In 1978 at Alma Ata, the date was set for achieving `Health for All by the Year 2000'. Achieving this seems more remote than it did then, due in part to Structural Adjustment Programmes (SAPs), the author argues. In Nicaragua, as elsewhere, structural adjustment provoked the redirection of resources away from public sector spending, including health care spending, and towards exports. The author advocates reasserting and implementing the Alma Ata recommendations in order to counteract this continuing erosion of health care.
