Caution over UK Health Initiative

from One World

The International Health Partnership, which Gordon Brown has adopted as his first international development initiative as Prime Minister, could be groundbreaking but only if it attracts sufficient international funding, technical support and political backing, said anti-poverty agency ActionAid.

Flagged as a key policy platform and launching this week (5 September), the Partnership seeks to strengthen the developing world's health services. It aims to co-ordinate at country level the aid given to health systems from donor governments and multilateral agencies such as the World Bank and WHO.

ActionAid policy officer, Romilly Greenhill believes that better coordination of aid to health linked to mutual accountability of donors and recipients can only be a good thing. "Getting the process right may not be glamorous but it is essential in order to make money for health work harder."

In addition to country-to-country and multilateral aid, there are more than 80 global ring-fenced health treatment funds in operation. All have their own ways of working and reporting mechanisms. The pressure on already overstretched health services leads to confusion, overlap and mismanagement.

Donors also rarely fund vital areas such as doctors and nurses salaries - for too long the Cinderella of front-line healthcare.

Romilly Greenhill said: "Few countries in the developing world have a coherent vision of what a strong health system looks like, and currently donors' health assistance too often cherry picks, encouraging further fragmentation of health services and delivery gaps."

Yet ActionAid still has concerns about the partnership and highlights key areas that need to be addressed.

Some of the major players are missing. More bilateral donors need to sign up and the UK government should continue to work hard to ensure that big and influential health donors, such as the US government, fully support the initiative.

Another prime consideration should be the role that women play in the community. As frontline carers of the sick, women of all ages often bear the brunt of failing healthcare systems. The partnership should be seen as an opportunity to redress the balance for the millions who provide life-saving treatment and care.

In South Africa, a country with one of the highest HIV and AIDS prevalence rates, a national evaluation of home-based care found 91% of community caregivers were women. Neither should it be forgotten that there are massive funding gaps in aid to health. Whilst this initiative is primarily about coordinating existing aid better, donors have previously promised more aid and that is not yet forthcoming.

"Effective coordination at country level demands complete international and national buy-in and also money, and that is still a long way from being realised", concluded Romilly Greenhill.