Thirty years after WHO highlighted the importance of primary health care in tackling health inequality in every country, Stephen Gillam reflects on the reasons for slow progress and the implications for today's health systems Is the declaration of Alma Ata still relevant to primary health care?

       After years of relative neglect, the World Health Organization has recently given strategic prominence to the development of primary health care. This year sees the 30th anniversary of the declaration of Alma Ata (box 1). Convened by WHO and the United Nations Children’s Fund (Unicef), the Alma Ata conference drew representatives from 134 countries, 67 international organisations, and many non-governmental organisations. (China was notably absent.) Primary health care “based on practical, scientifically sound and socially acceptable methods and technology made universally accessible through people’s full participation and at a cost that the community and country can afford” was to be the key to delivering health for all by the year 2000. 1