As we get closer to the 2015 deadline to meet the Millennium Development Goals, part of the debate on health has focused on donors that allocate most of their funds to certain key issues, rather than strengthening health systems in developing countries.
While most donors recognize the MDGs have done their part to advance global health, some point out that the U.N.-led global agenda set to expire in less than 500 days also has its downsides.
One of the latter is the Rockefeller Foundation, which since 2008 has focused on building the resilience of health systems — although most of its efforts have focused on health financing, part of the World Health Organization’s model of breaking down national health systems into six “building blocks”:
● Service delivery
● Information systems
● Essential medicines, vaccines and technologies
● Health workers
● Leadership and governance
● Financing
While the foundation recognizes that all are critical to have well-functioning national health systems, it opted to prioritize financing as it saw this particular element “as the critical lever which can enable and amplify improvements in the other building blocks,” according to Michael Myers, managing director and leader of the Transforming Health Systems global initiative at the Rockefeller Foundation.
In this sense, he told Devex the MDGs — which include separate health goals for 2015 — have “transformed global health” by galvanizing politicians and citizens, stimulating civil society, encouraging robust monitoring and evaluation frameworks, motivating research communities and creating new institutions to confirm that “progress for poor and marginalized people is possible.”
However, Myers pointed out, the current global development agenda has also had “shortcomings,” as the MDGs in his view have “ignored the central role of health systems, overlooked emerging health concerns such as non-communicable diseases, tended to exacerbate fragmented health systems by focusing on final health outcomes related to vertical programs rather than on building integrated health systems, and at times contributed to inequities in health.”
To redress these shortcomings and respond to new challenges, the Rockefeller Foundation has been encouraging the global health community to use UHC to frame the health goal from a system perspective instead of individual goals, he said.
Myers singled out the “disease-specific approach” of the MDGs as one of the main drivers of neglected health systems.
“Going forward, we need to focus on all aspects of the health system,” he said, citing the recent Ebola outbreak in West Africa as an excellent opportunity for development stakeholders to learn from past mistakes and strengthen the health systems of the countries affected by the virus so they will become more resilient to these situations in the future.
How? By prioritizing human resources to address the “outsized and devastating impact” the current crisis has had on health workers, Myers explained, adding that he hopes that this time Ebola really compels donors to go the extra mile to improve national health systems in the developing world.
“It is great to see that $150 million of the $200 million already pledged by the World Bank will go towards rebuilding health systems within West Africa,” he said. “In the short-term, the international community needs to continue to provide medical personnel; however, it will also need to provide technical assistance to help Sierra Leone, Liberia and Guinea to rebuild their health systems.”
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