Primary Care International Conference Lays a Foundation for Change

In July 2023, more than 170 global leaders in primary health care visited Washington, DC, to attend The Essential Role of Primary Health Care for Health Security and Securing Health Conference. This convergence of health care ambassadors was the culmination of efforts to increase primary care’s prominence on the world stage as a foundation which high functioning national health systems may rely upon.

The two-day conference provided an opportunity for international leaders to assess the changes to primary care prompted by recent milestones such as the Declaration of Astana and the National Academies of Sciences, Engineering, and Medicine’s (NASEM’s) influential report titled “Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care.” The meeting was designed to inform a long-expected Action Plan for Primary Health Care developed by the Secretary for Health and Human Services.

Leaders in attendance included physicians from over 20 countries as well as the Center for Professionalism and Value in Health Care (CPV), the American Board of Family Medicine (ABFM), the U.S. Department of Health and Human Services (HHS) and many more. A full list of partner organizations can be found at the end of the article.

Attendees were asked to consider the national and international challenges of securing health and health security and the solutions to both which primary health care offers. The first is about managing worsening life expectancy, access to care, mental health, and public health crises. The second considers primary health care as a means of monitoring for next epidemics, managing them early, and determining logical next steps through inter-organizational partnerships and coordination with the federal government.

“Primary health care is the only specialty that increases lifespans and improves health equity,” said Dr. Bob Phillips, CPV’s founding executive director.

“No one in government—state or federal–wakes up every day worried about primary care or its capacity to solve the nation’s most pressing health problems,” said Dr. Phillips. “This is a ripe opportunity for the HHS to coordinate across its agencies and with primary care organizations to frame what success looks like, and what we need to do to get there.”

Dr. Lauren Hughes, immediate past chair of the American Board of Family Medicine (ABFM) Board of Directors and co-chair of NASEM’s Standing Committee on Primary Care, authored a critical conference paper, “The HHS Action Plan to Strengthen Primary Care as a Model for Strategic Coordination,” a pithy description of why the U.S. needs coordinated leadership for primary care.

“I observed a lot of great networking and many important connections being made during the conference,” Dr. Hughes said. “Not just among conference attendees, but also HHS officials who heard from stakeholders why primary health care is important, how seriously we want to move forward, and what primary care examples we can learn from.”

For example, Dr. Phillips found a session hosted by Australia’s COVID-19 Czar to be particularly inspirational for discussing how primary health care can lead communities to better quality health outcomes.

“Australia led the fight against COVID-19 with a primary care strategy,” Dr. Phillips said. “Primary care physicians delivered two-thirds of their country’s vaccinations. Here in America, that number was around 5% during the first year in which vaccines were available. We hope to make primary care a greater part of the national strategy, including for pandemic preparedness.”

Ariadne Labs Interim Director of Primary Health Care Dr. June-Ho Kim believes that opportunity is just around the corner.

“During this decade, family medicine professionals in the U.S. have an opportunity to fully engage with the global primary health care community. Systems around the world are pioneering new models of care, transformed workforces, value-based financing systems, and new technologies,” Dr. Kim said. “Engaging organizations which promote primary health care both globally and domestically can build bridges internationally and allow us to learn from one another.”

Although the conference was brief, it has already prompted new avenues to progress. CPV and several partner organizations are preparing reports for the HHS which highlight specific priorities to improve primary health care across the nation. Additionally, NASEM’s new Standing Committee on Primary Care will be advising the HHS Action Plan. The goal is to keep all relevant parties involved in a strategy for growth.

“The U.S. can no longer afford to starve primary care and expect it to turn around major health problems. We are actively losing clinicians from primary care, and it is contributing to declining life expectancy. This problem preceded the COVID-19 pandemic, but while other countries are bouncing back from COVID-related deaths, the U.S. is continuing a dangerous path of worsening health outcomes,” said Dr. Phillips.

“The HHS Primary Health Care Action Plan will be necessary to pull out of this nosedive. It will allow us to join a primary health care movement already underway around the world and reap the rewards most other developed countries already enjoy.”

Conference partners include: The Center for Professionalism and Value in Health Care (CPV), The American Board of Family Medicine (ABFM), The ABFM Foundation, The World Organization of Family Doctors (WONCA), The Commonwealth Fund, Ariadne Labs, Resolve to Save Lives, The National Academies of Sciences, Engineering and Medicine (NASEM), The Pan American Health Organization (PAHO), The World Health Organization (WHO), and the Embassy of Canada to the United States.