Dear Colleagues,

Following international (health) politics can be dazzling. The large number of actors, the continuous formation of alliances and networks, the fact that one new global initiative after another seems to pop up, … one can be forgiven for not seeing the forest for the trees anymore. Obama, the beleaguered US president, probably felt the same way this week in his State of the Union when he chuckled that he hadn’t exactly been pushing for health care reform because it was ‘good politics’. Anyway, Obama made some effort to shift towards the centre. Health sector reform seems no longer his main priority (although he still wants to see the job done, he insisted); economic recovery is now key. Elsewhere, in Davos, Sarkozy stole the limelight with a speech on the need for moral capitalism. No kidding.

Since one year now, in the IHP newsletter, we try to keep you updated on the big picture and put things in perspective. One of the hot topics in the present health policy arena is health system strengthening. As it is a crucial issue, we are happy to introduce the ‘Selected Readings on Health Systems’ to you, an initiative linked to the ‘International Health Policy’ newsletter and developed by ITM and the health systems network. Its aim is to provide a monthly selection of recent health system articles with a short review of their relevance. Issues can be found at and subscription is possible via

Enjoy your reading.

David Hercot, Kristof Decoster, Josefien Van Olmen and Wim Van Damme

Global Health Financing

1. Lancet – Financing of health systems to achieve the health Millennium Development Goals in low-income countries

Robert Fryatt, Anne Mills, Anders Nordstrom ;

This interesting paper lists the challenges faced by the High Level Taskforce on Innovative International Financing for Health Systems and by its Working Groups. The summary already provides an interesting list of identified challenges. The authors conclude that these issues are similar to many issues that decision makers face in low-income countries. International institutions should team up with national policy makers “to improve the evidence base for strengthening health systems, increase long-term commitments, and improve accountability through transparent and inclusive national approaches”. 

2. Fox  –   Tax and Spend: U.N.’s Rx for New World Medical Order takes an in-depth look at a report by the WHO’s Expert Group on Research and Development Financing (EWG), released on Monday, on new and innovative sources of funding to reshape the global medical industry.

Global Health

3. PLOS – The Global Health System: Lessons for a Stronger Institutional Framework

Suerie Moon, Nicole A. Szlezák, Catherine M. Michaud, Dean T. Jamison, Gerald T. Keusch, William C. Clark, Barry R. Bloom ;

In the last in a series of four articles highlighting the changing nature of global health institutions, Suerie Moon and colleagues propose actions to strengthen these institutions.

4. PLOS – Meeting the Demand for Results and Accountability: A Call for Action on Health Data from Eight Global Health Agencies

Margaret Chan, Michel Kazatchkine, Julian Lob-Levyt, Thoraya Obaid, Julian Schweizer, Michel Sidibe, Ann Veneman, Tadataka Yamada ;

In this viewpoint published in PLOS, leaders from the self-proclaimed “Health 8” (mimicking the G8) argue that health information is key to make further progress in global health and commit themselves to both support and align with nationally integrated monitoring systems. These pledges should be printed out and hung on the wall in every national director of health information system’s office, in case their representatives pay a visit to get some information.

5. (Nigerian) Guardian – WHO lists gains, obstacles to public health

Chukwuma Muanya;

In a speech at the WHO executive board meeting, Margaret Chan listed the gains made in public health in the last decade and major challenges ahead.

6. Economist – The second epistle of St Bill

The Economist elaborates on Bill Gates’ second annual letter on philanthropy, which focuses on innovation as a solution to problems in health, poverty, hunger and education. Bill had a busy week: he attended a Belgian informal meeting in Davos, announced to double spending on vaccine over the next decade, found time to belittle Google in their clash with China’s leaders, and launched his own blog :

Health Financing

7. World Bank report – Paying primary health care centers for performance in Rwanda

Paulin Basinga et al. ;

The World Bank published a new paper in the Policy Research Working Paper series, with the first set of results from the impact evaluation of pay for performance for health centres in Rwanda.

Reaching Health MDGs

8. HPP Scaling up in international health: what are the key issues?

Lindsay J Mangham and Kara Hanson ; http://health policy

In order to contribute to a definition of scaling up, the authors reviewed the relevant literature. They look at issues raised by scaling up experiences and progress made so far. Finally they discuss how to gain “a better understanding of how to deliver priority health interventions at scale”. In a related paper, Gilson  further elaborates on two aspects of scaling up, “the importance of political commitment and of strategic management to scaling up”.

9. Lancet – Reforming country health systems for women’s health

Badara Samb  ; Full Text

Badara Samb lists three areas of health systems reform with great potential for increasing access and uptake of health services by women. Women should be able to access health care without encountering financial barriers. Women require health services centred on women. And finally, women should participate more in decision-making processes related to health systems and health-care provision.

10.    KFF – Canada To ‘Champion’ Major G8 Initiative To Tackle Maternal, Child Mortality

Canada wants Maternal and Child mortality to be a top priority at the next G8. The Canadian method to reduce mortality, as presented in the article and in line with previous investment in the ACSD project through the Catalytic Initiative, relies on community health workers. We wonder however to what extent maternal mortality can be tackled with this low-cost intervention approach.

11.    BMJ (Comment) – How can child and maternal mortality be cut?

The MDGs to reduce maternal and child mortality are off target. Tatum Anderson, a journalist, looks at the numerous obstacles to overcome in order to get them back on track.

Public Policy

12.    Lancet – A framework for mandatory impact evaluation to ensure well informed public policy decisions

Andrew D Oxman, Arild Bjørndal, Francisco Becerra-Posada, Mark Gibson, Miguel Angel Gonzalez Block, Andy Haines, Maimunah Hamid, Carmen Hooker Odom, Haichao Lei, Ben Levin, Mark W Lipsey, Julia H Littell, Hassan Mshinda, Pierre Ongolo-Zogo, Tikki Pang, Nelson Sewankambo, Francisco Songane, Haluk Soydan, Carole Torgerson, David Weisburd, Judith Whitworth, Suwit Wibulpolprasert ; Full Text

In this viewpoint, authors are making a plea for mandatory impact evaluations of any policy that affects the lives of people. “We need to make better use of what we already know and to assess better the effects of what we do”. They suggest legislation should be adopted that makes impact evaluations mandatory in any policy, as is the case in Mexico.

Aid Effectiveness

13.    WRR report – Minder pretentie, meer ambitie. Ontwikkelingshulp die verschil maakt

The Broker :

About ten days ago, the Dutch Scientific Council for Government Policy (WRR) presented its report ‘Less pretension, more ambition: development aid that makes a difference’ to the Dutch Minister for Development Cooperation. The study sketches the current picture and advocates far-reaching changes in the organisation of Dutch aid as well as more attention for global public goods. The report has already sparked heated debate, for example about its claim that in the past, aid to social sectors maybe got too much emphasis.



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