Dr. Margaret Chan

In a recent article written by Margaret Chan, Director-General of the World Health Organization, the growing gap between health indicators of developing countries and developed countries were brought to the forefront. In sub-Saharan Africa, Chan says, women are four hundred times more likely to die during pregnancy and childbirth than they are in Japan.

“This is the starkest statistic in public health: the difference in mortality rates between rich and poor countries,” Chan writes.

Chan’s article that appeared in Global Health Magazine is not meant to paint a hopeless picture of health in developing countries, but instead emphasizes that these types of inequities, which are greater today than in the past, can be overcome.

Strengthening national and local capacities to build strong health systems is at the forefront of improving access and overall care. Development aid can help to support this objective, but only if it takes into account country priorities. “Development initiatives must be country-owned,” Chan says. “Assistance must support national health plan strategies and match national priorities.”  By embracing this, no longer should aid duplicate efforts that the government is trying to build up. 

Many development partners now seem to be on the same page as Chan. Anne Peniston, Director of the USAID Office of Health and Family Planning and Global Health Initiative Field Deputy for Nepal told MLI’s Leading Global Health blog recently, “In Nepal, we’re seeing much, much less fragmentation, duplication and inefficiency than we have in the past,” now that the country is taking the lead.

Dr. Wondimagegnehu Alemu, WHO country representative in Sierra Leone, agrees, saying in an interview with Leading Global Health blog that he has observed health partners in the last year support the Ministry of Health and Sanitation in the areas they deemed as necessary to be able to deliver services to the population.

Previously, this was not the case. Dr. Alemu described how more than 200 NGOs were operating at the same time in the same area, dividing the support from development partners between all of them. Now, the Ministry of Health and Sanitation has implemented a monthly meeting including all partners to ensure funds are being used effectively and efforts are not being duplicated or fragmented.

Country leadership and ownership of health initiatives is not solely in the hands of the government though. Partners need to be ready to actually be partners, “Ultimately, it all depends on how well health development partners position themselves to better dialogue with the government to ensure the necessary resources for the provision of affordable and equitable health services to all citizens without undermining the leadership of the government,” Dr. Alemu states.

Chan concludes her article by stating, “Everyone should have equal access to health services and treatments – whether they live in Japan or Myanmar or Mali or Peru. Every country should be able to identify its own set of health priorities and have the capacity to conduct the research and produce the products necessary… we have the guidelines on how to address these issues, and together, we must find solutions. We cannot do less.”