Health systems development in the English-speaking Caribbean: toward the twenty-first century.

In 1977 the World Health Assembly resolved that the main social target for the world’s govemments should be the attainment of a socially and economically productive life for their citizens by the year 2000. In 1978 the Alma-Ata Declaration reaffirmed this pledge and stated that the “primary health care” strategy should be the main vehicle for achieving the goal of “Health for All by the Year 2000” within the broad context of national socioeconomic development (I). In 1979 the World Health Assembly urged member states to define and implement national, regional, and global strategies for achieving the goal of “health for all.” And in 1981 the Assembly approved the global strategy of “Health for All by the Year 2000” (2). A key implication of the “health for all” goal and the primary health care strategy is that the health of an individual depends not merely on the absence of disease but on the presence of a state of “well-being.” Obviously, procuring this state requires a multisectoral approach in which such issues as unemployment, poor housing, illiteracy, and poverty become major areas of