40 years of Alma-Ata: Challenges of Primary Health Care in Brazil and in the World

Luiz Felipe Pinto Daniel Soranz David Ponka Luís Augusto Pisco Zulmira Maria Hartz About the authors

The International Conference on Primary Health Care, held by WHO in Alma-Ata, Republic of Kazakhstan, has just turned 40 years old. It expressed, back in 1978, the “need for urgent action by all governments, all those working in the fields of health and development, and the world community to promote the health of all people of the world”. The so-called “Alma-Ata Declaration”11 Declaração de Alma Ata sobre Cuidados Primários. 1978. [acessado 2019 Dez 22]. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/declaracao_alma_ata.pdf
emphasizes Primary Health Care (PHC), stressing the need for special focus in developing countries, reaffirmed at the Astana Conference22 World Health Organization (WHO). Declaration on Primary Health Care, Astana 2018. [acessado 2019 Dez 26]. Disponível em: https://www.who.int/primary-health/conference-phc/declaration

The organizers of this thematic issue are proud that in the year that celebrates the 25th anniversary of the Ciência & Saúde Coletiva Journal - the leading Brazilian Public Health Journal according to the Google Metrics index for Portuguese-language publications - focusses its discussion on the Family Health Strategy and expands the discussion to include Community and Family Medicine (CFM). The intention is to discuss the fundamental importance of primary care, in the Americas and Ibero-American regions, and to underline how primary care plays a critical role at the intersection of clinical medicine and public health.

This issue contains 23 articles on the topic, written by about 80 authors from nine countries (Brazil, Uruguay, Peru, Jamaica, Haiti, United States of America, Canada, Portugal and Spain). Most of the articles were written by family doctors, family health professionals, teachers and researchers. The themes are divided under three axes: (1) management, care models, assessment of PHC organization and work process of PHC teams; (2) professional training in PHC and CFM (internship, residency programs, graduate degrees); (3) epidemiological studies, information systems, electronic medical records and use of technologies to expand access (telehealth / telemedicine for remote areas). In fact, on this last theme, the article written by the UFRGS group of researchers was one of the highlights of the “APS Forte for SUS - Universal Access” Award, granted by PAHO33 Organização Pan-Americana de Saúde (OPAS). Prêmio APS Forte para o SUS - Acesso Universal. Finalistas do Prêmio APS Forte para o SUS. [acessado 2019 Out 29]. Disponível em: https://apsredes.org/opas-e-ministerio-da-saude-vao-premiar-tres-experiencias-em-atencao-primaria-a-saude/
in October 2019. It was cited as the most successful Brazilian example of broadening access and regulation of services through the use of gold-standard telemedicine technologies. It represents the future in the new age of digital health and integration of complex needs44 Ribeiro JM. Saúde Digital, um sistema de saúde para o século XXI. Lisboa: Fundação Francisco Manuel dos Santos; 2019.. We hope readers will enjoy the series both for such break through lessons, but also to once again be reconvinced of the need to anchor health systems within primary health care.


Publication Dates

  • Publication in this collection
    06 Apr 2020
  • Date of issue
    Mar 2020
ABRASCO - Associação Brasileira de Saúde Coletiva Rio de Janeiro - RJ - Brazil
E-mail: revscol@fiocruz.br