317. Telegram From the Embassy in the Soviet Union to the Department of State and the Mission in Geneva1

22011. Geneva for Dr. Fortuine. Dept pass HEW/OIH. Subject: WHO/UNICEF Alma Ata Conference on Primary Health Care. Ref: Geneva 10701.2

1. The WHO/UNICEF Conference on Primary Health Care concluded 1800 hours September 12 with approval of Conference final report and reading of “Declaration of Alma Ata”.3 The Conference held relatively few surprises, with careful WHO/UNICEF staff preparations evident throughout and final document closely following an advance staff text.

2. The universal acceptance of the goal of making some type of primary health care available to everyone by the year 2000, with LDC recognition that each country bears prime responsibility for building a health delivery system suited to its economic and social conditions, is doubtless a milestone in international health matters. The full significance of the “Declaration”, however, will depend on how rapidly and effectively individual nations and intergovernmental organizations are able to translate the generalities of the “Declaration” into action programs.

3. As host nation, the Soviets played a generally useful and moderate role during formal Conference deliberations. Their effort to favorably impress conference participants with the Soviet health system was extraordinary. The entire city of Alma Ata and surroundings were freshly scrubbed and stocked with meat and other scarce food items (we had one report from a local inhabitant that mutton suddenly appeared on sale a few days before the start of the conference, after 18 [Page 1069] meatless months in the Alma Ata region.) The field trips the Soviets organized for Conference participants during the September 9–10 weekend to urban and rural Kazakhstan and Uzbekistan featured Soviet physicians and other health personnel in immaculate uniforms and surroundings reciting the usual stock phrases in praise of the Soviet system. Overstaging, and lack of visible patients, detracted from what could have been an impressive show.

4. Senator Kennedy’s address4 delivered to the plenary the evening of September 6 attracted wide attention, and brought warm response from the galleries packed with local Soviets. Hundreds of Soviets gathered in the square facing the conference hall to catch a glimpse of the Senator’s departure.

5. The Conference, in contrast to recent world health assemblies, was relatively free of extraneous political debate. Soviet Health Minister Petrovsky adroitly handled his duties as President of the Conference and assisted in the general move for consensus. The only political flap was created by the SWAPO delegate in the closing hours of the conference, who requested that “liberation movements” be inserted in a listing of groups supporting health care in the summary of discussions of the conference. A sharp exchange ensued with Algeria, Zambia, Afghanistan, Mozambique, GDR and the PLO registering support for the SWAPO proposal and the FRG, Canada, Australia, France, Guatemala, and Costa Rica noting opposition. The suggestion was referred to the Secretariat to work out appropriate wording for inclusion in the final conference report. Notwithstanding the heavy majority of LDCs participating, together with SWAPO and the PLO, the final conference document was moderate in tone. The racism-Zionism issue which had plagued previous WHO conferences was not raised.

  1. Source: National Archives, RG 59, Central Foreign Policy File, D780373–0912. Priority; Limited Official Use.
  2. Telegram 10701 from Geneva, July 13, provided an abstract of the draft Soviet “Final Document of the WHO/UNICEF International Conference on Primary Health Care,” and the Secretariat’s comments, urged the U.S. delegation to thoroughly prepare for the conference, and clarified conference logistics. (National Archives, RG 59, Central Foreign Policy File, D780291–0885) Richmond and Bryant represented the United States at the WHO/UNICEF Primary Health Care Conference, held in Alma Ata, Kazakhstan, September 6–12, 1978.
  3. In telegram 13186 from Geneva, August 31, the Mission transmitted a draft of the proposed Alma Ata Declaration. (National Archives, RG 59, Central Foreign Policy File, D780355–1284) The final declaration, consisting of 10 points, affirmed that health was a fundamental human right and insisted that governments devise policies, strategies, and plans of action to ensure that all people receive adequate primary health care. (Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata, USSR, 6–12 September 1978, pp. 1–6)
  4. Kennedy attended and spoke at the conference but was not part of the official U.S. delegation. See “Kennedy Will Visit Russia Next Week For Health Meeting,” The Washington Post, September 1, 1978, p. A–18.