Intended for healthcare professionals


Funding for primary health care in developing countries

BMJ 2008; 336 doi: (Published 06 March 2008) Cite this as: BMJ 2008;336:518
  1. Jan De Maeseneer, professor of family medicine1,
  2. Chris van Weel, professor of family medicine2,
  3. David Egilman, clinical associate professor3,
  4. Khaya Mfenyana, professor of family medicine4,
  5. Arthur Kaufman, professor of community health5,
  6. Nelson Sewankambo, professor of medicine6,
  7. Maaike Flinkenflögel, researcher1
  1. 1Department of Family Medicine and Primary Health Care, Ghent University, Belgium
  2. 2Department of Family Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
  3. 3Brown University, Providence, RI, USA
  4. 4Department of Family Medicine, Walter Sisulu University, Mthatha, South Africa
  5. 5Department of Community Health, University of New Mexico Health Sciences Center, USA
  6. 6Faculty of Medicine, Makerere University, Kampala, Uganda.

The World Health Organization’s World Health Report 2007 deals with access to primary health care as an essential prerequisite for health.1 It acknowledges the importance of the Alma-Ata declaration of 1978, which called for integrated primary health care as a way to deal with major health problems in communities and for access to care as part of a comprehensive national health system. Yet the mission of Alma-Ata—to provide accessible, affordable, and sustainable primary health care for all—has been implemented only partially in developing countries.2 We have therefore instigated the “15by2015” campaign (, which proposes a funding mechanism for strengthening primary health care in developing countries.

In the accompanying analysis article, Gillam notes that most developing countries have failed to provide even basic primary healthcare packages. Weaknesses in primary healthcare services often result from a variety of forces, including economic crises and market reforms, which limit the range and coverage of services and thus their effect on health.3 4 On the positive side, between 1997 and 2002, financial support to improve …

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