The Lancet – Global Primary Care – Dr Alexander Kumar


“I started my application to medical school by writing my belief that “every human being should have equal and fair access to adequate health care”. 18 years later and now a primary care academic clinical fellow, I stand by this belief. It was by no coincidence that the 1978 Declaration of Alma-Ata was signed at the International Conference on Primary Health Care. Global primary health care is key to unlocking inequality and inequity—it works not only to achieve the definition of health as physical, mental, and social wellbeing but also works to achieve family, community, and spiritual wellbeing.

Yet today the vision of the declaration has not been realised. The neglect and financial strangulation of primary health care services, which in turn perpetuate inequality and inequity in health care, are morally, economically, politically, and socially unacceptable and contrary to the Declaration of Alma-Ata. As global primary care doctors, we must not only care for our patients but also look into their homes, or lack of, through the social determinants of health and into their communities and to their leaders. However, we also need to recognise and help our colleagues who are struggling. The rate of suicide and burnout among primary care doctors is concerning. A healthy, sustainable, and supported primary care workforce is vital to the health of communities.

The photographs presented here celebrate the wonderful work primary care doctors do. They show this diverse global workforce across contrasting cultures, communities, and settings—from the Arctic to Africa to Asia and across the Pacific. 40 years after Alma-Ata, we must strive for robust primary health care, to have impact, and to achieve health and health-care equality and equity, irrespective of wealth or location. This fight may only just be starting.”


Born in the UK to dual British–Indian heritage, as a global health physician and award-winning professional photographer, Alexander Kumar uses public engagement and storytelling to raise awareness about global health challenges, security, and innovation. Before training in general practice, he trained in anaesthetics, intensive care, infectious diseases, and tropical medicine. In the past few years, he has worked in over 40 countries with groups, foundations, universities, governments, and non-governmental organisations. Of this work, Alex says: “I travel light, armed only with a sense of humour, stethoscope, camera, and my curiosity for life.”