Skip to Main content Skip to Navigation
Journal articles

An assessment of interactions between global health initiatives and country health systems.

Abstract : Since 2000, the emergence of several large disease-specific global health initiatives (GHIs) has changed the way in which international donors provide assistance for public health. Some critics have claimed that these initiatives burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. So far, most of the evidence for this debate has been provided by speculation and anecdotes. We use a review and analysis of existing data, and 15 new studies that were submitted to WHO for the purpose of writing this Report to describe the complex nature of the interplay between country health systems and GHIs. We suggest that this Report provides the most detailed compilation of published and emerging evidence so far, and provides a basis for identification of the ways in which GHIs and health systems can interact to mutually reinforce their effects. On the basis of the findings, we make some general recommendations and identify a series of action points for international partners, governments, and other stakeholders that will help ensure that investments in GHIs and country health systems can fulfil their potential to produce comprehensive and lasting results in disease-specific work, and advance the general public health agenda. The target date for achievement of the health-related Millennium Development Goals is drawing close, and the economic downturn threatens to undermine the improvements in health outcomes that have been achieved in the past few years. If adjustments to the interactions between GHIs and country health systems will improve efficiency, equity, value for money, and outcomes in global public health, then these opportunities should not be missed.
Document type :
Journal articles
Complete list of metadata

Cited literature [173 references]  Display  Hide  Download
Contributor : Pierre Chauvin Connect in order to contact the contributor
Submitted on : Friday, September 11, 2009 - 5:15:56 PM
Last modification on : Tuesday, September 13, 2022 - 6:56:06 PM
Long-term archiving on: : Saturday, November 26, 2016 - 12:05:00 PM


 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document




Badara Samb, Timothy Evans, Mark Dybul, Rifat Atun, Jean-Paul Moatti, et al.. An assessment of interactions between global health initiatives and country health systems.. The Lancet, Elsevier, 2009, 373 (9681), pp.2137-69. ⟨10.1016/S0140-6736(09)60919-3⟩. ⟨inserm-00416057⟩



Record views