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Resilient & Sustainable Systems for Health

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Weak systems for health end up being costly – and fatal – for nations, as the 2015 Ebola outbreak showed. According to the World Bank, the Ebola crisis cost the three countries most affected at least US$2.2 billion in foregone economic growth.

This is almost three times what it would have cost to build health systems capable of providing the minimum package of health services in these three countries.

Weak systems for health hit the poorest and most vulnerable the hardest. These are the people who often are least able to access health care because they are unable to pay or because they live too far from any health care facility.

The Ebola crisis in West Africa was a wake-up call and revealed the unique problems that occur in challenging operating environments. Health and access to health care needs to be understood as part of a development continuum.

And investments in systems for health need to be targeted based on where a country stands on that development continuum.

Investments in programs for AIDS, TB and malaria build stronger health systems because they free up resources to treat other conditions. For example, people suffering from AIDS-related illnesses once occupied 90 percent of all hospital beds in sub-Saharan Africa. That percentage has plummeted. Inpatient admissions for malaria have also declined significantly, making hospital space and health care professionals available to treat other illnesses.

Healing the community

Ethiopia’s population of 85 million people lives, for the most part, in small rural communities widely dispersed, making access to health care a significant challenge. In the last decade, however, the Ethiopian government has built or upgraded 15,000 village-level health care facilities across the country. These facilities, called health posts, have brought health care closer to the people. Now more than 92 percent of Ethiopians live within 10 kilometers of a public health care facility. The health posts are supported by the Health Service Extension Program, through which 38,000 women have been trained to serve communities as health extension workers.

Building health systems

A resilient and sustainable system for health relies on data. Quality health data is essential – data is what allows countries to design and deliver the right health services to the right people at the right time. Data allows resources to be spent in the most efficient and effective way. Data systems include everything from mobile phone applications to collect data on malaria cases to sophisticated national disease surveillance and reporting systems.

Another key element in ensuring health care is a reliable and dependable system for the procurement and delivery of drugs and supplies. Global Fund investments are helping countries improve their supply chain management, including commodity planning, logistics management, warehousing and information tracking.

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Investing in resilient and sustainable systems for health

Stronger systems provide more people with health care. Systems for health do not stop at a clinical facility but run deep into communities and can reach those who do not always go to health clinics, particularly the vulnerable and the marginalized. Systems for health involving the community will always be the first to identify, report and respond to emergency health threats. This is why we focus on supporting community-level solutions and community-level involvement wherever possible.

Our strategy for 2017-2022 focuses on the following priorities in terms of resilient health systems:

  • Support national health strategies and national strategic plans to control HIV, TB and malaria;
  • Focus on a person, not just a disease: support integrated service delivery;
  • Support specific aspects of a resilient health system central to the Global Fund’s mission and core competencies, such as procurement and supply chain management, quality assurance of programs through strong data management and human resources, and financial and risk management;
  • Capture and catalyze innovation from across all sectors to drive greater impact and value for money;
  • Promote and reinforce community responses and involve affected communities in national decision-making;
  • Support countries to leverage domestic and international financing for their systems for health;
  • Tailor investments to the unique stage a country is in along the development continuum, to its specific health system and to the unique constellation of partners in each nation.

Stronger health systems mean more people have access to health care. Better health leads to stronger economies. Between 2000 and 2011, 24 percent of income growth in low- and middle-income countries were driven by improved health. Investments in health go a long way.

Published 15 January 2017

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