We asked - you answered
August 1, 2009
When we unveiled this website earlier this month, we asked you to to submit your testimony to the Commission. You answered - with thought-provoking, insightful responses.
The Commission on Smart Global Health Policy can't complete its mission without quality input from experienced people like you, your friends and your colleagues. So thank you for your testimony, which we'll be sharing on our blog. Check back here often, or sign up for updates.
The first piece of testimony we feel compelled to share with you comes from Dr. Chad Swanson:
My name is Chad Swanson, and I am an ER physician, MPH student at Johns Hopkins, and the lead author on a recent publication in the journal Lancet calling for Health Systems Impact Assessments (HSIAs) on all global health activities. I am motivated by the prospect of more effective future global health interventions through the findings of your commission.
Experience and evidence suggest that one of the biggest challenges facing global health today is the disconnect between the need and the response. There is wide agreement that effective, efficient, and equitable health systems are needed to improve health in developing countries long-term. However, most of the recent funding has been targeted toward particular diseases. And understandably so: funding is easier to obtain because short-term indicators are easier to measure than the strength of the health system.
In the past few months, publications have reviewed the impact that those targeted, disease-specific (so-called "vertical") programs have had on the underlying health system. It has not always been positive. HSIAs would close the gap between the need and the response. Put simply, they would provide an evidence-based framework so that global health planners could consider the impact of their activitieis on the existing, underlying health system prior to implementation.
I am currently leading a number of global health professionals around the country and the globe to consider the very question that you are asking: What metrics and indicators should HSIAs use to be most effective, efficient, and equitable tools? For example, while a large portion of the global burden of disease is caused by diseases that can be prevented or treated by simple, cost-effective interventions in the home (diarrhea, pneumonia, etc.), few health systems assessment tools consider the household as an important component of the health system. I hope you'll consider involving our group's findings in your report, and hope for a continued discussion.
You can comment below on Dr. Swanson's testimony. Then submit your own testimony to the Commission.