Stronger Health Systems Are Key To Battling Disease In Poorest Countries, UK

Main Category: Public Health
Article Date: 26 May 2008 - 4:00 PDT

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In response to unprecedented demand from developing countries, the GAVI Alliance will increase its funding for health system strengthening to US$800 million.

The flexible long-term funds will enable the world's poorest countries to strengthen their healthcare systems to deliver vaccines and other health interventions more effectively.

Weak health systems are one of the main obstacles to scaling up immunisation and other life-saving interventions, and remain a key barrier to achieving the Millennium Development Goals, especially goals 4 and 5, which aim to reduce child and maternal mortality.

"Much of the world's burden of disease could be prevented or cured. There are known, afford¬able technologies to achieve this. The problem is getting those drugs, vaccines, and other forms of prevention, care, or treatment to those who need them - on time, reliably, in sufficient quan¬tity, and at reasonable cost," explained Dr Julian Lob-Levyt, Executive Secretary of the GAVI Alliance.

To address these issues, the GAVI Alliance decided, in December 2005, to invest an initial US$500 million for health system strengthening. Due to the demand from developing countries, the Alliance recently approved an additional US$300 million, bringing the total of GAVI funds allocated to health systems to US$ 800 million.

To date, 29 countries have been approved for health system strengthening funding by GAVI and 11 more countries are pending board approval in June 2008. These funds support multi-year commitments, many beyond 2012, to help countries plan more effectively and robustly. The investment will be rigorously monitored and evaluated to ensure results.

"Our programme to strengthen health systems will work toward the goal of universal coverage. It will improve health care access and equity as it helps increase coverage for those who need coverage the most," said Dr Julian Lob-Levyt, Executive Secretary of the GAVI Alliance.

GAVI's funding for health system strengthening aims to help integrate health care delivery. It provides money to boost existing programs that are proven to work well, and promotes innovative ways of reaching the hard to reach (including working with the civil society and the private sector). By promoting broader health care, health system strengthening fits within the framework of the International Health Partnership, of which GAVI is a partner. The International Health Partnership's priorities are to support countries to identify, plan and address health systems constraints to improve health, and enhance coordination and efficiency in aid delivery and strengthening health systems.

"If I had to select a single development over the past year that encouraged me the most, it would be this. Interna¬tional agencies working in health, the major funding agencies, foundations and donors now fully understand the absolute necessity of investing in basic health systems and infrastruc¬tures. This is a major step forward," said Dr Margaret Chan, Director-General of the World Health Organisation (WHO), leading member of the International Health Partnership.

Ethiopia, for example, has seen strong success from a health system strengthening programme to train community health workers. Through this programme, young women who have completed the tenth grade are selected by their communities to get one year of healthcare training. These women then return to provide basic services to their own communities including immunisation, family planning, and HIV prevention. They also are trained to teach people in their communities how to make compost heaps, dispose of waste, wash their hands, and build latrines. Ethiopia has already trained and placed 24,000 health extension workers, and aims at training an additional 6,000 by end 2008.

The Ethiopian example is featured in a documentary to be aired on BBC World next month as part of its Survivor's Guide series.

A 2004 study on barriers to immunisation coverage commissioned by GAVI, found that health system issues constrained the majority of partner countries trying to increase or maintain high im-munisation rates. Problems included unpre¬dictable funding for salaries, transport, and out¬reach, shortages of adequately trained human resources at all levels, and management issues at peripheral levels.

"GAVI will continue to place priority on support to the poorest countries for new and underused vaccines. However, it is clear that we must also provide support for health system strengthening. We are hopeful that support for both vaccines and health systems will ensure sustained increased immunisation coverage and prove to be a winning combination for the world's poorest countries," says Dr Lob-Levyt of the GAVI Alliance.

The GAVI Alliance

The GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation) is a public-private partnership of major stakeholders in immunisation. It includes developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, civil society, and the Bill & Melinda Gates Foundation. WHO estimates that GAVI support will have prevented more than 2.9 million deaths by the end of 2007.

GAVI Alliance