Usher Institute

Usher research group helps get palliative care firmly on the Primary Health Care agenda internationally

An update from Scott Murray, Emeritus Professor & Sebastien Moine, visiting research fellow, Primary Palliative Care Research Group.

Global Conference on Primary Health Care

Celebrating the 40th anniversary of the Declaration of Alma Ata, the Global Conference on Primary Health Care was held in Astana, Kazakhstan (25-26 October 2018).  It was co-hosted by WHO, UNICEF and the Government of Kazakhstan.

Dr Sebastien Moine, a GP and visiting research fellow in the Primary Palliative Care Research Group (Usher Institute), attended the conference as a member of the delegation of the International Association for Hospice and Palliative Care (IAHPC). Palliative care is now an explicit core activity of Primary Health Care.

Global Conference on Primary Health Care - on World Health Organisation website

International Association for Hospice and Palliative Care website

Global Conference on Primary Health Care 2018 - Pallitaive Care team

Declaration of Alma-Ata

The concept of primary health care was first enunciated in the Declaration of Alma-Ata, at the 1978 International Conference on Primary Health Care in Alma Ata, Kazakhstan. It was the first international declaration to identify primary health care as the main strategy for achieving WHO’s goal of Health for All, with a strong emphasis on equity, intersectoral collaboration and community participation.

Declaration of Alma-Ata 1978 - on the WHO website

An updated Declaration was approved in Astana, to which Professor Liz Grant of the Global Health Academy had contributed.  Dr Moine also contributed to this consultation on behalf of the European Association for Palliative Care, which he co-chairs with Professor Scott Murray.

New 2018 Declaration on Primary Health Care 

While the 1978 declaration did not mention palliative care, this new 2018 Declaration on Primary Health Care finally reads: “Promotive, preventive, curative, rehabilitative services and palliative care must be accessible to all” . This is a significant achievement, fully consistent with the inclusion of palliative care in Universal Health Coverage.

New 2018 Declaration of Astana - on WHO website

Dr Moine participated in the Ministerial Parallel Session on palliative care chaired by Katherine Pettus (IAHPC). Together with the Minister of Health of the Russian Federation, Minister of Health of Uzbekistan, Deputy Secretary of Health of Singapore, and Dr Eric Krakauer (Lancet Commission on Palliative Care and Pain Relief) he highlighted the critical role that primary health care services may have in triggering and delivering palliative care in the community.

Sebastian Moine speaking at Global Primary Health Care Conference 2018

Universal Health Coverage

The next key step is now to advocate for palliative care as a core component of Universal Health Coverage. We will do this in New York at the High-Level Meeting on Universal Health Coverage during the UN General Assembly in 2019.


Read more about the Primary Palliative Care Research Group on their website