC has rarely been properly resourced and has been undermined by more dominant, selective, biomedical approaches to health and primary care, as well as the widespread ascendancy of neoliberalism. The latter is incompatible with comprehensive PHC principles, has spurred structural adjustment and austerity policies that have seen a reliance on private health sectors and user payments, and has allowed private interests – including international donor agencies and philanthrocapitalists – to exert profound power over global public health efforts. The recent debates on Universal Health Coverage reveal a contemporary emphasis on private health insurance and the role of the private health sector. For comprehensive PHC to flourish, global action and a strong civil society are needed. Neoliberal approaches to health systems need to be wound back, and replaced with commitments to equity, health as a human right, and universal healthcare.
