Honourable Madam Minister of Health representing His Excellency the President of Kazakhstan,
Honourable Ministers, Excellencies,
Excellency Dr. Tedros, my dear brother,
Esteemed colleagues, dear friends,
When we think of primary health care, our minds turn to Kazakhstan—to Alma-Ata, where the bold vision for primary health care was born in 1978, and to Astana, where the commitment was renewed in 2018. We are reminded that health begins not in hospitals, but in communities, in families, in the daily lives of people across the life course.
But how do we make primary health care a lived reality for everyone, everywhere?
For us at UNFPA, the answers lie in ensuring every individual and couple can decide freely whether or when to have children, every woman can give birth safely, and every young person can fulfil their potential. All of this depends on robust, resilient, equitable and inclusive primary health care systems.
What does this look like in practice? We see it every day in the hands of skilled health professionals saving lives. We see it in reliable supplies of essential reproductive health medicines and commodities reaching the last mile. We see it in rights-based legislation and policies that expand access to high-impact interventions, including digital solutions. And we see it within communities themselves. That is where trust is built, and rights are realized.
Kazakhstan exemplifies a champion of primary health care, rooted in the principles of universal health coverage and a strong, state-funded healthcare system. Its commitment to providing comprehensive services – including through over 100 fully funded centers providing adolescent- and youth-friendly services – is globally recognized. This achievement is a testament to strong political commitment and a government-led partnership with UNFPA, WHO, UNICEF, the World Bank and others. Such investment strengthens human capital and fuels the country’s digital economy.
Primary health care is precisely where the struggle for sexual and reproductive health and rights is won or lost. Therefore, we must boldly re-think health financing. UNFPA’s financing strategy calls for four decisive shifts:
First, integration. Sexual and reproductive health must be embedded in universal health coverage through primary health care, supported by robust health promotion and prevention. Investing in the health workforce is essential—especially midwives, who can provide 90% of needed care but make up less than 10% of the global SRHR workforce.
Second, domestic investment. The most sustainable way to finance primary health care is through national budgets. Out-of-pocket costs break families; domestic financing builds nations. Investing in SRHR saves lives, prevents unintended pregnancies, lifts households from poverty, and delivers returns on investment that no finance minister can ignore. Every $1 invested in sexual and reproductive health and rights returns $8 in social and economic benefits.
This takes me to my third point.
Financial accessibility. Health care must reduce, not deepen, inequalities. Policies should uphold universality, equity and gender equality, shifting costs from individuals to pooled financing schemes that protect the poorest.
Finally, partnerships. None of us can do this alone. Governments, international financial institutions, global health partnerships, the private sector and the United Nations must align to channel resources where they matter most—strengthening PHC systems.
Excellencies, distinguished delegates,
Strong health systems—underpinned by primary health care—build resilient societies grounded in rights, dignity, and equality. With wise investment, no woman will die while giving life, no girl’s future will be cut short, and no community will be without essential care.
We reaffirm our commitment as UNFPA, as the United Nations, to equitable financing, and we commit to strengthening the health workforce to reach those furthest behind on the path to universal health coverage.
Together, let us realize the promise of Alma-Ata and make primary health care the great equalizer of our time.
Thank you
