Kazakhstan is Shining Beacon in Primary Health Care, Says Top WHO Official

ASTANA – The Kazakh capital is hosting an international conference on Oct. 23, which celebrates the 45th anniversary of the Alma Ata Declaration and the fifth anniversary of the Astana Declaration on primary health care (PHC). Kazakhstan has an important role to play on the international stage in terms of PHC, being a shining beacon, said Dr. Suraya Dalil, director of the WHO Special Program on Primary Health Care, in an interview with The Astana Times.

Dr. Suraya Dalil is the Director of the WHO Special Programme on Primary Health Care – a program established in 2020. Photo credit: WHO.

The conference on primary health care policy and practice is a major event for the region. Could you share your insights on its significance and what outcomes you hope to achieve?

The upcoming conference on primary health care policy and practice, titled Implementing for Better Results, is set to be a pivotal event for the region and the world. As we mark the 45th Anniversary of the Declaration of Alma Ata and the 5th anniversary of the Declaration of Astana, the significance of this conference cannot be overstated. It comes at a critical juncture for global health – the mid-point of the Sustainable Development Goals 2030, and more importantly, at the time when the call for equity, human rights, and social justice is rightly loud. 

The Declaration of Alma Ata, adopted in 1978, reinforced the idea that health is a fundamental human right and it laid the foundation for primary health care as a cornerstone of effective health systems. The Declaration of Astana, adopted in 2018, reaffirmed the commitment to primary health care as the only pathway to make universal health coverage a reality. This conference provides a platform to reflect on the progress made over the last five decades, what worked and why, sharing lessons from various country contexts, and charting a course for the future.

The UHC Global Monitoring Report 2023, released last month, highlights a stark reality – more than half of the global population still lacks access to essential health services. This is a sobering reminder of the work that remains to be done in ensuring equitable access to health care for all. The conference serves as an opportunity to discuss the barriers that impede access to essential services and identify strategies to overcome them.

The importance of primary health care has been underscored during the COVID-19 pandemic. Primary Care is the first line of defense for many communities, offering essential services as well as preventive care such as vaccination, disease surveillance, tracking, and reporting – demonstrating their indispensable role during calm times as well as during public health crises.

Achieving SDG3 is also intrinsically linked to the success of primary health care, making this conference a critical juncture to recalibrate efforts and strategies to meet the SDG targets.

The outcomes we hope to achieve from this conference are monumental. We aspire to see renewed commitments to the principles of PHC. We anticipate the sharing of innovative approaches and best practices that can enhance access to services, especially for underserved populations. We aim to foster discussions on equity, human rights, and community empowerment in health, promoting inclusivity and quality care for all.

Ultimately, the Implementing for Better Results conference is an international event. It provides a unique opportunity to reiterate our commitment to the vision of Alma Ata and Astana and to recalibrate our efforts to ensure that no one is left behind.

What are the key takeaways that you hope that participants will leave the conference with?

The Primary Health Care conference is set to be an illuminating event for global health, bringing to the forefront significant insights and actionable strategies. While the conference showcases a wealth of evidence and experiences, three key points from recent developments merit special attention.

Success Stories of PHC Implementation. It is essential to acknowledge that the PHC approach is not merely theoretical; it’s a proven reality. The program will feature insights from many countries across the world, who have demonstrated that the PHC approach is feasible and effective. The conference will provide attendees with firsthand experiences from these countries, demonstrating that long-term sustained vision and political commitment can pave the way for successful PHC implementation. These practical examples will inspire and motivate participants, offering tangible evidence of what is possible.

Time for Action: The conference underscores the urgency of translating policy into practice. It emphasizes that the focus should shift towards action and implementation. The content of the conference has been carefully crafted to amplify how PHC can be effectively put into action. Participants will not only gain conceptual knowledge but also a roadmap for practical application. This focus on implementation is crucial to bridging the gap between policy and practice, displaying evidence that worked.

Global Report (Primer): A significant development that will occur during the conference is the release of the Global Report titled Implementing the PHC Approach: A Primer, which will serve as a synthesis of implementation evidence. Steered in collaboration with the European Observatory for Health Systems and Policies, with support from around 70 authors and 50 contributors across all regions of WHO, the Primer provides valuable insights into the current state of PHC worldwide and will be an essential reference for health leaders, managers, practitioners, policymakers, and researchers. The Primer has around 50 country illustrations from around the world, offering a comprehensive overview of the global landscape of PHC, enabling readers to make informed decisions and shape the future of health based on a sound understanding of the existing challenges and opportunities.

By the end of the conference, we hope participants will leave with a practical appreciation for the historical significance of Alma Ata and Astana, a commitment to addressing global health inequalities, and a wealth of practical strategies to transform primary health care to meet the challenges of the 21st century.

What role do international partnerships and collaboration play in supporting Kazakhstan’s efforts to improve primary health care?

International partnerships and collaboration are playing a pivotal role in supporting Kazakhstan’s endeavors to enhance primary health care. The importance of these global alliances cannot be overstated, as they bring a wealth of expertise, resources, and shared experiences to Kazakhstan’s efforts.

Knowledge exchange: international partnerships facilitate the exchange of knowledge and best practices. They enable Kazakhstan to tap into the experiences of other nations, learning from both successes and challenges in strengthening their own primary health care and health system.

Capacity building and technical support: collaborations with international organizations and experts empower Kazakhstan with the necessary skills and expertise to develop a robust system and workforce. This includes training for healthcare professionals, improving healthcare infrastructure, and enhancing service delivery.  International collaborations often bring technical assistance and some financial support. Health services and systems are a dynamic and evolving reality, and so bringing the latest evidence through technical support is useful in many countries.

Advocacy and networking: international collaborations provide Kazakhstan with opportunities to engage in advocacy efforts, build networks, and participate in high-level discussions related to primary health care. These interactions raise the nation’s profile and create opportunities for mutual support.

Research and innovation: Kazakhstan benefits from international partnerships that promote research and innovation in primary health care. Collaboration with global research institutions and health care organizations can lead to breakthroughs, improved diagnostics, and better treatment options.

Learning from Kazakhstan’s leadership in PHC:  The WHO European Centre for Primary Health Care in Almaty demonstrates Kazakhstan’s commitment to work with WHO and to pioneer leadership and learning in PHC.  Kazakhstan’s PHC Demonstration Platform, launched in 2022, offers a valuable model of transformation from a biomedical care approach to a holistic, multidisciplinary team-based model with a focus on mental health and social work. Visiting delegations have the opportunity to witness firsthand the implementation of expanded multidisciplinary primary  care teams in rural areas. By offering practical insights, sharing experiences, and facilitating collaboration, the platform enables visiting countries to adapt and implement best practices in line with their unique contexts and needs, ultimately contributing to the enhancement of their own systems. The WHO European Center for PHC plays a central role in tailoring the programs to each visiting country’s specific requirements and offering technical support for further implementation.

What message do you have for the people of Kazakhstan about the importance of primary health care?

Kazakhstan, with its remarkable history of championing primary health care, has an invaluable role to play on the international stage. From the Declaration of Alma-Ata to the transformation into Astana, Kazakhstan has been a shining beacon in the field of primary health care.

During my days as a medical student, I was profoundly inspired by the Declaration of Alma Ata. It stood as a trademark in the world of public health and global health, emphasizing the noble goal of health for all. This vision has not faded over the years; in fact, it has grown stronger. Dr. Mahler, the Director-General of the WHO at the time, later described the adaptation of the Declaration of Alma Ata as a “sacred moment” and a “sublime consensus,” which was reasserted at this year’s World Health Assembly by Director-General Dr. Tedros.

In a world filled with competing priorities and challenges, we need Kazakhstan to continue being the eloquent voice of PHC on both the global and regional stages. PHC is not just about ensuring health for all and achieving the Sustainable Development Goals, although these are vital objectives. It is also the key to addressing climate change and pursuing sustainable development. PHC can act as a multiplier for progress, touching various facets of our lives and planet.

Kazakhstan’s unwavering commitment to PHC is a source of inspiration for not only your nation but also the entire world. Your dedication to this cause can be a beacon of hope in an era where health and well-being have never been more critical. So, let us together, through the power of Primary Health Care, strive for a healthier, more equitable, and sustainable future for all.

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