One certainty of global health meetings is that you will hear a version of: "we have affordable interventions that save lives; we just don't deliver them to people." Panelists at today's afternoon sessions urged everyone present to move beyond this hand wringing. Norway's Prime Minister Stoltenberg, who today pledged $1 billion for maternal and child health, encouraged other governments to match his country's effort of giving nearly 1% of GDP to development assistance. Alice Albright from the Global Alliance for Vaccines and Immunization (GAVI) said that, "People working in public health should think about taking more risks," to get needed services to people. Asked to identify a cost-effective health intervention, Helene Gayle, who runs CARE answered: "political leadership."
There was a proliferation of good ideas waiting to be hooked up with funders, like helping women learn to provide birthing care to others in their villages. "We can turn any home into a pediatric ICU," says Abhay Bang from SEARCH. "In India, a community health worker can be trained and employed for a year with $250."
Between the two health sessions I ran into Eric Goosby who runs Pangaea Global AIDS Foundation. Hearing him describe his organization's approach to delivering ARVs in China, it's clear that what sounds like a vertical (disease-specific) program may actually be more horizontal in practice. Eric says Pangaea's approach in China is to work with the Ministry of Health and existing health centers, and train health care workers who are already in the community. The strategy takes time, but the goal is to keep the response indigenous and sustainable, and support the larger health system.
But emergency responses are needed in much of the world. AIDS is different in different places, and in many places in Africa, millions face imminent death unless they receive treatment. The challenge for the leaders here, as well as donors, and governments, is to mobilize emergency responses and deliver effective programs with an eye to broader, sustainable systems of health care.
Chris Collins is a health policy consultant who lives in New York City.
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