[health-vn] EG4Health Newsletter 5]

Vern Weitzel vern.weitzel at gmail.com
Tue May 12 03:31:34 EST 2009 

Subject: 	PHA-Exch> EG4Health Newsletter 5
Date: 	Mon, 11 May 2009 20:03:41 +0700
From: 	Claudio Schuftan <cschuftan at phmovement.org>
To: 	pha-exchange at phm.kabissa.org


From: **info at eg4health.org <mailto:info at eg4health.org>


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     Welcome to the EG4Health Newsletter!


   Newsletter 5, 10th May 2009

In this newsletter from EG4H...

     * A decade of health funding from the World Bank - but to what end
       for the poor? Damning findings from the World Bank's Independent
       Evaluation Group
     * WHO Director Margaret Chan's withering critique of liberal
       economic governance and its impact on health
     * 'Just out' links to the latest global economic news and events


   Are you interested in helping us get the word out about the importance
   of economic governance for health?

Would you like to do more and join our active campaign outreach network?
We have an expanding number of 'outreachers' who help *amplify* our
message. Typically they do this by:

     * Forwarding information about EG4H to your own network of contacts
       and lists
     * Encouraging people to respond to an EG4H request or to take up
       action on an event we are promoting.

*If you are interested in joining* this network of active campaigners,
or can suggest organizations - or better still *key people within those
organizations* - whom we should contact, please send an email to
info at eg4health.org <mailto:info at eg4health.org>


     Unaccountable, inefficient, and weak: a decade of World Bank funding
     for health, nutrition, and populations

The World Bank's Independent Evaluation Group has just published
‘Improving effectiveness and outcomes for the poor in HNP’
<http://madmimi.com/redirects/65c08d704d9c8367b566512cd39fda6b?pa=95644929>
- its evaluation of ten years of Bank projects for Health, Nutrition,
and Population (HNP)

Since 1997 the Bank has provided $17bn for HNP. What has this massive
investment achieved, and what does it tell us about the Bank's role in
governing global health?


   Blind support for a Sector-Wide Approach (SWAp) to health

The IEG evaluation found that whilst the Bank’s support for SWAPs had
increased since 1997, its support for Health Systems Strengthening was
down *by over 50%.*. Moreover, *only one third* of Bank projects that
supported health SWAPs have performed satisfactorily on meeting their
health objectives. Furthermore, the Bank has absolutely no idea which
programs are working or why because monitoring and evaluation by the
Bank of its projects is almost completely absent.

The IEG leaves no doubt about the consequences of such weak M&E:
“irrelevant objectives…inappropriate project designs [and] unrealistic
targets”. The IEG's conclusion about the Bank's use of a SWAp is equally
worrying. Complex projects (such as SWAPs) were *least likely* to
achieve their HNP objectives.


   Nutrition and Population anyone?

And what about Bank support for Nutrition and Population? Support for
Nutrition is down by 50% - to just 10% of projects – reaching just 25%
of developing countries with high levels of stunting; whilst Bank
projects for ‘Population’ (meaning reducing fertility rates or improving
access to family planning) were down to just 4% of the Bank’s portfolio
of projects – reaching 25% of countries with highest fertility rates.
The IEG's summary statement says it all: *“Performance of HNP support in
Africa was particularly weak, with only 1 in 4 projects achieving
satisfactory outcomes”.*


   The Bank is not learning from its mistakes

The IEG makes a pointed comment in its Report that the reasons it gives
for such poor performance by the Bank are precisely the same reasons for
poor performance identified by its 1999 evaluation of the HNP sector.


   Who cares about the health of the poor? The Bank doesn't.

The IEG found that only 6% of all HNP projects committed to deliver
better health or nutrition to the poor in their statement of objectives.
Very few actually measured whether the poor benefited in relation to the
non-poor or in relation to those in areas not reached by the projects;
and even fewer measured whether the poor *had* disproportionately
benefited. Furthermore, the share of country poverty assessments with a
specific health component has dropped from 80-58%.

The final message of the IEG Report says it all: *“Bring the health and
nutrition of the poor and the links between high fertility, poor health,
and poverty back into poverty assessments”*


     Steadfast in the midst of perils - WHO head slams global liberal
     market economy

In her Keynote address
<http://madmimi.com/redirects/b1f2ffb845e77499a0baa9bd20f5f653?pa=95644929>
at the 12th World Congress on Public Health in Istanbul in April,
Margaret Chan delivered a scathing critique of the global liberal market
economy.

It is remarkable that such a senior health official is prepared to be so
frank in their criticism of the global economic system, and her words
resonate with many of the core messages that EG4H is trying to spread.

For example, Chan argues: "The single-minded pursuit of economic growth,
compounded by behaviours motivated by greed, has had negative
consequences well beyond the financial and economic sectors". EG4H makes
precisely this point in relation to trade and health - read more
<http://madmimi.com/redirects/23fd4f7a7508929ed068300c16ac9ebd?pa=95644929>
on our website.

Chan also argues for "a fundamental re-engineering of the international
systems", to give them "a moral dimension and to invest them with social
values - like equity, sustainability, community, and social justice".
Again, we are with Chan 100%. On social justice, for example, read what
the EG4H has to say here
<http://madmimi.com/redirects/9bddc3a075bb9678fa1836224520b56b?pa=95644929>.

In unambiguous terms, Chan asserts: "The market does not solve social
problems. Public health does", and draws the solution back to Primary
Health Care and the value system of the Alma Ata Declaration three
decades ago.


     Just out! Links to the latest writing and events on economic
     governance for health


   World Bank triples its financial support for health systems strengthening

The World Bank announced on the 24th April that it will be mobilizing up
to $3.1 billion this year in health financing - approximately $2 billion
more than the $1 billion it spent in 2008. According to the Bank, the
extra funds "will be used to strengthen health systems in poor
countries, boost their performance in preventing and treating
communicable diseases, and improving child and maternal health, hygiene
and sanitation". Read the announcement here
<http://madmimi.com/redirects/b22464dfd2994095e61588c193ceae6b?pa=95644929>


   International Civil Society position paper on global health presented
   to G8 health experts

In a new pape
<http://madmimi.com/redirects/676eb971f017c9540fb2984fdcc95447?pa=95644929>r
presented to G8 health experts, international CSOs are calling on the G8 to:

     * Honor their financial commitments to health made in the previous
       G8 Summit
     * Guarantee the full implementation of Health Millennium Development
       Goals (MDGs) by 2015,
     * Ensure that the innovative financing mechanisms for health
       mobilise resources that are additional to Official Development
       Assistance
     * Ensure that international health interventions are harmonized and
       aligned with national health plans
     * Strengthen free, public-led basic health services at the community
       level in order to effectively promote universal access


   A global fund for the health MDGs?

In a 2nd of May Comment in the Lancet,
<http://madmimi.com/redirects/16927ed47383732ba1e835badb383301?pa=95644929>
Giorgio Cometto , Gorik Ooms, Ann Starrs, and Paul Zeitz "recommend that
the Global Fund and the GAVI Alliance gradually move towards becoming a
global fund for all the health MDGs", and they list some desirable
features that they would like to see structure this new addition to the
global economic health governance architecture. Read more...
<http://madmimi.com/redirects/975dfc1de2497ba5641e55624420c270?pa=95644929>60835-7/fulltext?version=printerFriendly)


     EG4Health is more than words - Here's how you can get involved:

*Add your name to our open letter
<http://madmimi.com/redirects/8cf61176a98bcdc1628a7c6baea7f804?pa=95644929>*
to Dr Margaret Chan

*Join the group* – simply send an email to *info at eg4health.org
<mailto:info at eg4health.org>*

*Sign our 30 second supporter survey
<http://madmimi.com/redirects/83c9e61507e7d4ec42fe91893f29ce0c?pa=95644929>*
- we want to know how to help strengthen your collective voice through
our campaigning and advocacy work

©2009 Economic Governance for Health | London

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