Editorial Three global health reports: towards a growing consensus?

sive primary care for the first time on the international agenda. But in the context of limited resources and high disease burden in poor countries, these grand ideas were rapidly reduced to a few selective ‘cost-effective ’ interven-tions deemed affordable (Walsh & Warren 1979). This approach to health has dominated over the past 30 years and contributed more recently to the proliferation of global health initiatives, but left the health systems partly neglected with too little resources. Doubts about reaching the Health Millennium Devel-opment Goals (MDGs), in particular MDG5 on Maternal Health, again fuel calls for a more comprehensive approach to health care in low-income countries. It is against this background that the 30th birthday of Alma Ata in September 2008 was given attention by international agencies and academic institutions to discuss new strategies to overcome the unfruitful international divide between health systems strengthening and disease-specific interven-tions. One focus of a conference in Antwerp was looking for synergies between disease-specific intervention and health systems strengthening. An example of HIV/AIDS programmes in Africa has been elaborated from this point of view (ITG 2008). Overlooking the need for comprehensive people-centred primary health care and for reduction of global health inequities may also become increasingly politically incorrect, as the effects of neglecting these issues have been widely publicised, supported by a wealth of evidence recently summarised in three important health reports published in the autumn of 2008: WHO’s World Healt