Blog
Dec 14 2008
End of year post: Thinking before acting: the state of health policy and systems research in 2008
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The 2004 ministerial forum on health research in Mexico emphasized a 'historical neglect' of health policy and systems research focusing on, and from low-income countries. In the four years since, what has changed and what should be the focus going forward? A review of a recent Lancet article by Bennett et al. reveals the answers.
Oct 8 2008
Future Health Systems Part I: A Little Matter of Institutions
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Is it too premature to be thinking of Future Health Systems, especially for low-income and transition countries? Given that the existing systems in sub-Saharan Africa and in low-income Asia are under stress from high disease burden (demand-side) and a lack of resources (supply-side), shouldn't we fix the problems currently at hand? Not premature at all, say the editors of a recent series of papers in the journal Social Science & Medicine.
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 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
“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.
Aug 5 2008
Health systems is the conference late-breaking theme
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Although a search for "health systems"-related sessions at the Mexico conference yielded only a few sessions, this has clearly become one of the predominant themes of discussion here. Last night's session on "Positive Synergies between Health Systems and Global Health Initiatives" brought together all the "stars" in the observatory, as Julio Frenck noted.
