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POLICY November 2008

BRIEF

Sustainable Global Health
and Development
Recommendations
Problem
In collaboration with local and international partners, set country-specific health per-
United States formance targets to ensure that investments succeed in expanding access to quality,
development comprehensive health care that improves people’s overall health. Ensure that a U.S.
assistance for the
national development strategy comprehensively addresses basic health care needs,
health sector has
focused on certain with emphasis on strengthening local health care systems, increasing the number
diseases rather than of skilled healthcare workers, fostering community participation and reaching the
what should be its household level. To maximize effectiveness, the U.S. must harmonize its program
central aim: access interventions, guidelines and policies with those of host countries and other donors.
to sustainable
comprehensive
primary health Actions
care, with special
• Make improving health conditions and strengthening health systems in poor coun-
attention to the
health of families, tries a priority of a U.S. national development strategy;
mothers and • Significantly increase overall health sector funding, and plan scale-up to increase
children. To that access and coverage;
end, an effective • Build health workforce capacity and reduce inequalities of health care coverage and
U.S. government access, which primarily affect women, children and other marginalized groups, to
strategy for
help achieve U.S. global health goals;
international
development must • Assess the impact of global disease-specific initiatives on health system strengthen-
address goals of ing. Harmonize funding at the national level with bilateral and multilateral donors,
improving health in order to fully integrate health programs and leverage funding streams;
conditions and • Initiate a comprehensive review of US health development commitments to meet
strengthening the Millennium Development Goals and other key international frameworks; and
equitable health
• In at least 15 countries, selected based on overall health need and ability to suc-
systems in poor
countries. ceed, create a coordinated strategy in collaboration with governments and non-
governmental organizations to meet identified health care needs.

Results
1400 16th Street, NW Increased funding for primary prevention and health care services, improved coordina-
Suite 210 tion among donors and stakeholders, and new monetary commitments for strength-
Washington, DC 20036
ening health systems and workforce will increase access to quality health services,
202-667-8227
reform@interaction.org comprehensively address health needs; improve sustainability, and reduce avoidable
disease- particularly for the poorest and most vulnerable populations.

www.interaction.org
Background
The U.S. has been a relatively generous donor to ing demands. The integration of services between different
global efforts to address serious health challenges. This is providers will further maximize available resources. This will
particularly true within the past 6 years, during which U.S. allow health workers to spend more time and energy to-
funding for global health initiatives to combat HIV/AIDS, ma- wards providing direct health services, as well as coordinate
laria and tuberculosis has increased by billions of dollars. investments that strengthen health systems to retain staff
Despite this generosity, which has created notable health within local communities.
improvements for some, the general health of the global Because existing support is inadequate for universal access,
poor is severely lagging. Mortality rates, particularly amongst even for HIV/AIDS, we wish to see continued and enhanced
women and girls, still remain intolerably high, and millions support for the existing U.S. health development portfolio,
of people die needlessly every day from conditions that can as well as an expansion of support to achieve the universal
be easily addressed, such as diarrhea and child pneumonia. access to sustainable comprehensive primary health care.
Furthermore, the Millennium Development Goals (MDGs) We affirm that all people have a right to access basic health
related to maternal and child health are unlikely to be met care and the opportunity to be protected against disabling
by 2015, particularly in sub-Saharan Africa and South Asia, and fatal diseases and health conditions for which a vaccine,
undermining progress towards global human health and prevention method or cure is already available. Special at-
prosperity. Unfortunately, budgets for child survival inter- tention to: expanding quality health care to vulnerable and
ventions and reproductive health services have declined by marginalized populations; channeling resources to prevent
18% and 39%, respectively, over the last decade when ad- malnutrition and provide children with the energy neces-
justed for inflation and population growth. sary to learn life skills; and increasing access to clean water
Strengthening healthcare – not just the fight against and adequate sanitation is also imperative to successfully
specific diseases. Focusing on the treatment of disease, as preventing hundreds of millions of premature deaths.
opposed to the expansion of primary health care with the
aim of reducing morbidity and mortality, is a multi-year
trend of U.S. foreign assistance and continues to dominate
health program funding. For example, in the FY 2008 bud-
get only 13% of U.S. funding for global health was allocated
for non-disease specific interventions. This trend has had a
profound effect on health system delivery, as the narrow
push to medically treat HIV/AIDS, tuberculosis and malaria
has exacerbated infrastructure weaknesses that preclude
universal access to health services. Furthermore, foreign aid
programs must be designed sustainably by reducing depen-
dency on external supplies and helping build local capacity
to run health initiatives themselves. Moving forward, U.S. de-
velopment strategy must shift to increase access to a range
of health services within communities, including support for
family planning and reproductive health, for both the pre-
vention and treatment of infections and other health issues.
Tackling Brain Drain. The World Health Organization es-
timates that 57 countries have severe health worker short-
ages, with the crisis most pronounced in sub-Saharan Africa.
While rich countries and well-off institutions attract health
care workers from developing countries, this contributes to
the shortage of a skilled health labor force. This is a growing
problem that results in a “brain drain” in host countries.
Donor Coordination. Along with a U.S. development ap-
proach that increases access to a broader range of health
care services, we support the establishment of a joint donor
reporting strategy in each country to reduce the burden on
scarce health service providers by standardizing their report-
POLICY November 2008

BRIEF

Contributors to Health Policy Brief

Organization URL

Physicians for Human Rights www.physiciansforhumanrights.org
World Vision www.worldvision.org
International Rescue Committee www.theirc.org
Population Action International www.populationaction.org
Academy for Educational Development www.aed.org
U.S. Fund for UNICEF www.unicefusa.org
International Medical Corps www.imcworldwide.org
International Center for Research on Women www.icrw.org

InterAction Health in Relief and Development Working Group

Organization URL

Academy for Educational Development www.aed.org
ACDI/VOCA www.acdivoca.org
Action Aid www.actionaid.org
Acts of Compassion www.questia.com
Adventist Development and Relief Agency International www.adra.org
African Medical & Research Foundation www.amref.org
Africare www.africare.org
Aga Khan Foundation U.S.A. www.akdn.org
Agape Foundation for Literacy and Rural Development www.agapefdn.org
Aidspan www.aidspan.org
Air Serv International www.airserv.org
American Jewish World Service www.ajws.org
American Red Cross www.redcross.org
American Refugee Committee www.archq.org
Basic Education Coalition www.basiced.org
Bread for the World www.bread.org
CARE www.care.org
Catholic Relief Services www.crs.org
Center for Health and Gender Equity, Inc www.genderhealth.org
CHF International www.chfinternational.org
1400 16th Street, NW
Christian Children’s Fund www.christianchildrensfund.org
Suite 210
Washington, DC 20036
Christian Reformed World Relief Committee www.crwrc.org
202-667-8227
Church World Service www.churchworldservice.org
reform@interaction.org CIVICUS www.civicus.org
Compassion International www.compassion.com
Concern Worldwide www.concernusa.org
www.interaction.org Congressional Hunger Center www.hungercenter.org
InterAction Health in Relief and Development Working Group (cont)

Organization URL

Congressional Research Service www.crs.gov
Counterpart International www.counterpart.org
Eastern and Southern Development Forum
Doctors without Borders www.doctorswithoutborders.org
Family Health International www.fhi.org
Food for the Hungry www.fh.org
Global Health Council www.globalhealth.org
Habitat for Humanity International www.habitat.org
Heartland Alliance www.heartlandalliance.org
Heart to Heart International www.hearttoheart.org
Heifer International www.heifer.org
Heifer Kenya www.heiferkenya.org
Interplast www.interplast.org
International Center for Research on Women www.icrw.org
International Crisis Group www.crisisweb.org
International Institute for Rural Reconstruction www.iirr.org
International Medical Corps www.imcworldwide.org
International Relief & Development www.ird.org
International Rescue Committee www.theirc.org
International Youth Foundation www.iyfnet.org
Jesuit Refugee Services USA www.jrsusa.org
John Snow International www.jsi.com
Latter-Day Saint Charities www.providentliving.org
Liberation Alliance for Change www.freewebs.com/liberationalliance
Lutheran World Relief www.lwr.org
Management Sciences for Health www.msh.org
MAP International www.map.org
Mercy Corps www.mercycorps.org
Mercy USA for Aid and Development www.mercyusa.org
National Peace Corps Association www.rpcv.org
Oxfam America www.oxfamamerica.org
Pact www.pactworld.org
Pan African Organization for Sustainable Development www.posdev.org
PATH www.path.org
Pathfinder International www.pathfind.org
Physicians for Human Rights www.phrusa.org
Plan USA www.planusa.org
Population Action International www.populationaction.org
Population Council www.popcouncil.org
Project Concern International www.projectconcern.org
ProLiteracy Worldwide www.proliteracy.org
RADEM
Refugees International www.refugeesinternational.org
Relief International www.ri.org
Salvation Army www.salvationarmyusa.org
Save the Children www.savethechildren.org
Stop Hunger Now www.stophungernow.org
Tampa Bay International Network
InterAction Health in Relief and Development Working Group (cont)

Organization URL

TechnoServe www.technoserve.org
U.S. Conference of Catholic Bishops www.nccbuscc.org
U.S. Committee for Refugees and Immigrants (USCRI) www.refugees.org
U.S. Committee for UNDP www.undp-usa.org
U.S. Fund for UNICEF www.unicefusa.org
USA for UNHCR www.usaforunhcr.org
Volunteers Association for Bangladesh www.vabonline.org
Winrock International www.winrock.org
Women for Women International www.womenforwomen.org
Women Thrive Worldwide www.womenthrive.org
Women’s Commission www.womenscommission.org
World Concern www.worldconcern.org
World Council of Credit Unions www.woccu.org
World Education www.worlded.org
World Hope International www.worldhope.org
World Learning for International Development www.worldlearning.org
World Relief www.worldrelief.org
World Vision www.worldvision.org
YMCA of the USA www.ymca.net
YouthNet www.fhi.org