President Tokayev, Dr Tedros, ladies and gentlemen, colleagues, and friends.
Құрметті ханымдар мен мырзалар! Киелі Қазақ жерінде кездескенімізге өте қуаныштымыз! [Translation: Dear ladies and gentlemen! We are very glad for our meeting on the holy Kazakh land!]
It is my great honour to stand here today to mark the 45th anniversary of the Alma-Ata Declaration and the 5th anniversary of the Astana Declaration. I have a crystal-clear memory standing here 5 years ago signing the Astana Declaration, which rejuvenated primary health-care policies and practices 4 decades after Alma-Ata.
I vowed to translate these commitments into bold and pragmatic actions, and this is what I have been tirelessly championing in Europe and Central Asia under my tenure as Regional Director.
I was so impressed by the poster exhibit in the foyer this morning, showcasing 24 inspiring stories of primary health-care transformation from across the world and vividly demonstrating that the spirit of Astana isn’t merely an aspiration but a genuine reality. There are an impressive 70 countries represented here today, and therefore 70 inspiring stories of health and care just waiting to be told by you all, the true heroes of this transformation.
But while those of us here today do not need convincing of the value of primary health care, let us speak honestly and admit that in many countries we face an implementation gap between our vision and the reality on the ground.
We are challenged to get primary health-care strengthening high enough on the political agenda, resources are simply not in line with our ambitions, and as a result health workers are asked to deliver and take on huge workloads. The result is well known to all of you, and this is what keeps you up at night – health workforce shortages, industrial action and strikes, medical deserts, burnout, and a growing trust deficit.
So we must ask ourselves, candidly, why is primary health care so often overlooked in favour of more glamorous and high-tech medical advancements? Why is primary health care still consigned to the periphery of our health systems?
Think about it: if a government wants to invest in primary health care and use tax-payer’s money, it first needs to demonstrate a clear return on investment.
And we know that putting a financial figure on the value PHC produces for our communities and societies is tough – if not unrealistic. How can you really measure the value of a relationship between doctor and patient and their families over the course of a lifetime? How can you quantify the benefits of mental health care in the community? How can you put a value on emotional and social support for victims of violence?
Secondly, and more so, it needs the buy-in of the powerful actors in health care and this is sadly often where the resistance lies.
Truth is, it has been historically so much easier to make the business case and political case for a sparkling new hospital, of bricks and mortar, with a certain number of beds and turnover of patients.
Yet times are changing: increasingly, countries, regions and municipalities are recognizing that healthy and happy societies are more resilient, more productive, and more cohesive, and if imagining our health system was a tree, primary health care would be its roots. Without strong roots, the tree cannot grow, let alone blossom. At its heart, primary health care is about the people – the doctors, nurses, therapists – who remain with you throughout your life, through complex illnesses, in good times and bad. They know you and your community intimately.
And here, allow me to express my gratitude and admiration to our hosts – Kazakhstan. Mr President, I applaud your leadership championing health and well-being at the centre of your social agenda – domestically, regionally here in Central Asia, and globally.
With your support, we have, for the first time ever, had heads of states from Central Asia approve a landmark “Roadmap for health and well-being in Central Asia” in Dushanbe back in September, elevating health to the center of the social, political and economic development agendas.
We are so grateful to Kazakhstan for hosting the WHO European Centre for Primary Health Care, based in Almaty, which is in high demand for the technical assistance on primary health care development it provides to many countries across the region.
In closing, we can’t settle for business as usual. We need to radically shift our mindset. And my simple request to you all is that, with every decision you make, stop and ask yourself: am I promoting the strengthening of PHC? Am I contributing towards health equity and inclusion? Am I leaving anyone behind? Am I promoting a PHC-led health system or is PHC doomed to be siloed and left to compete with other programmes time and time again?
Reframing our health systems with a PHC lens is not just a choice; it’s a moral obligation, a prerequisite to the kind of society in which we all aspire to live – a society grounded in trust and empathy, where health and happiness flourish for all.
Барлығына зор денсаулык пен амандық тілеймін! Рақмет! [Translation: Good health and prosperity to all! Thanks!]