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Primary care / Review Revolution Starts With the Middle Class This review must be seen in the context of the challenge to deliver equitable healthcare in a world ruled largely by global capitalism, a world where power, status and profit are entrenched in healthcare. It is important to read this Position Paper on Primary Care and other Network: TUFH Position Papers. These documents grow from action, experience and evidence. They provide crucial guidance and information to primary care academics, especially those who are passionate about the social responsiveness of their institutions. A list of resources, provided by some of the other Position Papers, would make this one even more useful. The Position Paper on Primary Care gives the rationale for increasing primary care as a valued specialty in academic health institutions, and it explains how this goal can be achieved. Networking and community involvement are crucial elements. The definitions, developments and examples communicate important principles and illustrate how implementation can be done in different contexts. Examples of advances through collaboration between institutions and countries are absent. These would provide evidence for the value of networking, and would encourage academics to develop joint projects. Contact details of institutions and individuals interested in collaboration will enable beginners and strugglers to collaborate. The local alliances needed, and the attributes of primary care-oriented academic health centres are useful and practical. The evidence for health benefits of primary care has been clearly summarised. This is a pivotal point in the argument for large-scale redirection of resources to primary care. This excellent work done by many and integrated by Starfield changed our argument from the position of ideology and ideas to that of evidence. And evidence requires change in practice (as it is the case in clinical care). The position proposed by The Network: TUFH is unequivocally to share with communities, decision makers and colleagues the information that “primary care produces better outcomes”, and to advocate shifting resources to primary care. The power and practice of the corporate health industry - with the large profit margins in technology, hospital care, drugs and health management - needs to be acknowledged and analysed in the section “Why do so few AHC's embrace primary care?” This issue would change the goal from ”encourage equitable distribution of primary care resources” to “equitable distribution of healthcare resources”. Primary care is at the divide between corporate profit interest and social responsiveness. Primary care can be the way to change. In a world that increasingly tolerates expanding inequities, a more activist stance is required. From this activist stance, the following areas need attention: equity in healthcare; post-graduate education; the standard of primary care in AHC's; the role of primary care specialists in planning and integration of the whole health system; the district health system in resourcing poor countries; and the integration of vertical programmes at the level of the individual and the family. This Position Paper is a solid foundation for serious building work. Jannie Hugo / Associate Professor, Department of Family Medicine, University of Pretoria, Republic of South Africa Email: jh38@mweb.co.za