2016 Winners & Losers in Global Health

With the holidays this past week I had some time to read Devex’s article on the Winners and Losers in Development in 2016. So I thought about the winners and losers in global health. Here is my list. Share yours. I would love to talk with you and learn more about your views.

I am afraid there are more losers than winners on my list… Here is my list of the winners and losers in global health:

Winners:

1. Transparency. The Foreign Aid Transparency and Accountability Act was passed in July and USG agencies have a year to develop their plans to implement the act. You can read it here.  What are you going to implement this act? More on what I will do next year.

2. Small Businesses. USAID Washington exceeded its targets of contracts to small businesses and in 2017, the contracts given by USAID missions overseas will also have to achieve small business targets. As you know, I started RGH twelve years ago and it is a small consulting business. I did not want to create a non-profit because I believe that there are enough of those already in global health, and what was needed was a think tank of innovation providing effective and sustainable solutions to achieving the health goals of a Millennium Development Goals. Now, RGH is focused on providing innovative solutions to develop self-reliant and sustainable health systems that achieve Sustainable Development Goal 3 by 2030. We are winning more contracts, and with that, the chance to do more and spread our innovative solutions worldwide. RGH was definitely winner in 2016.

Losers:

1. The Principles of the Paris Declaration. Still over 10 years since so many countries and organizations committed to the its principles, progress towards stronger country ownership, alignment with country’s structures and institutions, harmonization of interventions, focus on results and accountability are not implemented fully. I am hopeful, though. With the new Act passed by the US Congress this year, The Paris Declaration can be a winner next year and we may see sustainable solutions lasting and thriving after donor-funded interventions end.

2. Donor Coordination. This is my subjective opinion, I know. But I have seen too many donors doing their own thing, duplicating and in some cases even complicating things because they do not share plans, do not coordinate implementation, do not anticipate changes and do not make timely corrections. I have seen how little coordination effort is put into implementing nationwide reforms and changes, and have seen too much fragmentation that confuses the healthcare workers that are on the front lines of healthcare delivery, and too much short-term thinking and interventions that are not sustained. That is why RGH is planning to conduct a study and test various ways for countries to effectively coordinate the donors that want to help them.

3. Health Systems. This is the loser that saddens me the most. I have seen too many countries where projects write a new National Health Policy and then do nothing to implement them. I have also seen too many countries where projects train healthcare workers about how to improve quality of healthcare delivery but do not coach them or provide them with the resources to implement the changes required to actually improve quality. And I have seen projects that provide technical advice to local management teams but they do not actually assist to help them actually improve how they manage health services. A successful project is one that leaves the country’s health system working a bit better, hopefully a lot better.

4. Disease control programs. We public health professionals know that every country needs to manage a number of disease control programs based on the information provided by their epidemiological surveillance program. That is how things work in developed countries. Why doesn’t WHO and other donors coordinate their work to ensure that each country has effective and well managed disease control programs and a sound epidemiological surveillance system? No wonder Eboal, Zika and still malaria, TB and AIDS are not controlled effectively in most developing nations.

What do you think? In any case, I wish you a very happy and successful 2017! May we all achieve global health targets for the New Year.