The article I will be discussing today is: The Challenge of Global Health. This article elaborately details the many aspects and factor that play into the success and failures of global health initiatives. It analyzes problems that arise on behalf of the donors, explains the current conditions of these nations, primarily those in sub- Saharan Africa, and illustrates optimal conditions needed for successful initiatives. The article begins by stating the various amounts of rather huge donations given to improve global health. The writer explains how much money is being given but for narrowing targets that hinder progress. The writer also explains many countries are short in health care workers because many, once trained emigrate to wealthier nations through recruitment or seeking a better life; and hold wealthier nations accountable for making situations in these countries worse because of their frequent recruitments. The article goes into much detail about where the money is coming from- whether it be philanthropic work (a significant amount from the Bill and Melinda Gates Foundation), PEPFAR (provided by the Bush administration), individuals, among many other sources.
It also explains how much of this money comes with strings attached and narrow purposes, making it very hard for change to occur. The article then goes on to explain problems with the funds actually being spent appropriately with estimation that about "half of all the funds donated for health efforts in sub-Saharan Africa never reach the clinics and hospitals." The article continues to analyze all these different problems hindering success, but most importantly, near the end, it states the correlation between maternal health and life expectancy and global health. It explains the optimal conditions required for acceptable global health and how donors should broaden their perspectives and be held accountable for the money they supply, and how these are practical solutions for better global health.
The reasons that I see are most valid for the worsening of public health globally in the developing world is definitely the lack of a health force base in these nations as well as the narrow targets of donors. I see these reasons as the leading causes of this worsening because as the article states briefly, you can help a nation as much as you want, but if they can't stand on their own after you leave, then you have actually done them a disservice. The lack of a healthcare force is a hindering factor also in that with all the money supplied, it’s almost like a lot of it has no receiving end and almost like its being thrown in the air for whoever is around to catch- good or not. The narrow targets of donors greatly inhibits progress because though HIV/Aids is a major issue, it’s only a symptom of the lack of funding when it comes to family planning and maternal health- this is the major issue. The narrow targets almost act like a teaser or a deceiver. Yes, a lot of money is being put in to help, but its helping the wrong things and is yielding no progress.
The two markers considered the most important indicators of the status of health care systems in developing countries are maternal health and overall life expectancy. Maternal health is an important marker because "pregnant women survive where safe, clean, round-the-clock surgical facilities are staffed with well trained personnel and supplied with ample sterile equipment and antibiotics"- all characteristics of a general good facility, and what better place to have that than when life is born. Life expectancy is also an important marker because if children can survive passed their 5th birthday in optimal conditions such as safe drinking water, available immunizations, nutritional food, etc. If any of these factors are absent, many do perish- causing low life expectancy.
Two examples of diseases that extend from faulty systems and the lack of sustainability of current donor practices which led to more deadly diseased states than what was first initially encountered are malaria and HIV/Aids. The current donor system contributes to malaria by most of the time increasing the quantity of bed nets handed to children to block disease carrying mosquitoes. The current donor system contributes to HIV/Aids by usually increasing the number of people receiving necessary drugs. The aid in these cases is both "tied to short term numerical targets" rather than addressing the issue of public health itself.
In such a big world, how can you make a difference?
Until next time,
Thomasina
Thanks for the post.
ReplyDeleteTry to keep the post closer to 500 words next time. Your was about 750.
I agree with your reasoning that a lack of health workforce and narrow goals of donors are big reasons why a lot of donated money is not having a bigger impact.
I liked your words "The narrow targets of donors greatly inhibits progress because though HIV/Aids is a major issue, it’s only a symptom of the lack of funding when it comes to family planning and maternal health- this is the major issue. The narrow targets almost act like a teaser or a deceiver."
You were right that life expectancy and maternal mortality are proper indicators of a nation's health system status.
About the last question. I see what you are saying. If we mean to say the same thing, the narrow targets of donors (what the author calls "stovepiping") leads to ignoring other important public health efforts such as protecting women during childbirth, childhood vaccines, and sanitation and hygiene efforts to reduce infectious disease.
Great post.