Environmental Engineering Reference
In-Depth Information
to encourage the production of needed, but low-profit, pharmaceuticals through
price incentive schemes.
on the discord between short-term assistance and the need to establish lasting
comprehensive health services in the developing countries, the DFID white paper is
lacking. It touches briefly on the need for effective healthcare systems in developing
countries, but this is done in relation to the delivery of the programmes to eradicate
disease (DFID 2000, 36). Here the paper does not allude to any greater quandaries
such as the impact of short-term targets on core health services or the need to
encourage sector-wide approaches while vertical responses are delivered through
global health initiatives to meet the challenge of infectious diseases.
United States Agency for International Development
the U.S. State Department and USAID (2003) put out the first joint strategic plan in
2003, which covers the period from 2004 to 2009. this document marked a growing
trend to place 'international development in line with defense and diplomacy as the
third pillar of U.S. national security'
(USaID 2005). It recognises that the primary
health challenge is posed by infectious disease, particularly the HIv/aIDS crisis.
It also declares that the U.S. government favours global responses such as global
health initiatives, given that it is the foremost country donor to the Global Fund
(U.S. Department of State and USaID 2003, 25; USaID 2002, 87). In fact, despite
a tendency to push its own large-scale bilateral initiatives, such as the United States
President's emergency Plan for aIDS relief (PePFar), the U.S. government does
pay attention to how its programmes fit in the overall global effort and framework
(U.S. Department of State and USaID 2001).
with regards to the issue of brain drain, both internal and more broadly, there is
no discussion. The strategic plan refers briefly to the matter of migration but does not
discuss its impact on health systems in the developing world (U.S. State Department
and USaID 2003, 27). additionally, the health section of USaID's website mentions
health systems, health workers, and health resources but not the international
movement of health practitioners, despite the fact that the U.S. is a major recipient
of such migrant workers, or the lack of resources in the developing world as a major
cause of poor health services (USaID 2007). rather, USaID focusses its strategies
for improving health systems through cost effectiveness, implementation of best
practices, and efficient time management. This can be a difficult set of solutions to
implement when the health practitioners necessary are not available.
the issue of local capacity for health matters as well as global research capacity
is also not discussed. the USaID (2002, 85) document mentions that 'for some
diseases endemic in the developing world, particularly parasitic diseases, scientific
knowledge remains inadequate to generate technological solutions in the near
term'. It goes on to acknowledge that GavI is working toward overcoming such
problems.
the lack of analysis of such growing concerns for health governance stems from
the overall framing of health challenges in the developing world. USaID's (2002)
