PHA-Exchange> BUILDING STRONGER HEALTH SYSTEMS KEY TO REACHING THE HEALTH MILLENNIUM DEVELOPMENT GOALS

[Claudio]

From: "Vern Weitzel" <vern.weitzel at undp.org>
 *BUILDING STRONGER HEALTH SYSTEMS KEY TO REACHING THE HEALTH  MILLENNIUM
DEVELOPMENT GOALS*
> >
> > *Geneva -* Building up and strengthening health systems is vital if
> > more progress is to be made towards the Millennium Development Goals
> > (MDGs), the World Health Organization (WHO) said in a new report.
> > Unless urgent investments are made in health systems, current rates of
> > progress will not be sufficient to meet most of the goals.
> >
> > The report,/ Health and the Millennium Development Goals,/
> > _http://www.who.int/mdg/publications/mdg_report/en/index.html_
> > presents data on progress on the health goals and targets and looks
> > beyond the numbers to analyse why improvements in health have been
> > slow and to suggest what must be done to change this. The report
> > points to weak and inequitable health systems as a key obstacle,
> > including particularly a crisis in health personnel and the urgent
> > need for sustainable health financing.
> >
> > Without more rapid progress on developing health systems, large
> > numbers of people will continue to die from mostly preventable
> > diseases. Annual avoidable deaths in developing countries include:
> > almost 11 million children under five, approximately one million
> > people from malaria, and more than half-a-million women in pregnancy
> > and childbirth. The HIV/AIDS pandemic takes three million lives each
year.
> >
> > "Building strong health systems requires improvements across
> > governments - in public financial management, manpower planning, roads >
> and infrastructure, and many other areas," said WHO Director-General
> > Dr LEE Jong-wook. We need to look beyond the health sector if we are > >
to be successful, and we must take an integrated approach. If we do,
> > success/ is/ possible.
> >
> > Despite gains in reducing poverty worldwide, the data presented in the
> > new WHO report indicate that if trends established in the 1990s
> > continue, the majority of developing countries will not achieve the
> > health MDGs. This in turn will affect progress towards other goals.
> > With less than ten years to the target date of 2015, none of the
> > poorest regions of the developing world are on track to meet the child
> > mortality target. For maternal mortality, declines have been limited
> > to countries which already have lower mortality levels. The goal of
> > reversing the spread of HIV/AIDS and reversing the incidence of
> > malaria and other communicable diseases remains a huge challenge in
> > sub-Saharan Africa. The safe water target may be achieved globally,
> > but not in sub-Saharan Africa.
> >
> > "Providing universal access to broad-based health services could save
> > several million children's lives each year,said Dr LEE.  That would
> > reverse the downward trends and bring us two-thirds of the way to
> > meeting the child mortality goal, and 70% to 80% towards meeting the
> > maternal mortality goal.
> >
> >  We have the treatments; the technology is known and affordable,Dr LEE
said. The problem in many countries is getting the staff, medicines,
> > vaccines and information to those who need them on time and in
> > sufficient quantities.  In too many countries, the health systems to
> > do that either do not exist or are on the point of collapse.
> >
> > WHO says securing sustainable health systems financing is key. A
> > minimum of  US$ 30-40 per capita is needed annually to finance a
> > minimum health package, but many poor countries invest far less, on
> > average US$ 10 per capita, and in some countries, as little as US$ 2
> > per capita.  Achieving the health MDGs will be impossible without a
> > considerable increase in investment and commitment from developing and
donor countries.  The UN Millennium Project recently said that meeting
> > all the MDGs would require an estimated US$ 135 billion of Official
> > Development Assistance, rising to US$ 195 billion by 2015.
> >
> > Health systems require not only urgent investment, but also
> > commitments from developing countries to increase accountability and
> > prioritize health in national and poverty reduction plans, and from
> > donors to better coordinate aid. One example of lack of coordination
> > given in the report is that of Viet Nam, where 400 donor missions
> > visited in one year.  Lack of coordination renders already fragile
> > health systems even weaker. In an effort to tackle this problem in
> > relation to health statistics, a wide range of partners has come
> > together to form the Health Metrics Network, a global partnership
> > designed to improve the availability and quality of health data and
> > thus enhance accountability.
> >
> > In many countries, particularly in Africa, lack of staff is at the
> > centre of the health systems challenge. Out-migration, deaths from
> > AIDS and above all, poor pay and conditions have created a human
> > resources crisis,said Dr Ties Boerma, WHO director of Measurement and
Health Information Systems, 90% of Africa lives in areas where there
> > are fewer than five doctors per 10 000 people.
> >
> > At the 2005 World Health Assembly, WHO Member States repeated the call
for donors to raise levels of Official Development Assistance to 0.7%  of
GNP; this was coupled with a call for developing countries to also
> > prioritize health in their national budgets and for African countries
> > to meet their pledge to do so made in Abuja in 2001.
> >
> > /Health and the Millennium Development Goals/ also identifies future
> > health challenges in the developing world. If health is to have its
> > full impact on reducing poverty, there is a need to address:
> >
> >     * the growing burden of noncommunicable disease in the developing
> >       world, which is leading to a double burdenof ill-health;
> >     * the nutrition transitionin which people in developing countries
> >       begin to adopt unhealthy eating habits common in richer
> >       countries and suffer the health consequence;
> >     * the need for universal access to reproductive and sexual health
> >       services as agreed at the Cairo International Conference on
> >       Population and Development; and
> >     * the impact of globalization on the spread of disease and
> >       migration of health staff.
> >
> > Achieving the health-related goals and targets is a critical part of
> > the MDGs, agreed to by 189 world leaders through the Millennium
> > Declaration at a summit in 2000. Heads of state and government will
> > again gather in New York from 14 - 16 September for the 2005 World
> > Summit to review the commitments made in the Millennium Declaration.
> >
> > Three out of eight goals relate to health, as well as eight out of 18
> > targets, and 18 of 48 indicators.  With other agencies, WHO is
> > responsible for statistics on 17 of the 18 health indicators.