The international health partnership

Abstract

A 2009 study of aid effectiveness in Kenya (Mwega 2009) characterized the problems with fragmented aid as follows: ‘With aid fragmentation, donors impose a huge number of missions. Recipient countries have to wine and dine donors instead of focusing on what they should be doing: running their countries and trying to develop their own policies. Micro-management of aid implies different procedures for accounting that a country has to cope with. Donors have gone behind the ministers for finance and planning, adopting regions, creating enclaves and running them without bothering to talk to governments, and recruiting with high salaries the best civil servants for their administration, thus undermining the countries institutional capacity. Lack of donor coordination means that donors frequently initiate projects that require counterpart funding or future financing from the government without considering if such funding is likely to be available (Lancaster 1999). Hence, while aid may be effective in a good policy environment, it may nevertheless be the case that, beyond a certain amount, it becomes detrimental at the margin (Collier 1999). The government becomes so overwhelmed by aid projects that the business of government becomes dominated by the need to satisfy donors, replacing the need to satisfy citizens.’ In 2010, the World Health Report (WHO 2010a) noted that ‘the international community has made progress by adopting the Paris Declaration on aid effectiveness and the subsequent Accra Agenda for Action…However, much remains to be done. Viet Nam reports that in 2009 there were more than 400 donor missions to review health projects or the health sector. Rwanda has to report annually on 890 health indicators to various donors, 595 relating to HIV and malaria alone.’ These stark facts set the context for the following discussion on aid effectiveness in the health sector and underline the importance of the International Health Partnership (IHP+) and the principles that the IHP+ promotes.