The Global Health System: Lessons for a Stronger Institutional Framework
AbstractThe global health system is in a period of rapid transition, with an upsurge of funds and greater political recognition, a broader range of health challenges, many new actors, and the rules, norms and expectations that govern them in flux. The introductory article of this series (SzlezÃ¡k et al. ) laid out some of the many challenges facing the global health system. This system is defined as the constellation of actors (individuals and/or organizations) â€œwhose primary purpose is to promote, restore or maintain health â€ and â€œthe persistent and connected sets of rules (formal or informal), that prescribe behavioral roles, constrain activity, and shape expectation â€ among these actors. The second article (Frenk ) defined the key attributes of national health systems as a core component of the global system. The third article (Keusch et al. ) analyzed the institutional evolution of one of the system's most important functionsâ€”the integration of research, development, and delivery. This concluding article draws on the others in the series. It also draws from a year-long effort that included case studies, two international workshops of scholars and practitioners and ongoing discussions by the authors, to summarize lessons learned and propose future actions to strengthen the system as a whole. The project used as a case study the global health system's evolving response to malaria. Nevertheless, the workshops and discussions that informed this analysis drew from a broader range of cases, and we believe lessons learned may usefully apply beyond malaria alone. Furthermore, while recognizing the many determinants of health and interlinkages between health and other issue areas such as trade and environment ,, we limit our scrutiny here to the global health system. The project concluded that an effective global health system must accomplish at least five core functions: agenda-setting; financing and resource allocation; research and development (R&D); implementation and delivery; and monitoring, evaluation, and learning. We discuss here ways to improve each of the five functional areas, consider the implications for the role of the World Health Organization (WHO), and make recommendations for future action.
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Bibliographic InfoPaper provided by Harvard Kennedy School of Government in its series Scholarly Articles with number 5341873.
Date of creation: 2010
Date of revision:
Publication status: Published in PLoS Medicine
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- Bloom, Barry R. & Keusch, Gerald T. & Michaud, Catherine M. & Moon, Suerie & SzlezÃ¡k, Nicole A & Jamison, Dean T. & Clark, William C., 2010. "The Global Health System: Actors, Norms, and Expectations in Transition," Scholarly Articles 5341871, Harvard Kennedy School of Government.
- James Putzel, 2004. "The global fight against AIDS: how adequate are the national commissions?," Journal of International Development, John Wiley & Sons, Ltd., vol. 16(8), pages 1129-1140.
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