Despite the global economic situation, investment in health systems that provide accessible, affordable and quality care to the developing world cannot wait. The Rockefeller Foundation, with its deep global health history, is positioned to take on the challenge of strengthening health systems
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Lanham, MD (Vocus) July 2, 2009
On Wednesday, July 1st, Rockefeller Foundation President Judith Rodin announced a new initiative reaffirming its legacy in and commitment to the field of global health - a history which includes founding schools of public health, developing a Nobel Prize-winning vaccine for yellow fever, pioneering Africa's earliest AIDS treatment programs, and mobilizing public-private partnerships that accelerate the search for AIDS, tuberculosis and malaria drugs. In launching "Transforming Health Systems" (THS), the Foundation shifts its focus from treatments and vaccines to informing the efforts of low-income countries to take on the challenges of health systems. The goal is to expand health coverage and provide new health and financial protections for all.
While health spending has increased dramatically around the world, access to affordable, quality services has not, particularly in developing countries. In many places, financial support and technical interventions cannot reach the people who most need them. The Foundation's work will help low income countries remove barriers to effective, efficient health systems, thus opening new avenues to bring revolutionary treatments and cures to the places and communities where they'll make the greatest difference.
In well-built, accessible health delivery systems, disease and death rates should decrease as spending and the number of people cared for increases. In Sub-Saharan Africa, however, under-5 mortality rates have decreased by only 15 percent since 1990, despite increased health spending. This is a relatively low success rate compared to a decrease of more than 50 percent in Latin America and the Caribbean during the same period. Additional research shows that Sub-Saharan Africa shoulders 24 percent of the global disease burden, but benefits from only 3 percent of the world's health workers.
In developing countries with inefficient health systems, the majority of health spending is paid out-of-pocket, making care unaffordable for most people. A recent report from the World Health Organization estimated that as a result of inadequate health systems, 125 million people spend nearly half their annual income in health care, and catastrophic health expenditures send 25 million families back into poverty every year.
"The Rockefeller Foundation has long been committed to public health interventions in the developing world to break bottlenecks that prevent access to quality health services," said Dr. Judith Rodin, President of the Rockefeller Foundation. "Although it is imperative that we continue developing and delivering new vaccines and medicines, many people still cannot access a clinic, pay out-of-pocket costs for medication and treatment, and fall into poverty as a result. As countries begin to make significant investments in public health, the Foundation's Transforming Health Systems initiative will help ensure that investment is felt universally by supporting national efforts to provide equitable access."
"The Foundation and its partners will work on both promoting a global agenda on health systems strengthening and the progressive adoption of universal health coverage," said Dr. Ariel Pablos-Mendez, Managing Director responsible for THS. "A country's shift to universal coverage does not happen overnight. As some low-income countries have already demonstrated, it is built on the reorganization of domestic financing rather than the influx of increased amounts of foreign aid. If invested more wisely, increases in health spending can contribute to sound economic policy, better health outcomes, and lower rates of poverty."
The Foundation and its partners will foster more accessible, efficient health systems with improved financial protections to make universal health coverage an accepted, feasible, and desirable goal adopted by countries throughout the world. The Foundation hopes to provide governments and leaders with resources and information to manage their country's health systems - and to ensure that integrated ehealth systems are developed and leveraged to improve the quality, access, and affordability of health services among low-income populations.
The five-year THS initiative will launch with investments in three countries, Ghana, Rwanda, and Vietnam, and also support select activities at the regional and global level. Learning from these countries will then be applied to others in the region with subsequent investments and be key to the initiative's success.
Beyond international research and advocacy, the THS initiative will utilize a three-tier strategy to create lasting, impactful, and measurable systemic health shifts at the country level:
I. Enhancing professional capacity for national stewardship of health systems
THS will support health leadership development, innovation in health, health policy and financing, and the collection of crucial data for planning and monitoring health system performance.
II. Harnessing the private sector as a significant component of health systems
Since the private sector accounts for 50 to 80 percent of health systems in Africa and Asia, THS will work to leverage the capacity and innovation of non-state actors while enhancing the capacity of the state to regulate and contract the private sector.
III. New partnerships and interoperable eHealth systems and applications
THS will support new partnerships and the development of local capacity to build and leverage information technologies, including mobile phones, electronic health records, integrated health information systems, and their applications to improve quality, access and affordability of health services.
"Despite the global economic situation, investment in health systems that provide accessible, affordable and quality care to the developing world cannot wait. The Rockefeller Foundation, with its deep global health history, is positioned to take on the challenge of strengthening health systems," said James Nyoro, Managing Director Rockefeller Foundation Africa. "With the incredible influx of funding that has gone into vertical interventions in the region, the Foundation feels that now is the necessary time to build on our successes in capacity building and technological interventions to help countries develop systems that will enable new innovative drugs and treatments to reach the people truly in need."
The Foundation's newest initiative will coordinate with key grantees and partner institutions, including government and non-government organizations, policy and research centers, professional associations, private sector entities, and international development agencies and donors.
The Rockefeller Foundation fosters innovative solutions to many of the world's most intractable challenges, affirming its mission, since 1913, to "promote the well-being" of humanity. Today, the Rockefeller Foundation works to ensure that more people can tap into globalization's benefits while developing stronger resilience to its risks. In addition to its health work, Foundation initiatives in Africa include integrated efforts to mobilize an agricultural revolution, create new markets for impact investing, shape advances in urban planning, finance, infrastructure, and governance, and help vulnerable communities cope with imminent and worsening affects of climate change.