The U.K. Department for International Development has been focusing on results in its projects as a means to ensure value for money for every pound spent — but by taking this more short-term approach, some argue the British aid agency is often missing the opportunity to make a bigger impact.
This seems to be an emerging problem for instance regarding DfID’s role in strengthening national health systems, as the International Development Committee kicks off on Tuesday its parliamentary inquiry into the agency's work in this area, in particular to determine how effective and sustainable its health interventions really are and how they contribute to the agency’s set objectives.
One of the experts taking part in the inaugural session’s panel is Simon Wright, head of child survival at Save the Children UK, who told Devex his testimony will focus largely on getting DfID to prioritize interventions that will help governments transform their health systems in the long-term, rather than short-term fixes that don't really do much to bring significant changes that would help developing countries move toward achieving universal health coverage.
For instance, he explained, instead of spending 500 million pounds ($851 million) on vaccinating a certain number of children, or training several health workers, the British aid agency should instead channel its funds to helping a country's health ministry improve its service delivery to reach even the most remote areas.
The United Kingdom, Wright said, has one of the most efficient public health systems in the world and can serve as a model for other nations.
"I think DfID has quite big ambitions, so the numbers [it is targeting] are usually quite high. But it's whether DfID is playing a role in helping to develop the systems, in the way that they are needed, that's the question," he noted. "Does it get the government to review its health financing policy, or does it work to make sure British aid does some good in the areas where it's being used?"
Moreover, suggested Wright, the aid agency appears to be inching away from its previous position of leadership on global health — be it through bilateral engagement or in important international fora.
In Liberia, for example, aid implementers are worried that the new government may re-introduce user fees in the public health system. DfID encouraged the previous administration to remove those cash payments, but now, the Save the Children expert pointed out, "we have not seen the U.K. government taking a strong stand anymore that cash payments on the point of view of health services are the worst possible way of funding it."
And he is seeing the same with regard to the government's approach on debates on universal health coverage. In addition, the U.K. has been missing in some important fora, such as last year's Third Global Forum on Human Resources for Health that took place in Brazil. No U.K. minister attended the event, nor did DfID reveal any plans on how it plans to build a healthy workforce despite earlier indications.
"That was an important international process where we would have expected the UK to be the leader, a very vocal voice, but it was absent and silent," Wright said.
DfID will be given a chance to respond to these arguments — and more from several World Health Organization officials, academics and its former chief health adviser Julian Lob-Levyt who will also be attending Tuesday's inquiry — on its work, as is always the case in IDC inquiries. The committee’s recommendations will be release in a full report in the next few weeks.
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