Global Health Initiatives
Annan stated that the GHI's mission was to engage businesses in public-private partnerships to tackle HIV/AIDS, tuberculosis, malaria, and health systems.
Gavi has approved US$3.7bn for the period 2000-2015[8] The amount of political priority given to Global Health Initiatives varies between national and international governing powers.
Global political priority is demonstrated through national and international leaders expressing sustained concern both privately and publicly, political systems and organizations enacting policies to help alleviate the issue, and national and international agencies providing resource levels that reflect the severity of the given crisis.
[1] However, case studies have shown that the likelihood of global initiatives garnering public and political attention is not limited to the aforementioned factors.
[10] As such, a common response in evaluations of GHIs is to acknowledge the inherent limitations of establishing causal chains in what is a highly complex public health environment, and to base conclusions on adequacy statements resulting from trends that demonstrate substantial growth in process and impact indicators.
Accordingly, existing debates suggest that GHIs should be less concerned with the eradication of specific diseases, and should instead focus primarily on factors – such as basic living conditions, sanitation, and access to nutritious food – that are essential to delivering a sustainable heath program.
Longitudinal studies enable researchers to establish baseline data and then track and compare GHI effects on disease control or country health systems over time.
[13] In 2009, research findings were published from tracking studies in Kyrgyzstan, Peru and Ukraine that sought to identify the health effects of the Global Fund at national and sub-national levels.
[citation needed] In contrast to longitudinal studies, multi-country analyses of GHIs can provide a 'snapshot' of GHI effects but are often constrained by "aggressive timelines".
[14] The Maximising Positive Synergies Academic Consortium, for example, reported in 2009 on the effects of the Global Fund and PEPFAR on disease control and health systems, drawing on data from 20 countries.
[15] Most GHI evaluations – both internally and externally commissioned – rely on this type of short-term analysis and, inevitably, there is often a trade-off between depth and breadth of reporting.
Early synthesis studies include a 2004 synthesis of findings on the effects of the Global Fund in four countries[16] by researchers at the London School of Hygiene and Tropical Medicine (LSHTM), a 2005 study by McKinsey & Company[17] and an assessment of the comparative advantages of the Global Fund and World Bank AIDS programs.
In a comparison between the three largest donors in sponsoring efforts to win the fight against AIDS in Africa, a research study found that PEPFAR performs best in money transfer and data collection; the Global Fund outperforms in tailoring programmatic initiatives and sharing data; and MAP performs highest in collaborating with government systems, strengthening health systems, and helping to build the capacity of local recipients.
[citation needed] The primary purpose of the MAP initiative was to introduce a major upscaling of multi-sectoral approach to responding to the HIV/AIDS crisis in Sub-Saharan Africa by involving a multitude of stakeholders including community-based organizations (CBOs), non-governmental organizations (NGOs), line ministries, and state governments at the highest levels.
In 2005, the Bank conducted an internal evaluation – "Committing to Results: Improving the Effectiveness of HIV/AIDS Assistance" – which found that National AIDS strategies were not always prioritised or costed.
However, the existing global debate questions the efficacy of HSS programs aimed at targeting technical solutions with clear measurable outcomes versus those more broadly focused on supporting holistic health systems.
