The global health system: lessons for a stronger institutional framework.

Suerie Moon,Gerald T Keusch,Nicole A Szlezák,Dean T Jamison,Barry R Bloom,Catherine M Michaud,William C Clark,Gill Walt

doi:10.1371/journal.pmed.1000193

Abstract

In the last in a series of four articles highlighting the changing nature of global health institutions, Suerie Moon and colleagues propose future actions to strengthen these institutions.

Highlights

The global health system is in a period of rapid transition, with an upsurge of funds and greater political recognition, a broader range of health challenges, many new actors, and the rules, norms and expectations that govern them in flux
This concluding article draws on the others in the series. It draws from a year-long effort that included case studies, two international workshops of scholars and practitioners, and ongoing discussions by the authors, to summarize lessons learned and propose future actions to strengthen the system as a whole
The project concluded that an effective global health system must accomplish at least five core functions: agenda-setting; financing and resource allocation; research and development (R&D); implementation and delivery; and monitoring, evaluation, and learning

Summary

Introduction

The global health system is in a period of rapid transition, with an upsurge of funds and greater political recognition, a broader range of health challenges, many new actors, and the rules, norms and expectations that govern them in flux. The project concluded that an effective global health system must accomplish at least five core functions: agenda-setting; financing and resource allocation; research and development (R&D); implementation and delivery; and monitoring, evaluation, and learning. The framework requires that the affected countries and the public, who are co-producers of health, be represented as key participants [4] These partnerships, anchored by the legitimacy of the WHO, represent creative approaches to eliciting the broad participation necessary to construct widely accepted agendas and forge consensus at the global level. Even when public sector delivery capacity is weak, some countries have still managed to expand primary health care coverage and improve childhood survival by engaging the private for-profit as well as nonprofit sectors [29] These non-state actors can energize national health systems by sharing knowledge of how better to achieve efficiency, outreach, and user satisfaction. The challenge is to secure the evidence, and to have the political and procedural legitimacy that, to date, few organizations other than the UN agencies have been chartered to provide

The Role of WHO

Lessons and Future Needs

Findings

Author Contributions