PHM-Exch> A fabulous result (2)

[Claudio Schuftan]

From: NGHANIA, Frehd f_nghania at yahoo.com

This is a very encouraging inititative not only because it addresses the
concerns of wold's poorest communities but also initiated and spearheaded by
the developed economies and our health mother - WHO. However, I am
interested in knowing the criteria used to select first batch of countries
to benefit from it and adequacy of this meagre $5bn. What about the roll out
to other nations, how will it be handled, is it demand driven or supply
driven?

Also, I am a proponent of policies that  address sustainability of
programmes from the start. I am personally intrigued and would be happy to
get documents about this bilateral initiative so I can understand their
sustainability strategies.

I also would urge these developing nations .. to understand the 'seemingly
inevitable packages' before thinking they are as good as they look on the
surface. They have far reaching implications. If the implications are not
thought over at the start, countries risk going into ventures that cannot be
sustained and will harm our countries' fragile health systems.

Tere are other challenges such as inadequate  political will to deliver
health services to the poor, human resources imbalances between private and
public sectors that will hamper comittments to provide free health services,
etc. Unless these myriad challenges are addressed or atleast  be seen to be
addressed right at the programme development stages, provision of free
health services will remain a dream never to be achieved. I think developing
countries' health problems, besides financing,  are around dysfunctional
health systems, with a very rigid and selfish leadership, rampant
corruption, etc. We cannot fight this problem by getting a lot of money but
by conditional provisions. Developed countries, I think, play double
standards in many of the 'big brother' deals.

 Iam seeking other peoples' opinions on this 'seemingly fantastic solution'
to developing countries' health concerns.

 Nghania Frehd

PHM Uganda Chapter member

Kampala, Uganda
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