This report presents country experiences in developing and shaping work to address long-term planning for the health sector. It identifies areas of action to which the national commissions have contributed, from mobilising political will and building much-needed evidence, to strengthening national planning processes. These lay the groundwork for sustainable improvements in health for the world’s poor people. The report clarifies the most intractable challenges that have impeded faster health progress, and gives concrete examples of how countries have started to address them through an integrated approach to health sector development and financing.
Resource allocation and health financing
Investing in health for development: Experiences from national follow-up to the Commission on Macroeconomics and Health
Spinaci S, Currat L, Shetty P, Crowell V, Kehler J
Medical bills push people deeper into poverty
McIntyre D, Thiede M, Dahlgren D, Whitehead M: ID21 Health, 28 July 2005
In some developing countries public health clinics charge patients for medical consultations. These medical fees, together with a loss of earnings due to ill health, have catastrophic consequences for families already living in poverty.
The downside of $billions
Birn AE: Toronto Star, 16 Aug 2006
Without taking social and political realities into account, the Gates Foundation patronage of even the most powerful medications cannot meet the goal of reducing global inequities. Recently Warren Buffett has received near-universal praise for his $31 billion donation to the Bill and Melinda Gates Foundation. The foundation has likewise enjoyed wide acclaim for its global health and educational programs, with Buffett's gift the highest tribute of all. So what could possibly be wrong with Gates-Buffett philanthropy, aimed at improving global well-being? Five such issues are highlighted, warranting pause to the all-around backslapping.
The Global Fund Secretariat’s suspension of funding to Uganda: How could this have been avoided?
Kapiriri L, Martin DK: WHO Bulletin 84, August 2006
In August 2005, the Global Fund to fight AIDS, Tuberculosis and Malaria Secretariat suspended its five grants to Uganda following an audit report that exposed gross mismanagement in the Project Management Unit. How could this have been avoided? How can other countries avoid a similar pitfall? We argue that if a legitimate and fair decision-making process were used, the suspension of funding to Uganda could have been avoided, and that this lesson should be applied to other countries. The “accountability for reasonableness” framework of relevance, publicity, revisions and enforcement would help in implementing legitimate and fair decision-making processes, which would improve effectiveness, accountability and transparency in the implementation of Global Fund programmes, preventing future suspension of funding to any Global Fund projects.
Uganda: Foreign envoys demand action against Global Fund culprits
Plusnews, 23 August 2006
European envoys in the Ugandan capital, Kampala, have asked the government to take "expeditious" action against individuals, including senior politicians, accused of mismanaging HIV/AIDS grants. The diplomats were further concerned at the slow implementation of the judicial commission of inquiry report.
A costing analysis of community-based programs for children affected by HIV/AIDS: Results from Zambia and Rwanda
Dougherty L, Forsythe S, Winfrey W: Eldis, 5 July 2006
This paper analyses the programmatic costs of CARE Rwanda's and Bwafwano Zambia's two community-based programmes for children affected by HIV/AIDS in Rwanda and Zambia in order to provide information on the current costs of the two programmes. The paper also discusses additional costs related to scaling up the existing programmes and outlines issues relating to long term sustainability of programmes for children affected by HIV/AIDS.
Lack of resources affects all children, not only those with heart disease
Reynolds L, Sanders D: The Sunday Independent, 18 June 2006
We share the distress of our colleagues at the large numbers of children in South Africa who suffer and die from surgically correctable heart disease because there are insufficient human and other resources to provide them with the operations they need. But the plight of children with heart disease only gives us a small glimpse into children's health in South Africa generally and into the crisis affecting the public health sector. Our government and health service administrators must provide more explicit policies and frameworks that guide the allocation of health resources according to agreed priorities.
Further details: /newsletter/id/31622
Social protection: The role of cash transfers
McKinley T (ed.): Poverty in focus, June 2006
Poverty reduction is the result of several interacting factors, including importantly: redistribution of incomes, assets, and opportunities; pro poor economic growth; and social provision and protection. This issue of IPC's journal Poverty in Focus highlights the importance of social protection in the struggle against global poverty. For South Africa, the implications of income grants are analysed, including both poverty reduction outcomes and the macro-economic feasibility; while cash transfers in Zambia and social protection for pro-poor growth are just some of other areas covered relevant to Southern Africa.
A free for all? Removing health user fees in Africa
Gilson L, McIntyre D: id21 Health Systems, 31 May 2006
Charging patients for basic health care hits the poorest members of society the hardest. Many fall into debt or simply do not seek care from public health services. The Commission for Africa has called for basic health care to be free for everyone. How would this impact on already under resourced health services?
A price to pay? Increasing insecticide-treated net coverage in Malawi
Stevens W, Wiseman V, Ortiz J: id21Health, 31 May 2006
Nets treated with insecticide have proved to be an effective method of reducing malaria. Before increasing the scale of this intervention, however, policymakers need to be fully informed of the costs involved and the effect that the scaling-up will have. Cost-effectiveness has been measured in trials, but what does the intervention cost in practice?