Politics, power and poverty: health for all in 2000 in the Third World?

Health for All by 2000 could become a reality in the Third World countries. On present resource allocation, medical professional and political patterns and trends that is unlikely to happen in more than a few countries. For it to happen requires basic priority shifts to universal access primary health care (including preventative). The main obstacles to such a shift are not absolute resource constraints but medical professional conservatism together with its interaction with elite interests and with political priorities based partly on perceived demand and partly on (largely medical) professional advice. These obstacles are surmountable-as illustrated by divergent performances among countries--but only if education, promotion, efficiency in terms of lives saved and healthy years gained, community participation and political activism for Health for All are more carefully analytically based and pursued more seriously and widely than they have been to date.