Blog
Aug 26 2008
If it's not broken, then make it better
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Now that we've all heard at IAC'08 and after: disease-specific programs do no harm to health systems and may in fact help them, what's on the agenda for integration and health system strengthening? An analysis of a recent piece by Daniel Low Beer from the Global Fund reveals some hints of what is on the horizon.
Aug 19 2008
Another critique of the Abuja target
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The Abuja target calls for African countries to spend 15% of their public budget on health, typically measured as funds allocated to the ministry of health.
Aug 13 2008
Is robbing Peter to pay Paul worth worrying about?
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Few health systems topics received more attention at the IAC than the question of whether we should blame the advent of the AIDS virus as the cause of funding and resources being channeled away from the general health system (into vertical programs) or applaud the arrival of AIDS as the catalyst for the activism needed to identify the inadequacies of health care systems. Of course, as you would expect from persons attending an AIDS conference, just about everyone agreed that AIDS advocacy and funding efforts were strengthening health systems in general.
I tend to agree with those who were not concerned about how we arrived here, or the merits of one catalyst for change over another, but who were anxious to move forward. Various health systems and funding systems exist. There will always be vertical and horizontal funding streams. There will always be competing priorities. We should stop wasting time and resources discussing which one works better or which priority is more important. We need to move forward the best we can. As Sigrun Mogedal, Ambassador for AIDS and Global Health Initiatives Norway and Chair of GHWA said: We are in the midst of competing priorities and voices… We have to work across all sectors… We cannot wait until all these things are fixed. We have to live with the complexity and be involved under several streams of activity at the same time.
Aug 12 2008
Is the HIV/AIDS Response Strengthening Health Systems?
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There were no less than four sessions* looking at the question of how the AIDS response is affecting country health systems – here are some highlights.
Aug 8 2008
Health systems versus AIDS programs: A new discussion on a familiar topic
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Thirty years ago a similar discussion happened in relation to Family Planning programs. At that time there was an important concern about the apparently opposite approaches to the so called “vertical health programs” versus “comprehensive health programs,” the latter related today to the modern expression “health systems.” Probably everybody remembers the end of this story: vertical programs were a good idea in the short term but in the long term they necessarily had to be integrated into the national health systems for many reasons. Probably the most important reason was to guarantee they were sustainable. The other lesson learned was that vertical and comprehensive health programs were not really opposite approaches. The programs were inseparable parts of the system.
Aug 6 2008
What’s love got to do with it
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A study of 700 sero-positive adolescents in Uganda revealed them to be an ignored yet high risk group. As they entered adulthood, both young women and men expressed the desire to have a loving relationship and raise a family.
“Diagonality” in Practice: Julio Frenk on “Diagonal” Health System Reform in Mexico
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In his introduction to Bill Clinton’s keynote address on day 2 of the International AIDS Conference, Mexico’s former Minister of Health, Julio Frenk, made an impassioned plea for the virtues of “diagonality.” Frenk argued that the intense attention and relatively lavish funding being directed at tackling the global pandemic offer an opportunity to settle the long-standing debate between horizontal and vertical (or disease-specific) approaches.
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