Mexico City – As delegates gather at the International AIDS Conference, the World Health Organization (WHO) and the World Bank address the pressing global debate around health systems and initiatives in specific aspects of health, nutrition and population.
Critics claim that disease-specific initiatives are eroding already weak health systems, while others assert that weak health systems are holding back progress in disease-specific initiatives.
In an effort to gather evidence and provide technical guidance in this area, WHO and the World Bank have agreed to join forces in collaboration with a wide range of interested stakeholders including country officials, academic and research institutions, Global Health Initiatives and civil society organizations.
During the past decade, global health initiatives have become a prominent part of the international aid architecture, bringing new resources, partners, technical capacity and political commitment. Examples include The Global Fund to Fight AIDS, Tuberculosis and Malaria, the GAVI Alliance, and the US President’s Emergency Plan for AIDS Relief, known as PEPFAR. Now numbering more than 80, these initiatives have contributed to a dramatic increase in the level of resources for health in low- and middle-income countries.
Notwithstanding the gains that have been made in funding and access to health services, critics allege that Global Health Initiatives have also exposed weaknesses in health systems. These weaknesses in overstressed health systems in many low- and middle- income countries are thought to be limiting the effectiveness of Global Health Initiatives and may be undermining investments that are now being made. The new effort will examine the issues in the debate, separate reality from rhetoric, and provide governments with sound technical guidance to enhance health systems without diminishing the benefits of disease specific initiatives.
“It is not about choosing between health systems strengthening on the one hand and disease-specific programmes on the other,” said Dr Carissa Etienne, WHO Assistant Director-General, Health Systems and Services, at a press conference during the XVIIth International Conference on AIDS in Mexico City. "It is about working together to generate added value. The time has come to move from observing the intentional and unintentional impacts of health investments, to actively managing better outcomes that can be sustained.”
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