When I started as director of MLI nearly four years ago, I had very few preconceived notions.  I wanted to keep as open a mind as possible about how MLI could help developing countries follow through on their priorities for the health care of their people.  Today, March 31, 2012, MLI is coming to a close and I wanted to take this opportunity to reflect on the program’s journey.

My initial thought going into the job was that we could help build leadership in health ministries.  But I soon realized that it wasn’t about building leadership--  that dynamic leadership was present but sometimes swamped beneath the enormous pressures of huge jobs with little resources.   MLI looked for ways to support ministry leaders’ efforts and to better position and promote their voices and their priorities to national and global audiences.  And we gained an appreciation for the value of senior ministry leaders supporting, learning, and sharing with each other. 

I soon learned the key to MLI’s future success -- we needed to build trust.

There’s a lot of discussion now about the upcoming federal government budget debates following the Obama administration’s request to Congress. Those supporting global health already have voiced opposition about several cuts in funding for programs.

But funding is only part of the issue.

Finding ways to become more efficient – and saving money -- is also a critical focus of what’s going on behind the scenes. Some of that is a byproduct of a new approach under the administration’s Global Health Initiative: Fund the priorities of developing countries rather than solely the priorities of the donors.

This movement of country-led development has been around for a long time, but it is gaining steam now.