Abstract
Since 2000,the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources,whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far,most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data,and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far,and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings,we make some general recommendations and identify a series of action points for international partners,governments,and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work,and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close,and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency,equity,value for money,and outcomes in global public health,then these opportunities should not be missed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2137-2169 |
| Number of pages | 33 |
| Journal | The Lancet |
| Volume | 373 |
| Issue number | 9681 |
| DOIs | |
| State | Published - 2009 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
An assessment of interactions between global health initiatives and country health systems. / World Health Organization Maximizing Positive Synergies Collaborative Group.
In: The Lancet, Vol. 373, No. 9681, 2009, p. 2137-2169.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - An assessment of interactions between global health initiatives and country health systems
AU - World Health Organization Maximizing Positive Synergies Collaborative Group
AU - Samb, Badara
AU - Evans, Tim
AU - Dybul, Mark
AU - Atun, Rifat
AU - Moatti, Jean Paul
AU - Nishtar, Sania
AU - Wright, Anna
AU - Celletti, Francesca
AU - Hsu, Justine
AU - Kim, Jim Yong
AU - Brugha, Ruairi
AU - Russell, Asia
AU - Etienne, Carissa
AU - De, Susna
AU - Mwase, Takondwa
AU - Wang, Wenjuan
AU - Wright, Jenna
AU - Daré, Lola
AU - Delfraissy, Jean François
AU - Boillot, François
AU - Miege, Pierre
AU - Zhang, Xiulan
AU - Rhatigan, Joseph
AU - Weintraub, Rebecca
AU - Pun, Sok
AU - Abé, C.
AU - Caceres, Carlos
AU - Camara, Mamadou
AU - Coriat, Benjamin
AU - D’Almeida, Cristina
AU - Aleshkina, Julia
AU - Murzalieva, Gulgun
AU - Kadzandira, John
AU - Hammami, N.
AU - Mwapasa, Victor
AU - Chkhatarashvili, Ketevan
AU - Buch, Eric
AU - Miti, Katabaro
AU - Kamenga, Claudes
AU - Elouma, Marthe Sylvie Essengue
AU - Schwalbe, Nina
AU - Greenberg, Alan
AU - Frehywot, Seble
AU - Markus, Anne
AU - Goeman, Lieve
AU - Khan, Alia
AU - Amati, Jael
AU - Mwaura-Muiru, Esther
AU - Ivers, Louise C.
AU - Rao, Krishna
PY - 2009
Y1 - 2009
N2 - Since 2000,the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources,whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far,most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data,and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far,and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings,we make some general recommendations and identify a series of action points for international partners,governments,and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work,and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close,and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency,equity,value for money,and outcomes in global public health,then these opportunities should not be missed.
AB - Since 2000,the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources,whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far,most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data,and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far,and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings,we make some general recommendations and identify a series of action points for international partners,governments,and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work,and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close,and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency,equity,value for money,and outcomes in global public health,then these opportunities should not be missed.
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UR - http://www.scopus.com/inward/citedby.url?scp=67249115636&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(09)60919-3
DO - 10.1016/S0140-6736(09)60919-3
M3 - Article
C2 - 19541040
AN - SCOPUS:67249115636
VL - 373
SP - 2137
EP - 2169
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 9681
ER -