In 1978 world leaders, international organizations and health authorities gathered in Alma-Ata (now Almaty), Kazakhstan, and released the Declaration of Alma-Ata on Primary Health Care, which remains a landmark document in the history of global health. The Alma-Ata Declaration established a standard of public commitment to making community-driven, quality health care accessible, both physically and financially, for all. This was the forerunner of the Global Strategy for Health for All by the Year 2000 that was pursued by WHO and its partners for the rest of the 20th century, and of Sustainable Development Goal (SDG) 3: “Ensure healthy lives and promote well-being for all at all ages” by 2030.

A Vision for Primary Health Care in the 21st Century provides the rationale for and foundation of the Astana Declaration, with its continued political focus on the right to integrated, quality, personal and population-level primary care; on health as a multisectoral social and economic construct, dependent on many sectors; and on community engagement in health, and empowerment with respect to health services. It reviews evidence gathered over the last 40 years, and explains why progress on PHC, as originally envisioned, has been mixed. It provides a detailed description of how the components of PHC might evolve, and ends with an appealing and achievable vision for PHC in the 21st century.