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    Health for all by the year 2000: the countdown has begun.

    Roy BN

    Journal of the Indian Medical Association. 1983 Apr; 80(7-8):108-11.

    In 1977 the World Health Assembly launched the movement for "Health for all by the year 2000." The 1st step was taken at the International Conference on Primary Health Care in Alma Alta, USSR, in 1978. The conference declared that primary health care (PHC) was the key to realizing the goal of health for all by 2000. It also emphasized the need for urgent and effective national and international action to develop and implement a PHC program throughout the world. A general review of the progress in terms of the indicators will facilitate tracing the progress and realizing the magnitude of the tasks ahead. In terms of the 1st 2 indicators, the target has been endorsed at the highest official level by parliaments or governments in most countries and the mechanism has been strengthened in most of the developing countries to involve people in the implementation of the health development programs. The trouble begins with the 3rd indicator which requires countries to spend at least 5% of the gross national product (GNP) on health. For most of the developing countries where health development is inextricably linked with socioeconomic development, investing 5% of the GNP on health is difficult. It is almost an impossibility for the least developed countries (LDCs). The position of the developing countries like India, though somewhat better than that of the LDCs, is not very encouraging either. In India's 6th Plan the allocation on health as percentage of total allocation in the budget was 2.40 in 1978-79 and 2.10 in 1979-80. India's position with regard to the 4th global indicator, requiring that a reasonable percentage of national health expenditure be devoted to the local health care, is not yet satisfactory though considerable efforts have been made in this area. In regard to the 5th indicator, namely, equitable distribution of resources on various population groups or geographical areas, the desired standard has not been achieved. A most important indicator, indicator 7, set by the WHO for monitoring the progress of the global strategy is that PHC should be available to the entire population. About 361 million of India's rural population do not have adequate drinking water facilities and sanitation facilities. In respect to the drug requirement of indicator 7, only a few of the essential drugs of the 20 required, are available. About 50% of the children live in conditions of poverty, deprivation, and malnutrition, and about 40% of all deaths in the country occur among children below age 5 and 10% of all children born do not live to celebrate their 1st birthday. Despite the conditions, child care continues to receive low priority from the government of India. Nutrition programs have been launched, but most of these programs have only touched on the problem.
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