Thirty years ago the Alma-Ata declaration on primary health care was developed. Implementation has been compounded by inadequate financing, changing disease patterns and immature health systems, and there is an ongoing discussion between selective and comprehensive primary health care supporters. Globally, child mortality for under-five-year-olds has been reduced by 50%, but there are still large regional differences. This year the WHO development report is about revitalisation of the primary health care strategy. Recognition of this strategy may be the best instrument to improve health globally.