We are fast approaching the 30th anniversary of the World Health Organization’s Alma Ata declaration, which set the aspirational target of “Health for all by the year 2000” (BMJ 2008;336:536-8, doi: 10.1136/bmj.39469.432118.AD). The reasoning, laid out in the declaration’s article 10, was that “an acceptable level of health for all the people of the world by the year 2000 can be attained through a fuller and better use of the world’s resources, a considerable part of which is now spent on armaments and military conflicts.” Tragically, since 1978, spending on war and armaments has continued unabated, while the Alma Ata target came nowhere close to realisation and has since been replaced by the United Nations’ eight millennium development goals, with a new target date of 2015. It is frighteningly clear that this sequence is in danger of degenerating into an elaborate ritual, which provides the illusion of activity for the richer countries of the world while making little difference to the realities of daily life for the world’s poorest and most marginalised people.

The …