Strong health systems: “The secret ingredient”


As a global health community, we have the skills and know-how to accomplish these goals, but we must work together and recognize that the ‘secret ingredient’ that binds all of our collective knowledge, skills and interventions is a strong health system. The Lancet Commission on Investing in Health reported this past year that such goals are indeed feasible and would bring about a grand convergence in life expectancy between poor and rich nations in our lifetime. The required investment would pay off 9 to 20 times in full-income returns, and to succeed, half of the resources should be used to strengthen health systems – from human resources to better governance of the sector’s public and private components.

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The Daily Impact: USAID Unveils $1 billion development innovation lab

April 4, 2014

Yesterday saw the launch of a $1 billion innovation lab by USAID that brings together scientists, corporations, universities and charities in a collective to dream up and test new tools to fight poverty. From the Guardian:

The lab is being billed as USAid‘s equivalent of the Defence Advanced Research Projects Agency (Darpa), the US Defence department wing known for its development of the stealth fighter and involvement in the creation of the internet.

The agency describes it as a new way of working, but some anti-poverty campaigners have received news that the lab’s 150 staff will collaborate with several corporate “cornerstone partners” – among them Coca-Cola, DuPont, Unilever, Walmart, Syngenta and GlaxoSmithKline – as further proof of the increasing commercialisation of development.

The Oakland Institute said the initiative’s science and technology-based approach to development challenges was “a case of emperor with no new clothes”, while the World Development Movement said it would do nothing to tackle the root causes of poverty.

USAid, however, argues that the creation of the lab, other partners in which include Save the Children, World Vision, the Smithsonian Institution and the Massachusetts Institute of Technology, marks a fundamental shift in its approach to development innovation. “Instead of selecting a proposed answer, we bring together a whole group of partners to attract ideas, test them and take them to scale,” said Lona Stoll, senior adviser to Rajiv Shah, the head of USAid.

“The lab has ambitions of disruptive technologies and game-changing solutions really helping improve the lives of 200 million people in five years: things like eliminating the transmission of HIV/Aids from mother to child using the Pratt Pouch – a two-cent package [of antiretroviral drugs] that looks like a ketchup packet – or looking at how you get electricity access out to rural communities without building the kinds of grids that previously were a big part of development programmes.”

In addition to the manure-powered fridge and the Pratt Pouch, the agency has helped fund trials of the Odón device, a low-cost instrument that resembles a bicycle pump but has been hailed by some as the greatest aid to assisted births since the invention of the ventouse suction cup.

There are also innovations that fall into a more nebulous bracket. “We consider electronic payments to be in this category – the ability to reach communities that have never been reached with infrastructure with financial services; the ability to save,” Stoll said. “We are very focused on scaling both broadband access and electronic payment systems to hundreds of millions of people.”

The agency hopes the lab will one day yield “a handful of real game-changers” in development thinking and technology. “We use the reference points of oral rehydration therapy and the seeds of the green revolution or microfinance as things that are akin to the kinds of breakthroughs that we would like to help shepherd,” Stoll said.

The initial focus will be on six areas deemed consistent with US development and foreign aid priorities: food security and nutrition; maternal and child survival; energy access, sustainable water solutions; child literacy; and connected technologies. To that end, it is looking into everything from climate-resilient cereals to off-grid energy services and electronic educational devices.

“This is a win-win for our country: bringing America’s scientific and entrepreneurial capability to the service of those intractable global challenges is something that we think we really need to do,” Stoll said. “At the end of the day, the results get us to development goals better, faster and cheaper.”

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Smart investments in maternal health

From the Impact Magazine-Devex survey of over 1,000 global health professionals: 85 percent believe public-private partnerships are important or extremely important.

Impact interviews Dr. Naveen Rao, lead of Merck for Mothers. In 2011, Merck, known as MSD outside the United States and Canada, created Merck for Mothers, a 10-year, $500 million initiative to reduce maternal mortality globally. Rao shares his thoughts on public-private partnerships and the importance of engaging local partners in efforts to improve maternal health.

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The Daily Impact: NTD fight gets $240 million boost from donors

April 3, 2014

Global donors, including the Gates Foundation and the World Bank, committed $240 million in new funding to address neglected tropical diseases in low-income countries. Reuters reports:

The new money follows a pledge by 13 drugmakers two years ago to donate medicines to tackle 10 parasitic and bacterial infections — such as river blindness, Guinea worm and sleeping sickness — that threaten one in six people worldwide.

Microsoft founder Gates and international agencies announced the new funding at a meeting in Paris on Wednesday, where experts gave a positive update on advances to date.

Margaret Chan, director-general of the World Health Organization, said large-scale drug donations had already led to “tremendous progress.”

“Together with the governments of endemic countries, we are fast approaching the goal of controlling or eliminating many of these ancient causes of human misery,” she said.

There is still more to do, and $120 million of the new money will be channeled into a collaboration to combat soil-transmitted helminths, a group of intestinal worms that are among the most common infections in children living in poverty.

The new collaboration includes $50 million from the Bill & Melinda Gates Foundation and $50 million from the Children’s Investment Fund Foundation.

In addition, the World Bank Group is committing $120 million to support the fight against neglected diseases, including support for school-based deworming programs.

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From idea to impact: Bringing health innovations to scale


Taking an idea to market and, eventually, saving and improving the lives of people around the world is a lengthy process, and many potential innova­tions fail along the way. Although governments and industry players are seeking to reduce barriers, the process is arduous and requires strong partnerships and coordination at many levels.

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5 Best Buys for improved maternal health

By Jennifer James. Originally posted at

What are the best buys for global health and development? During a two-hour conversation held at the Center for Global Development global health experts and practitioners discussed the best places to invest in global health and the best investments for global health dollars. Overall, health systems strengthening emerged as the biggest best buy in global health. When health systems are improved the costs for key heath interventions subsequently decreases.

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The Daily Impact: World Bank Announces Development Fund Boost

April 2, 2014

World Bank President Jim Kim announced plans to boost its overall funds for development by around 40 percent per year in order to stay relevant and help the world’s poorest people. From Reuters:

[Kim] said the World Bank will focus its work on 10 countries — including India, China, Bangladesh and Democratic Republic of Congo — which are now home to 80 percent of the world’s extreme poor, who live on less than $1.25 a day.

Kim said the bank’s annual commitments should grow to more than $70 billion a year in the next decade, from about $45 to $50 billion now.

“The world’s development needs, of course, far outstrip the World Bank Group’s abilities to address them,” Kim said, according to remarks prepared for delivery at the Council on Foreign Relations. “But we can do much, much more.”

Kim spoke ahead of next week’s spring meetings of the World Bank and the International Monetary Fund.

The growth in the World Bank’s lending and investment guarantees, alongside planned staff and budget cuts, are part of its first major strategic realignment since 1997.

Since Kim assumed his post nearly two years ago, he has sought to energize the institution around a poverty-eradication goal and make it more nimble and useful, especially to middle-income countries.

The bank’s growth will involve expansions in all major branches, including a $100 billion boost in the fund for middle-income countries, known as the International Bank for Reconstruction and Development. Reuters first reported this increase in February.

The bank’s private sector arm, the International Finance Corporation, will boost annual commitments to $26 billion a year. And the Multilateral Investment Guarantee Agency, or MIGA, which provides political risk insurance, aims to increase its guarantees by 50 percent over four years.

“If we are going to help developing countries end extreme poverty and boost shared prosperity, we have to provide them with more financial resources, more solutions-based knowledge, and help leverage more private sector investment,” Kim told reporters ahead of his speech.

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Why we need government regulation

The latest edition of Impact magazine seeks to uncover global health’s best investments, identify global health trends, and discuss barriers and solutions to scaling up promising interventions. Read the interview below from the issue,  find the rest of the articles from the magazine here, and continue the conversation on Twitter using #BestBuys4GH. Ask Dr. Arun Gupta, a pediatrician based in the […]

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Are we leaving the private sector out of health systems strengthening?

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Health system strengthening is widely recognized as the key to making progress toward the Millennium Development Goals and post-2015 successors. So it came as no surprise that development professionals who responded to the Devex survey identified it as a ‘best buy’ in global health. But to get the most out of this best buy, we should move beyond what is too narrow a definition of health system strengthening.

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The Daily Impact: Climate change poses risk for floods, conflict and hunger, says report

April 1, 2014

The UN’s expert panel warned that soaring carbon emissions will amplify the risk of conflict, hunger, floods and mass migration this century. From AFP:

Left unchecked, greenhouse gas emissions may cost trillions of dollars in damage to property and ecosystems, and in bills for shoring up climate defences, it said, adding the impact would increase with every additional degree that temperatures rise.

“Increasing magnitudes of warming increase the likelihood of severe, pervasive, and irreversible impacts,” a summary said, in a stark message to policymakers.

The report is the second chapter of the fifth assessment by the Intergovernmental Panel on Climate Change (IPCC), set up in 1988 to provide neutral, science-based guidance to governments.

The last overview, published in 2007, unleashed a wave of political action that at one point appeared set to forge a worldwide treaty on climate change in Copenhagen in 2009.

But a global consensus failed to emerge as the developing world and developed world squabbled, with big polluters like China insisting it was up to rich countries to take the lead, arguing they could not be expected to sacrifice growth.

And in the United States, President Barack Obama’s attempts at passing climate change legislation have been stymied in Congress, where some Republicans remain unconvinced of the scientific case for warming and argue that mitigation efforts are an unnecessary block on economic growth.

The new document, unveiled in Yokohama after a five-day meeting, gives the starkest warning yet by the IPCC of extreme consequences from climate change, and delves into greater detail than ever before into the impact at regional level.

It builds on previous IPCC forecasts that global temperatures will rise 0.3-4.8 degrees Celsius (0.5-8.6 degrees Fahrenheit) this century, on top of roughly 0.7 Celsius since the Industrial Revolution.

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