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Lancet. 2010 Oct 30; 376(9751):1439-40.This commentary discusses how the pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria from countries, the private sector, and innovative funding sources have fallen short of the demand estimates, despite the pledged sum being the largest amount ever mobilized for global health. The US $11.7 billion pledge for the 2011-2013 time range is an increase of more than 20% over 2007-2010 and will go toward maintaining programs at their current scale and support further significant expansion of health services in many countries. It explains that the shortfall to meet the $13 billion will result in challenging decisions about which new programs to support and a slower rate of scale-up for new programs.
Indian Journal of Community Medicine. 2010 Apr; 35(2):326-330.Background: The World Health Report, 2008, contains a global review of primary health care on the 30th anniversary of the Declaration of Alma-Ata. The period covered by the study reported on here corresponds with that of the Report, allowing for a comparison of achievements and challenges in one primary health care centre vis-a-vis the WHO standards. Materials and Methods: This study uses qualitative and quantitative data from a rural primary care facility in Western Maharashtra, collected over three decades. It analyzes the four groups of reforms defined by WHO in the context of the achievements and challenges of the study facility. Results: According to the WHO Report, health systems in developing countries have not responded adequately to peoples needs. However, our in-depth observations revealed substantial progress in several areas, including in family planning, safe deliveries, immunization and health promotion. Satisfaction with services in the study area was high. Conclusion: Adequate primary health care is possible, even when all recommended WHO reforms are not fully in place.
Expanding Concern for Women's Health in Developing Countries. The Case of the Eastern Mediterranean Region.
Women's Health Issues. 2010 May-Jun; 20(3):171-177.Background: Women's health is still largely associated with the notion of reproduction in developing countries despite a more varied disease burden, including noncommunicable conditions resulting from consequences of changing epidemiologic and demographic patterns on women's health. Methods: The World Health Organization (WHO) Global Burden of Disease data base is used to derive for the Eastern Mediterranean Region (EMR) cause-specific rates of death and of disability-adjusted life-years (DALYs) by age for adult women, and percent of total deaths and total DALYs for women in the reproductive ages, as related to maternal conditions and to three selected noncommunicable conditions, namely, cardiovascular disease, cancer, and neuropsychiatry conditions. Inequalities by country income category are examined. Results: Maternal health conditions still form a substantial component of the disease burden, with an increasing burden of cardiovascular disease and cancer starting in the late reproductive years and beyond. The burden of neuropsychiatric conditions is also high during the reproductive years, reflecting possibly the stress of multiple roles of women as well as stress of war and conflict that permeate the EMR. Women in low- to middle-income countries suffer more from maternal health conditions and less from neuropsychiatry conditions than women in high-income countries. Conclusion: The wider disease burden of women should be addressed making use of available reproductive health services taking special account of interactions between reproductive and noncommunicable conditions for better health of women during and beyond reproduction. Better measures of the burden of illness should be developed. There is a special need for improved health information systems in the EMR.
Strong ministries for strong health systems. An overview of the study report: Supporting Ministerial Health Leadership: A Strategy for Health Systems Strengthening.
[Kampala], Uganda, African Centre for Global Health and Social Transformation [ACHEST], 2010 Jan.  p.This overview is adapted from the report Supporting Ministerial Health Leadership: A Strategy for Health Systems Strengthening by Dr. Francis Omaswa, executive director and founder of The African Center for Global Health and Social Transformation (ACHEST) and Dr. Jo Ivey Boufford, president of The New York Academy of Medicine (NYAM). The study and report were commissioned by the Rockefeller Foundation to explore the feasibility of establishing a support mechanism for ministers and ministries of health especially in the poorest countries, as part of the Foundation’s Transforming Health Systems initiative, The study was initially designed to assess the potential value of three proposed programs to strengthen the leadership capabilities of ministers of health: a global executive leadership program for new ministers; an ongoing, regional, in-person and virtual leadership support program for sitting ministers; and a virtual global resource center for ministers and high level ministerial officials providing real-time access to information. During the course of the study, it became clear that it was essential to expand the inquiry to better understand the challenges and needs of ministries as a whole, as they and their ministers provide the stewardship function for country health systems.The content of the report was derived from six major activities:a comprehensive literature review of the theory and practice of effective leadership development and organizational capacity building, and an environmental scan to identify any existing or planned leadership development programs for ministers of health or any that have occurred in the recent past globally; a survey of the turnover of ministers of health; targeted interviews with ministers, former ministers, and key stakeholders who interact with them, conducted between October 2008 and September 2009, to better understand the roles of ministers and ministries, the challenges they face, resources at their disposal, and their thoughts on what additional resources might enhance their personal effectiveness and that of their ministries; a consultative meeting of experts and stakeholders held in Bellagio, Italy part way through the project; participation of the project leaders (Omaswa and Boufford) in relevant global and regional meetings, as well as individual meetings about the project with critical leaders in international and donor organizations and potential champions of this effort; and a consultation with African regional health leaders to discuss the final report, held in Kampala, Uganda. (Excerpt).