In October, 2018, WHO celebrates 40 years since the International Conference on Primary Health Care (PHC) and offers a renewed vision of PHC—building on, but not replacing, the Declaration of Alma-Ata. In those four decades, PHC has faced challenges. Undermined early by the divisive selective-comprehensive debate, PHC was marginalised by structural adjustment and sectoral reforms in the 1990s. PHC was, however, acknowledged in the World Health Report 2000 Health Systems: Improving Performance as a precursor of the new universalism: “high quality delivery of essential health care, defined mostly by the criterion of cost-effectiveness, for everyone, rather than all possible care for the whole population or only the simplest and most basic care for the poor”. The essential values of PHC—social justice and the right to better health for all, participation, and solidarity —have endured. They were rearticulated in World Health Report 2008 Primary Health Care: Now More Than Ever in interconnected reforms that addressed the gaps between the promise of PHC and its delivery: universal access and social protection through universal coverage; people-centred, responsive, integrated service delivery; health policy across all sectors; and inclusive, participatory, accountable leadership.

中文翻译：

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初级卫生保健和全民健康覆盖：竞争的话题？

2018年10月，世卫组织庆祝国际初级卫生保健会议（PHC）成立40周年，并提出了对PHC的新愿景-以但不取代《阿拉木图宣言》为基础。在这四个十年中，PHC面临挑战。PHC在1990年代由于结构调整和部门改革而被边缘化，被分裂的选择性全面辩论所破坏。然而，PHC在《 2000年世界卫生报告：卫生系统：提高绩效》中得到承认作为新普遍主义的先驱：“为所有人提供高质量的基本卫生保健，主要由成本效益的标准来定义，而不是为整个人口提供所有可能的护理，或者仅为穷人提供最简单，最基本的护理”。PHC的基本价值观是社会正义和人人享有更健康，参与和团结的权利。它们在《 2008年世界卫生报告：初级卫生保健：如今比以往任何时候都多》中进行了相互关联的改革，这些改革解决了初级卫生保健的承诺与其实现之间的差距：普遍获得和通过普遍覆盖的社会保护；以人为本，响应迅速，集成的服务交付；所有部门的卫生政策；包容性，参与性，负责任的领导。