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To Achieve "Health for All" We Must Shift the World's Paradigm to "Primary Care Access for All"

From the Department of Family Medicine, Boston University Medical Center, Boston, MA

Correspondence: Corresponding author: Alain J. Montegut, MD, Director, Global Health Primary Care Initiative, Department of Family Medicine, Boston University Medical Center, Dowling 5, 1 Boston Medical Center Place, Boston, MA 02118 (E-mail: Alain.Montegut{at}bmc.org)

Since the early 1950s, the World Health Organization has proposed programs to promote primary health care around the world. From the 1978 Alma-Ata Declaration to the current promulgation of the Millennium Development Goals, the World Health Organization has tried to improve health in developing countries through a focus on disease-oriented (vertical) programs. The World Health Organization and other organizations have not focused on the horizontal role of primary care. The expectations created by these programs have not been met. Evidence demonstrates that the advent of health care through a base of primary care improves health better than through the traditional vertical disease-oriented health programs used around the globe. The global "family" of family medicine must advocate for a shift from the current solutions to one in which the family doctor is part of a well-trained health care team that can function in networks that incorporate the vertical programs into a broad horizontal approach for better access to primary care. Perhaps in this way "health for all" can be achieved.

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