The Declaration of Alma-Ata established in 1978 by the World Health Organization was created to ensure and promote health for all people of the world. Dr. Otmar Kloiber, Secretery General of the World Medical Association, Ferney-Voltaire, France, claims that after thirty years of this declaration, there has been very little change and health has increasingly become an issue. The problem, he argues, is that health systems today have concentrated on primary care. Indeed, the basis of the health care system is primary care, but Dr. Kloiber suggests that once this structure is in place, we must continue to grow and develop it into a community based type of care. Developing countries suffer from their poor economies and the common phenomenon is the emigration of physicians from developing countries to the North. These are incredible challenges that health systems in developing countries face and physicians around the world must collaborate in order to create a better system for development. "Health care is trust and trust inspires hope," he says. "If we don't develop, people lose trust and go away."
Equally, Dr. Maaike Flinkenfl�¶gel, Coordinator of Primafamed-Network, Belgium, discussed the importance of community based primary care and the role of the family doctor or General Practitioner (GP). The 21st century is an era where the role of the family doctor has evolved. Today, GPs no longer work individually but collectively to promote health and to guarantee people access to health care. The community-oriented primary care, a system used in Belgium, strives to develop the health of the community as a whole, not just on an individual level. Physicians, as a result, spend a lot of time researching and gathering information that enable them to understand the needs of the community and treat them accordingly. Thus, the role of the 5-star doctor is broadened in which he becomes an advocate for social change and development.
Dr. Nicolas Perone, Chief Resident of the Division of International and Humanitarian Medicine at the University Hospitals of Geneva, Switzerland, also underlines the importance of the participation of GPs in research and raising awareness. Taking example from the former Yugoslavia health system, Dr. Perone maintains that physicians today must move beyond the "family doctor" structure and direct their work towards public health services.
Dr. Hans Wolff, Head of the Penitentiary Medicine Unit at the University Hospitals of Geneva, Switzerland, equally acknowledges this advocacy role explaining his personal experience as a physician for marginalized groups. The penitentiary medical unit at the Champ-Dolllon prison in Geneva aims to offer high quality care to the detainees and makes sure that they are treated like all other patients. However, disparities still exist within the system where there is low communication between the doctors and the patients, access to care is limited and prevention of violence is unsuccessful. Dr. Wollf insists that the world is changing and we must change with it. As advocates of social change, physicians all over the world must work together towards equality and harmony within the health system.
Health is a universal human aspiration and a basic human need.