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December 14, 1984

Doctors—Barefoot and Otherwise: The World Health Organization, the United States, and Global Primary Medical Care

Author Affiliations

From the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md. Dr Mullan is now with the Division of Health Services, Health and Environment Department, Santa Fe, NM.

JAMA. 1984;252(22):3146-3148. doi:10.1001/jama.1984.03350220052030

BY ALL standards, the United States is a doctor-rich nation with almost one physician for every 500 people. Most countries in the developed world enjoy a physician-to-population ratio in the vicinity of one to 1,000, whereas two thirds of the world's population lives where the ratios are vastly less favorable. Although these nations may show one physician or more for every 10,000 people on international tabulations, it is not unusual to find only one physician for every 50,000 to 100,000 people in their rural areas.

In 1978 at Alma Ata in the Soviet Union, the World Health Organization adopted the goal of "Health for All by the Year 2000" as the overriding priority of the organization as well as a target for the health activities of its constituent nations.1 The success of any such ambitious scheme clearly depends on the availability and capabilities of large numbers of appropriately trained