Upon an examination of the development of health services in India, it is evident that the primary health care strategy was a logical outcome and justification for health policies that were (and are) antithetical to the principle of social justice. Thirty years down the line, the village health worker has metamorphosed into the Accredited Social Health Activist, but the health situation cannot be significantly improved without challenging the exploitative social structure.
It is possible today to voice a proposal to take the idea of primary health care, stated in the bold language of the Alma-Ata declaration 30 years ago, forward and work towards making it a reality.
Binayak Sen, a paediatrician, public health professional and national vice-president of the People's Union for Civil Liberties, is the recipient of the tenth annual Jonathan Mann Award for Global Health and Human Rights.
A government which believes that medical education and healthcare are best provided by the private sector is deliberately starving government hospitals of funds. Until a clear plan to ensure health for all is in place and the poor demand medical care as a fundamental right, public health services will remain skewed and unjust.
George Thomas (firstname.lastname@example.org) is chief orthopaedic surgeon at St Isabel's Hospital, Chennai and editor, Indian Journal of Medical Ethics.
The Alma-Ata Declaration of 1978 on Primary Health Care together with the slogan of Health for All by 2000 AD is considered one of the most significant public health initiatives of the 20th century. The 30th anniversary of the declaration provides an opportune time to revisit its history and arrive at some fresh perspectives. This article examines the role of World Health Organisation in developing countries as a directing and coordinating authority on international health, and in providing impartial, evidence-based technical information.