PHA-Exch> How have Global Health Initiatives impacted on health equity?

[Claudio Schuftan]

-------From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org


 *How have Global Health Initiatives impacted on health equity?*



Johanna Hanefeld

*Health Policy Unit, London School of Hygiene and Tropical Medicine
*Promotion & Education, Vol. 15, No. 1, 19-23 (2008)

* *

PDF online at: http://ped.sagepub.com/cgi/reprint/15/1/19



Website: http://ped.sagepub.com/cgi/content/refs/15/1/19



"……..This review examines the impact of Global Health Initiatives (GHIs) on
health equity, focusing on low- and middle-income countries.



It is a summary of a literature review commissioned by the WHO Commission on
the Social Determinants of Health. GHIs have emerged during the past decade
as a mechanism in development assistance for health.



The review focuses on three GHIs, the US President's Emergency Plan For AIDS
Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the
Global Fund to Fight AIDS, TB and Malaria. All three have leveraged
significant amounts of funding for their focal diseases — together these
three GHIs provide an estimated two-thirds of external resources going to
HIV/AIDS.



This paper examines their impact on gender equity. An analysis of these
Initiatives finds that they have a significant impact on health equity,
including gender equity, through their processes of programme formulation
and implementation, and through the activities they fund and implement,
including through their impact on health systems and human resources.



However, GHIs have so far paid insufficient attention to health inequities.
While increasingly acknowledging equity, including gender equity, as a
concern, Initiatives have so far failed to adequately translate this into
programmes that address drivers of health inequity, including gender
inequities.



The review highlights the comparative advantage of individual GHIs, which
point to an increased need for, and continued difficulties in, harmonisation
of activities at country level. On the basis of this comparative analysis,
key recommendations are made. They include a call for equity-sensitive
targets, the collection of gender-disaggregated data, the use of
policy-making processes for empowerment, programmes that explicitly address
causes of health inequity and impact assessments of interventions' effect on
social inequities. …."
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