Health Partnership to strengthen health systems

International Health Partnership (IHP) was launched on 5 September 2007 to save millions of lives by fostering better co-ordination between global aid donors, helping developing countries improve their national health systems and supporting the specific health priorities of developing countries.

IHP brings together a range of stakeholders including health ministers from developed and developing countries, and leaders from the major health agencies and foundations.

Burundi, Cambodia, Ethiopia, Kenya, Mozambique, Nepal and Zambia are the seven 'first wave' countries in Africa and Asia that announced to join the new IHP, which is supported by donor governments and agencies representing half of the world's aid spending on health, which totals $14 billion.

"It is not lack of cash or commitment, or lack of good tools to get the job done. The biggest bottlenecks are inadequate systems for delivering these powerful tools, and ineffective aid. Without explicit support, health systems will not be able to reach the poor, with essential interventions, on an adequate scale, in time" remarked Dr Margaret Chan, Director-General of the World Health Organization at the launch.

IHP will help build national health systems in some of the poorest countries in the world. It will mean healthier people, living longer lives.

The lack of strong health systems, have appallingly slowed down the health response in most of the developing countries. Over time these countries can potentially address the massive health challenges they face, only if they take on the task of strengthening their health systems and receive sufficient international support.

"There is no greater cause than that every man, woman and child in the world should be able to benefit from the best medicine and healthcare. And our vision is that we can triumph over ancient scourges and for the first time in history conquer polio, TB, measles and then with further advances and initiatives, go on to address pneumococcal pneumonia, malaria and eventually HIV/AIDS" said UK Prime Minister Gordon Brown at the launch.

Despite advances over recent years – for example, in expanding vaccination coverage and access to antiretroviral therapy – progress towards achieving the key health targets in the Millennium Development Goals (MDGs) is too slow, costs lives and must improve One woman dies in childbirth each minute. Every day, about 28,000 children under five die from largely preventable causes, including malaria; more than 10,000 people are infected with HIV; and 22,000 people become sick with tuberculosis.

This is neither fair nor tolerable. Rates of death and illness must be reduced, health inequalities resolved and access to basic health services vastly increased.

Urgent action is needed if we are to get back on track to reach these goals. This process must be country-led and outcome-driven, based on priorities set out in comprehensive national health plans. It will require increased emphasis on collaboration, teamwork and effective coordination.

The renewed political interest in strengthening health systems gives the important opportunity to redouble efforts to meet the challenge of the MDGs (Millennium Development Goals) head on. Strengthening health systems means addressing key constraints related to health worker staffing, infrastructure, health commodities, logistics, tracking progress and effective financing.

Donor agencies that signed the partnership agreement at the launch were: World Health Organisation, European Commission, World Bank, UNAIDS, UNFPA, GAVI Alliance, UNICEF, Bill and Melinda Gates Foundation, African Development Bank, Global Fund to Fight HIV and AIDS, Tuberculosis and Malaria, and UN Development Group.

Inequities in health are among the major development challenges. The WHO World Report on "Knowledge for Better Health: Strengthening Health Systems" argued that science must help to improve public health systems and should not be confined to producing drugs, diagnostics, vaccines and medical devices. Biomedical discoveries cannot improve people's health without research to find out how to apply them within different health systems and diverse political and social contexts, thus ensuring that they reach those who need them the most.

Health systems research suffers from a poor image and has been under-funded compared to biomedical research despite widespread recognition of its importance. The field attracts less than one tenth of 1% of total health expenditure in low-income countries. The lack of attention given to this field is also reflected in the fact that only 0.7 % of scientific articles published globally in the year 2000 were in the area of health systems research.

Health systems strengthening, is a continuous process of implementing effective changes in policies and management within the health sector. The approaches to health systems strengthening are manifold and often may be different from country to country, however some of the existing interventions have demonstrated that reducing bureaucracy by streamlined management, increasing cost-effectiveness, improving efficiency through reorganized services, decentralizing health systems, and allocating resources to better address the needs of the population, improve the health systems by making them effective, efficient, and equitable.

(The author is a health and development journalist, writing for newspapers in Asia and Africa. He can be contacted at: bobbyramakant@yahoo.com)

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