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At the International Conference on Primary Health Care in Alma-
Ata (in what is now Kazakhstan) in 1978, public health officials
from around the world agreed on a commitment to “Health for All
by 2000,” a goal to be achieved by providing universal access to primary
health care worldwide. Critics argued that the attainment of
this goal by the proposed date was impossible. In the ensuing years,
a strategy of selective primary health care emerged that included
four inexpensive interventions collectively known as GOBI: g rowth
monitoring, o ral rehydation, b reast-feeding, and i mmunizations
for diphtheria, whooping cough, tetanus, polio, TB, and measles.
GOBI later was expanded to GOBI-FFF, which also included f emale
education, f ood, and f amily planning. Some public health figures
saw this as an interim strategy to achieve “health for all,” but others
criticized it as a retreat from the commitments of Alma-Ata. Similar
debates still rage, with “vertical” disease-specific programs for HIV,
TB, and malaria often seen as competing with primary health care
efforts for critical economic, human, and political resources. Global
primary care is examined in detail in Chap. e1.
At the International Conference on Primary Health Care in Alma-
Ata (in what is now Kazakhstan) in 1978, public health officials
from around the world agreed on a commitment to “Health for All
by 2000,” a goal to be achieved by providing universal access to primary
health care worldwide. Critics argued that the attainment of
this goal by the proposed date was impossible. In the ensuing years,
a strategy of selective primary health care emerged that included
four inexpensive interventions collectively known as GOBI: g rowth
monitoring, o ral rehydation, b reast-feeding, and i mmunizations
for diphtheria, whooping cough, tetanus, polio, TB, and measles.
GOBI later was expanded to GOBI-FFF, which also included f emale
education, f ood, and f amily planning. Some public health figures
saw this as an interim strategy to achieve “health for all,” but others
criticized it as a retreat from the commitments of Alma-Ata. Similar
debates still rage, with “vertical” disease-specific programs for HIV,
TB, and malaria often seen as competing with primary health care
efforts for critical economic, human, and political resources. Global
primary care is examined in detail in Chap. e1.
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