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Since the historieal conference held in Alma Ata in 1978, it has
been possible to observe a reorientation of the medical profession.
More and more, issues of health enter the stage and curative
medicine is not just loosing ground but some interest. 'How
effective is health education?' and 'Whose task is primary pre
vention?' are questions which stimulate great concern and public
debate. It seems also to be the first time since the last decades
of the 19th century that the social dimension of health receives
adequate consideration. Thus the reeent publication of the
so-called Black Report on Inequalities in Health (Penguin 1982) led
to a heated discussion in Great Britain, certainly of relevance to
many other countries. The 6 years since 1978 are much too short a
time to proceed far towards 'Health for All', as the slogan of the
World Health Organization puts it, but the concepts are spelled
out, vaguely but convincing to many of us. It is the right time to
discuss first experiences and to move from philosophy to empiri eal
work. This work - as it relates to the process evolving since Alma
Ata - is characterized by participation, cooperation and
prevention: Participation, because 'disease' concerns only the
individual patient, his or her family and immediate social
environment, while 'health' concerns everyone and should involve
everyone. It is a task of the whole of society rather than the
domaine of a single profession or party."
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