Upholding the Principles of Development Effectiveness for Health System Strengthening in the Eastern Mediterranean Region (EMR)—Why It Is Important Now More than Ever

The Eastern Mediterranean Region (EMR) of the World Health Organisation (WHO) consists of 22 countries and territories which are exposed to high levels of natural and man‐made emergencies, and which have significant gaps in coverage of essential health services. Narrow fiscal space, economic distress, periodic shocks of conflicts, pandemics and natural disasters, and sharp declines in development assistance, are factors contributing to gaps in access to essential health services. The region receives development assistance from a range of development partnerships, which, although contributing to improved programme coverage and disease prevention, has been limited in developing and sustaining longer term health system capabilities. The increasing threats of conflict, pandemics and climate‐related natural disasters, as well as the recent sharp downturns in development assistance, builds the case for more effective, efficient and equitable development assistance programming. Development assistance principles of alignment of health partnerships with sector priorities and building of country systems provide opportunities to sustainably address chronic health coverage and equity challenges, improve the capability of health systems to withstand periodic shocks, and sustain health programme improvements over longer time frames. In this paper, we describe how these principles are being applied in the region through country health compacts for universal health coverage, country and regional coordination models, and implementation of monitoring and evaluation of development effectiveness. Given the rapidly changing development landscape, application of development effectiveness principles provides opportunities to strengthen health systems, safeguard health security, and progress towards universal health coverage.