Watching the money at the World Health Assembly

David Melody has now returned to London and I am now covering the rest of this event. For an organisation working on health, getting all the world’s Health Ministers and senior officials together in one place is an important opportunity. Normally the World Health Assembly (WHA) goes on for two weeks, too long for a Save the Children staff member to be away (so I don’t understand how Health Ministers can spare the time).

This year it has been cut to one week and I suspect they will continue this practice. I was one of the speakers in a meeting on Wednesday morning on the Task Force on Innovative Financing for Health Systems. As the others included Anders Nordstrom (Director-General of Sweden’s government aid agency) and Joy Phumaphi (Vice-President of the World Bank), I kept my contributions short and posed some questions.

In particular, I wanted to get commitments from them that new money (if it appears) will be targeted to help national governments build health systems, not repeating the mistakes of the past. I was also pushing that health services provided to reduce maternal and child mortality should be free at the point of use and that the Global Fund to Fight AIDS TB & Malaria be given an expanded remit to fund health systems, given that we have major concerns about the way that the World Bank provides its funding to developing countries. What was most interesting was the different responses. Whereas Anders Nordstrom was very clear about supporting governments, Joy Phumaphi (a former Health Minister for Botswana) kept raising objections to this. Anders Nordstrom also talked about the importance of a “single source” of financing for developing countries and implied that the final report of the task force would encourage the major international funding bodies to get their act together. Later we had a private meeting with Joy Phumaphi to exchange views on the Bank’s record on health spending which has recently been criticised by an independent evaluation.

Today, one of the main topics has been primary care renewal. Last year, Save the Children was strongly supporting the renewed focus on basic primary health care – local clinics providing a range of services for poor people including in rural areas instead of governments only investing in big hospitals in the main cities. The role of civil society – meaning Save the Children and other charities – is being discussed with agreement that our role as champions for primary health care will be crucial if this initiative has more chance of success than previous primary care movements 30 years ago when civil society was much weaker.