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The article “Political Economy Dichotomy in Primary Health Care: Bridging the Gap Between Reality and Necessity,” published in The Lancet Regional Health, explores the persistent challenges in securing political commitment and investment in primary health care (PHC) despite evidence of its long-term benefits. Drawing on the WHO Global Report on PHC, the article highlights the misalignment between investment priorities and actual health needs, with a focus on specialist and hospital care over essential front-line community services. This dichotomy is exacerbated by under-resourced PHC systems, public mistrust, and the perception of PHC as inferior, poverty-focused care. Additionally, the preference for vertical health service delivery approaches further limits comprehensive PHC investment. The article calls for policy-makers to understand these political economy dynamics and invest in integrated, high-quality PHC to ensure equitable and effective health systems.