纪念《阿拉木图宣言》发表40周年:全球基本医疗卫生服务发展经验及中国医疗卫生人才队伍建设

The publication of the Alma-Ata Declaration at the International Primary Health Care Conference in 1978 is a milestone in global health history.The concept of primary health care(PHC) proposed at the meeting 40 years ago laid the foundation for the development of a modern,high-quality national health system.China has played a key role in the formation and development of the original concept of PHC by introducing its implementation experience of the barefoot doctor system and Rural Cooperative Medical Scheme.Since the adoption of the Alma-Ata Declaration,most developed countries and regions in the world,as well as Cuba,a developing country,have successfully established relatively mature PHC systems,but also witnessed failure of achievements in most developing countries.Since 2009,China has started a new round of health reform in Chinese mainland and has obtained many achievements,but its PHC system development is still in the initial phase.This paper reviews and analyzes the history,results and experience of the global development of PHC over the past 40 years,and puts forward that the unsatisfied development of a PHC system in China is due to the failure of strategic emphasis on contemporary high-quality health education and professional training,and lack of government requirements on the establishment of a vigorous high-quality health workforce for delivering high-quality health care services.On this basis,the concept of a dual-center construction (two-wheel drive) for the development of a national high-quality PHC system was proposed,that is,simultaneously building a people-centered basic health care system and a health workforce-centered health care system.It is hoped that this concept can provide a new way of thinking and strategic choice for the ongoing health reform and PHC system establishment in China.