Realizing global health: Effective health systems

Abstract

How must global health work to make sure that everyone has access to quality healthcare everywhere every day with almost 200 countries, the UN and its global health organizations such as WHO, UNICEF, UNDP, UNFPA and hundreds of private donors such as the Gates and Clinton Foundations, multilateral and bilateral donors such as the US Government through its agencies, and other governments, including the new BRICKS (Brazil, Russia, India, China, Korea, and South Africa)? The answer is not easy but it is simple. Our world has a very complex and fragmented global health architecture that is not well-understood, defined, or coordinated yet and that must be solved now. In Chap. 2, you learned about human rights, the Millennium Declaration, and the principles of the Paris Declaration. In Chap. 2, you learned about the slow progress in the first 5 years right after the Millennium Declaration and the targets that have not been met by 2015 in spite of the important achievements and best practices demonstrated in global health, medicine, and public health knowledge that can save millions of lives. In Chap. 2, you also realized the complexity of the global health field, the fierce competition for funding, and the fragmentation in approaches and efforts that have made the effective transfer of new medical knowledge and best practices that actually strengthen health systems and programs very limited in scale. Instead of having clear and measurable performance standards and tangible and measurable progress being achieved consistently by a design that makes use of the knowledge and technology available, we have a puzzle of projects, organizations, and initiatives that confuses even those that have created them. In addition, you also know that the sustainability of the results of many projects and initiatives is not part of most projects’ design and it is not measured or evaluated consistently, and therefore, the degree of sustainability achieved is unknown, thus rendering many projects, programs, and organizations ineffective to deliver lasting change or significantly improve global health outcomes. This chapter will show you what you can and must do to break the ineffectiveness cycle and simplify the global health field you can influence, so you know where you and your project or organization fit and how you can make a bigger and more effective impact. This chapter lays out simple, though not easy, guidelines to not only improve the effectiveness of global health projects and initiatives, but also shows how to create an effective aid framework in global health, so we are clear about what we practice and can confidently advance the field of global health. I will also make practical recommendations for the next 15 years of global health practice to be effective and achieve the 2030 sustainable development health targets and help fulfill the right to health of everyone everywhere every day.