Major accomplishments in global health over the last decade demonstrate that adequately resourced programs, focused on achieving specific results, can improve health outcomes for millions and support economic progress. They also show that distinct public health challenges are closely interconnected and that a comprehensive and integrated strategy is needed to ensure that ambitious health goals are met.
Topic:
Globalization, Health, Human Welfare, and Humanitarian Aid
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Globalization means a threat to any of the world's peoples is a threat to all the world's peoples. As American journalist Laurie Garrett says in her famous book The Coming Plague: Newly Emerging Diseases in a World out of Balance, none of us can escape from a pandemic in our increasingly globalized world. Most of us are active members in prosperous communities, whose daily lives involve interactions with dozens of people of varied backgrounds; even if we were Robinson Crusoes safely living a life of autarky on an isolated island, a fly or bird could bring an avian or swine flu virus to puncture our well-protected balance.
Global health donors, like national governments, have traditionally paid for inputs such as doctors' salaries or medical equipment in the hope that they would lead to better health. Performance incentives offered to health workers, facility managers, or patients turn the equation on its head: they start with the performance targets and let those most directly affected decide how to achieve them. Funders pay (in money or in kind) when health providers or patients reach specified goals. Evidence shows that such incentives can work in a variety of settings. But making them effective requires careful planning, implementation, and monitoring and evaluation.
Topic:
Health, Humanitarian Aid, Third World, and Foreign Aid
The crisis that started with Hamas winning the Palestinian Authority (PA) elections in January of 2006 seems to have entered a new stage with the start of 2009. Israel, which provides the occupied PA with the bulk of its economic resources, the US and the EU classifying Hamas as a terrorist organization and the resulting 3 year long economic siege and blockade, and the Israeli operation that started on the 27th of December and lasted for 22 days have all made the humanitarian situation in this region unbearable.
This paper focuses on the causal factors, implementation, and side effects of administrative reforms launched within the United Nations system, in the field of HIV and AIDS. It is based on an empirical analysis of the UNAIDS Programme, an interorganizational system bringing together ten UN agencies to combat the worldwide epidemic, with the support of a Secretariat. Firstly, the paper argues that the administrative reform of UNAIDS was unlikely to have come from the UN organizations themselves, although the Programme was expected to lead these organizations to better coordinate and harmonize their AIDS strategies. Secondly, it identifies three external factors that have led UN organizations to reform their governance mechanisms and procedures. Thirdly, it explores the conditions under which the reform of UNAIDS has been implemented since 2005, with particular attention to the Secretariat that has become involved as an active “reform entrepreneur.” Finally, it identifies some of the unexpected effects of the reform, with a particular emphasison competition between UN agencies, organizational complexity, and bureaucratization. The concluding remarks argue that when analyzing administrative reforms within international organizations, one should investigate the interrelations between the external pressures that drive reforms and the activity of reform entrepreneurs.
Topic:
HIV/AIDS, Health, Humanitarian Aid, United Nations, and Infectious Diseases
U.S. global AIDS spending is helping to prolong the lives of more than a million people and is widely seen as a foreign policy and humanitarian success. Yet this success contains the seeds of a future crisis. Life-long treatment costs are increasing as those on treatment live longer, and the number of new HIV infections continues to outpace the number of people receiving treatment. Escalating treatment costs coupled with neglected prevention measures threaten to squeeze out U.S. spending on other global health needs, even to the point of consuming half of the entire U.S. foreign assistance budget by 2016.
Late in the evening of 15 November 2007, Cyclone Sidr struck Mahmouda's home and thousands of other villages across Bangladesh's southern coastal areas, leaving around 4000 people dead and millions homeless. The initial response to the disaster was prompt and vigorous, but three months after the disaster the affected communities' needs – particularly in terms of housing and livelihoods – remain staggering.
The situation for 1.5 million Palestinians in the Gaza Strip is worse now than it has ever been since the start of the Israeli military occupation in 1967. The current situation in Gaza is man-made, completely avoidable and, with the necessary political will, can also be reversed.
Increasing insecurity and criminality is jeopardising progress in Afghanistan. With low government revenues, international assistance constitutes around 90% of all public expenditure in the country, thus how it is spent has an enormous impact on the lives of almost all Afghans and will determine the success of reconstruction and development. Given the links between development and security, the effectiveness of aid also has a major impact on peace and stability in the country. Yet thus far aid has been insufficient and in many cases wasteful or ineffective. There is therefore no time to lose: donors must take urgent steps to increase and improve their assistance to Afghanistan.