Læknablaðið - 15.02.1985, Blaðsíða 51

LÆKNABLADID
33
mobilize the necessary support of the general popula-
tion and of the specific groups mostly concerned, so as
to make such programmes national priorities and
procure the resources needed to carry them out
efficiently. In the years ahead, the richer countries of
the Region should give more effective help to develop-
ing countries in their efforts to improve their socioeco-
nomic development in general and their health develop-
ment in particular.
However, problems of poverty, inadequate nutri-
tion, bad housing, functional illiteracy, poor sanitation
and poorly developed primary health care are also to be
found in countries with a high per capita income. Such
countries may need to develop different priorities for
different geographical areas or different social groups.
Strengthening people’s ability and opportunity to
choose healthy lifestyles and to reduce tobacco and
alcohol consumption are high priorities for all coun-
tries, especially the most industrialized ones. It is in
these fields that effective action is most likely to result
in important improvements in health. No less impor-
tant are the specific programmes to give all people, and
in particular groups such as the elderly, the disabled,
etc., full opportunities to lead a productive and
satisfying life. It is of major importance for the less
developed parts of the Region to find paths to
development that do not bring in their train the serious
health hazards that afflict the more affluent countries.
Cigarette smoking, alcoholism, accidents and the
breakdown of family and community networks are
hazards that are probably easier to prevent than to
reduce once they exist. If the developing countries fail
to tackle these problems when they first begin to arise,
all their efforts to control their existing problems may
not in the end lead to the overall improvement in health
hoped for.
One principle is true for all countries: the key to
solving many health problems lies outside the health
sector or is in the hands of the people themselves. High
priority should therefore be given to stimulating the
contributions which other sectors and the public at
large can make to health development, particularly in
the localities. It is essential in this respect to accept the
basic principle that the people’s involvement in health
development cannot be merely passive. It is a basic tenet
of the health for all philosophy that people must be
given the knowledge and influence to ensure that health
developments in communities are made not only for,
but also with and by the people. Primary health care,
based on the principles of the Alma-Ata Declaration
with its emphasis on strong community participation
and multisectoral cooperation, is the most important
single element in the reorientation of the health care
system and will require very strong support.
It is also important to ensure more economical,
effective and humane use of existing health care
resources.
5. The future
The targets presented in this document are a deliberate
attempt to change the course of European health
development. What is at stake is ultimately the health
and wellbeing of Europe’s children, of the coming
generations. Success of the health for all movement will
mean that all children of the Region will have a much
better chance of:
— being born healthy to parents who want them and
who have the time, means and skill to bring them up
and care for them properly;
— being educated in societies that endorse the basic
values of healthy living, encourage individual
choice and allow it to be exercised freely;
— being provided with the basic requirements for
health and being effectively protected against
disease and accidents;
and that all people would have an equal opportunity of:
— living in a stimulating environment of social
interaction, free from the risk of war, with full
opportunities for playing satisfying economic and
social roles;
— growing old in a society which supports the
maintenance of their capacities, provides for a
secure, purposeful retirement, offers care when care
is needed and, finally, allows them to die with
dignity.
This is a challenge which goes to the heart of human
aspirations. It will be necessary to create a broad
consensus among the people of the Region that health
for all is an objective which should, can and will be
attained by the year 2000. A joint endeavour of this
kind by the 32 Member States will not only ensure better
health and a better life for people in the Region, but can
also help to reduce international tension by creating
solidarity and mutual support in health that will cut
across political, cultural and ethnic barriers. In this
way, it can be a major force in fostering greater
understanding and trust among people of the Region
and thus contributing to the satisfaction of the most
basic need of all — peace.
I. PREREQUISITES FOR HEALTH
Introduction
Other chapters in this document propose targets for
health for all in the Region. To reach these targets,
much will have to be done to improve specific, health-
related aspects of lifestyles, environmental conditions
and health care, but such improvements will have little
effect if certain fundamental conditions are not met.
Without peace and social justice, without enough food
and water, without education and decent housing, and
without providing each and all with a useful role in
society and an adequate income, there can be no health
for the people, no real growth and no social develop-
ment.
The main responsibility for attaining the objectives
set in these respects lies outside the health sector. At the
national level, this responsibility must be fully recog-
nized so that priorities in overall national development
take into account the need to strengthen those aspects of
life that are a prerequisite for health. At the internatio-
nal level, it requires collaboration of Member States
with each other as well as concerted efforts by all the
United Nations organizations who share the main
responsibility for setting specific objectives in these
domains and for ensuring that these prerequisites are