A global "return to primary healthcare" is needed to steer world health systems towards better performance.
Thiswas the message of the World Health Report 2008, launched today (14October 2008), which documents failures that have left the healthstatus of different populations, both within and between countries,"dangerously out of balance".
The report, titled Primary health care – now more than ever,champions the "holistic approach" of primary care, as opposed to a morenarrow focus on specialist care to treat certain diseases.
Whencountries at the same level of economic development are compared, saysthe report, "those where healthcare is organised around the tenets ofprimary healthcare produce a higher level of health for the sameinvestment."
In particular, the report praises primary care foran approach that "makes prevention equally important as cure in acontinuum of care that extends throughout the lifespan."
TheWorld Health Organization (WHO) estimates that better use of existingpreventive measures could reduce the global burden of disease by asmuch as 70%.
"Viewed against current trends, primary healthcarelooks more and more like a smart way to get health development back ontrack," said WHO Director-General Dr Margaret Chan.
In awide-ranging review, the World Health Report found striking inequitiesin health outcomes, in access to care, and in what people have to payfor care.
It says that personal expenditures on health now pushmore than 100 million people below the poverty line each year. Anddifferences in life expectancy between the richest and poorestcountries now exceed 40 years.
In rural parts of the developingworld, the report says, care tends to be fragmented into discreteinitiatives focused on individual diseases or projects, with littleattention to coherence and little investment in basic infrastructures,services, and staff.
"A primary healthcare approach, when properly implemented, protects against many of these problems," it argues.
Conversely,it says: "When health is skewered towards specialist care, a broad menuof protective and preventive interventions tends to be lost."
Byputting families and communities at the hub of the health system,primary care "honours the resilience and ingenuity of the human spiritand makes space for solutions created by communities, owned by them,and sustained by them."
"Primary healthcare, includingintegrated services at the community level, can help improve health andsave lives," said Ann Veneman, Executive Director of UNICEF.