Aspiring to build health services and systems led by primary health care in the Eastern Mediterranean region.

In celebrating the 30th anniversary of primary health care (PHC) and the declaration of Alma Ata in 1978, it is useful to remind ourselves that PHC was identified as the means or strategy to achieve health for all. In other words PHC was considered a comprehensive health developmental approach. Such an approach includes several features and each word in the phrase “primary health care approach” represents an essential constituent. Thus the “Primary” element means that it involves what is essential from the perspective of burden of disease, epidemiology, morbidity, mortality and cost–effectiveness, as well as what is acceptable. The “Health” element means complete health as defined by the World Health Organization (WHO), i.e. a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Health is also seen in the context of overall development and encompasses the social determinants of health. Related sectors and the community usually contribute more to the “H” of PHC than the Ministry of Health which focuses on services or rather the PC of PHC. The “Care” element (which is broader than cure) includes preventative, curative and rehabilitation-related care. It also covers personal and public aspects. The “Approach” element indicates that PHC is dynamic, health system-oriented and is the means to achieve health for all. As the health system orientation covers health services and nonhealth services, such as nutrition, water and sanitation, primary care (PC) is sometimes used interchangeably with PHC. There is, however, a clear difference. PC can be considered the essential or basic service provided by the health authorities and is the most widely addressed component of PHC as a whole worldwide. PC provides promotive (mainly health education), preventive and curative care.