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Richard Lord,

A country's primary care system often provides a window on the overall health of the population. General primary care?usually the first point of contact for families?can offer cost–effective interventions close to home, thereby averting costly trips to specialists and hospitals. In developing countries, however, factors such as geographic and financial inaccessibility, limited resources, erratic drug supply, and faulty equipment often mean that the services offered at the primary care level are disappointingly limited in their range, coverage, and effect.

Unique advantages result from cost–effective interventions delivered at the primary care level, including the potential for reducing the burden of disease and keeping families healthy and functioning in social and work environments. Evidence from high–income countries may well be applicable to the developing world: a strong orientation to primary care is likely to result in better health levels and lower health care costs. Moreover, adequate delivery of services at the primary care level is fundamental to effective functioning of health systems—and to achievement of health goals.

The creation of dynamic health teams at the primary level is one of the greatest requirements for scaling up effective primary care. In many settings, the opportunity exists to increase the efficiency of primary care teams by giving attention to working conditions, assuring functioning equipment, and maintaining a stable drug supply. The challenge facing these countries is not only to inject additional resources?financial and human?into the primary care sector, but also to make a political commitment to the centrality of general primary care in the battle against devastating diseases and their causes. Efficient primary care, in turn, paves the way for major health and development gains that provide good value for the money.