A career in global health is a peek into all that is right and wrong with the world. There are still so many people in both lower income countries (but even in marginalized communities in higher- income countries) that die from treatable diseases and preventable causes. Well meaning donor entities know this and try to rectify this problem by providing resources to Ministries of Health to sort out these issues. The problem is that the way public health interventions are developed and funded can be more disruptive than helpful and often times unsustainable. In a recent Lancet publication, my co-authors and I describe how the focus on ‘Global Health Security’ functions have become a parallel system that many times diverts funding from the main health system (i.e curative health services) to fund specialized activities around preventing, detecting, and responding to disease outbreaks. I think functions such as these are essential—but they are part of a strong health system and not the health system itself. In this paper we advocate for better strategic coordination between donors, Ministries of Health, and global health governance decision makers to ensure that the way we define and fund health systems is compatible with the way they should operate in real life. This is especially important as WHO, led by the dynamic Dr Tedros, push all countries to work toward Universal Health Coverage. See the abstract below and click on the above image to access the full text.
In the wake of the recent west African Ebola epidemic, there is global consensus on the need for strong health systems; however, agreement is less apparent on effective mechanisms for establishing and maintaining these systems, particularly in resource-constrained settings and in the presence of multiple and sustained stresses (eg, conflict, famine, climate change, and globalisation). The construction of the International Health Regulations (2005) guidelines and the WHO health systems framework, has resulted in the separation of public health functions and health-care services, which are interdependent in actuality and must be integrated to ensure a continuous, unbroken national health system. By analysing efforts to strengthen health systems towards attaining universal health coverage and investments to improve global health security, we examine areas of overlap and offer recommendations for construction of a unified national health system that includes public health. One way towards achieving universal health coverage is to broaden the definition of a health system.