One of the world’s biggest challenges is improving global healthcare in developing countries. However, according to the World Bank Group President Dr Jim Yong Kim, although there’s been progress in improving global health over the past twenty years, the failure to address “the gritty business of actually delivering health care in developing countries”, is causing ineffective and inefficient health care for many.

The report was published in this week’s issue of The Lancet by Professor Paul Farmer of Harvard Medical School and Professor Michael Porter of Harvard Business School, just before the 66th World Health Assembly in Geneva, from May 21st to 26th, 2013.

Dr Kim will give his speech at the assembly, emphasizing the need for effective delivery of universal health coverage and achieving goals to put an end to extreme poverty by 2030.

Efforts were made three years ago in a World Bank and Pfizer Inc. collaboration to improve healthcare infrastructure, specifically the supply chain, in developing countries, starting with Africa.

The authors wrote:

“The gritty business of actually delivering health care in developing countries has not attracted much academic interest, even though improving capacity to deliver care in these settings will save lives, leverage substantial and growing philanthropic support of global health, and increase returns on existing and new investments in both discovery and development of new resource.

What scant attention to research and teaching of health-care delivery exists is focused on specific questions about particular interventions (eg, the feasibility of administration of a vaccine, and its cost-effectiveness) rather than on the broader systems and conditions.”

They proposed:

    1. A new framework to establish a better understanding and set of activities for any medical condition.

    2. The need for a shared delivery health infrastructure – whereby care is integrated and co-ordinated across all components.

The authors said:

“The current, fragmented approach is costing us dearly in terms of duplication, inefficiency, poor use of human resources, and high procurement costs. It is costing patients most of all: they are dying of preventable diseases and suffering without therapies readily available elsewhere. A strategic approach to global health delivery will help us to move from the fragmentation of services and providers registered in most developing (and many developed) countries towards integrated, effective delivery systems that provide value for patients.”

They concluded that in order to finally put an end to extreme poverty, there will need to be sustained investment in healthcare delivery.

The authors wrote: “We will not end extreme poverty without sustained investments in healthcare delivery. If delivery systems can be transformed around the principle of value, the promise of health and productivity for those now facing both poverty and disease will not be squandered.”

A previous paper, published by Professor John-Arne Røttingen, of Harvard School of Public Health and University of Oslo, revealed that there have been too few investments targeted at addressing the health needs of low-and-middle-income countries.

They added that a global health observatory under the World Health Organization (WHO) could effectively address the issue.

Written by Joseph Nordqvist