Tuesday, May 19, 2009

A Proposal for a Global Health Fund

A recent article published in The Lancet calls for "bold action to streamline the global aid architecture for health" through the creation of a global fund for the Health MDG's. In May and June of this year, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance will hold their annual board meetings. These meetings provide an occasion to propose recommendations for an expansion of the Global Fund and the GAVI Alliance toward becoming a broader global health fund to address the lack of progress toward the MDG's.

Maternal mortality has remained stagnant for far too long, child mortality is declining at too slow a pace, HIV/AIDS remains a huge problem throughout the world, and inequalities are continuing to widen. In order to address these problems and work toward reaching Millennium Development Goals in time, radical action must be taken immediately. Increased funding and efficient spending are the two most imperative reforms that must be addressed.

In the past 10 years funding for global health has been unable to meet the demands of modern societies. Attention to HIV/AIDS has lead to increased funding, yet it is still inadequate in addressing the multitude of new infections occurring every day. Resources for other health needs have remained stagnant, or in some cases, have declined. In the past, developing countries heavily relied on international funding to combat health problems in society, but lately there has been a shift toward national financial autonomy. Such a concept requires that nations receiving assistance should eventually be able to finance their own health services through a reliance on their domestic revenues. Such a model has thus far proven to be ineffective, and serves as a major constraint to "scaling up service provisions in countries where public services rely heavily on international resources."

Increasing prevalence of diseases and other health related problems, such as maternal mortality, combined with the lack of commitment to a national financial autonomy based approach, has shifted reliance back to the international community. More specifically, the GAVI Alliance and the Global Fund, who have themselves admitted that “It is time to take a comprehensive approach with the necessary support from key donors to refocus on all of the health-related MDGs."

Health systems in many countries lack the capacity to implement many of the programmes or assistance plans provided for them, Unable to take full advantage of funding provided is a complete waste and unravels the entire global health funding process. It is thus essential that health systems themselves be strengthened before any further funding in doled out to communities unable to reap the benefits in their entirety. By overcoming structural challenges to service delivery the results will be much more effective, and progress toward the MDG's will in theory speed up.

The Lancet article recommends that the Global Fund should sustain successful programmes while expanding the effective approaches already put in place by the Global Fund and the GAVI Alliance. Eventually, the hope is that such a fund would allow for the prevention and treatment of specific diseases through revamped health services as well as a reduction in costs and a streamlining of the global health architecture.

Radical action must immediately be undertaken in order to achieve the Millennium Development Goals by 2015, and more importantly to save millions of lives that are lost to treatable and often preventable health problems.

You can access the entire article that appeared in The Lancet and learn more about the recommendations for the Global Fund and the GAVI Alliance at: http://www.familycareintl.org/UserFiles/File/Lancet_Global%20Fund%20Health%20MDGs_web.pdf

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