Partnerships for Health
Given the high proportion of external resources, the number of initiatives and the multiplicity of actors involved in health development in the African Region, coordination and harmonization of efforts through some form of partnership is essential to avoid waste and target real needs.
Fig. 1. External resources on health as % of total health expenditure in the African Region, 2012
Partnerships have multiplied in one form or another: there are funding partnerships; technical cooperation; policy and strategic dialogue partnerships; advocacy; and joint ventures. Some partnerships have been initiated at global level while others have been established at the regional or country level.
In the last decade, global health partnerships such as the Global Alliance for Vaccines and Immunizations (GAVI) and The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) have mobilized important new resources for major health threats, and brought much needed political and technical focus to priority diseases and interventions. Other partnerships such as the international drug purchase facility (UNITAID), established in 2006, secures lower prices for quality medicines that are otherwise out of reach to poorer populations or, like Roll Back Malaria Partnership (RBM), launched in 1998, implement coordinated action against a single disease, in that case malaria.
There are concerns that these initiatives aggregate around issues or diseases rather than on more comprehensive approaches to health, such as health systems development. Their multiplication also complicates the harmonization of efforts and alignment with national systems and priorities. This has been recognized, and a number of donors have agreed to better harmonize their efforts and align with country-led priorities – as outlined in the 2005 Paris Declaration on Aid Effectiveness (see figure).
Fig. 2. Five mutually reinforcing principles of the Paris Declaration on AIDS effectiveness (2005)
Mechanisms have been put in place at global and regional levels. For instance, the United Nations Reform aims to make the multiplicity of UN agencies work in a more unified manner in the ‘Delivering as One’ (DaO) initiative. Harmonization for Health in Africa (HHA), formally established in 2006, is a regional mechanism focusing on providing coordinated support to strengthen health systems and achieve the health-related MDGs. HHA plays a significant role in the Region in promoting policy dialogue between Ministries of Health (MoH) and Ministries of Finance (MOF), Parliamentarians and other health sector stakeholders. Currently, this mechanism comprises 16 members, including bilateral, UN Agencies and development and financial institutions.
The International Health Partnership+ (IHP+) created in 2007, aims to improve delivery of MDG outcomes and universal access to health services.by supporting the establishment of country compacts – negotiated and signed time-bound agreements – in which partners commit to implement and uphold the defined priorities outlined in the country health strategy. Nearly 20 countries in the African Region now have, or are developing, some form of compact or, if they never had any form of partnership agreement, ‘pre-compacts’ as a first step.
Fig. 3. Countries that have signed compacts in the African Region, 2012
Partnerships have been useful in strengthening health systems, including maternal and child health programmes, the prevention and control of communicable and noncommunicable diseases and in tackling key determinants of health. Harmonizing and aligning partners’ interventions to national priorities help reduce fragmentation and duplication of efforts.
AHO Regional profile on Partnerships for health development
Atlas of African Health Statistics – Progress on health-related MDGs
Global Alliance for Vaccines and Immunizations (GAVI)
Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)
Harmonization for Health in Africa (HHA)
International Health Partnership (IHP+)
- Country compacts
- IHP Global Compact Signatories May 2014
Paris Declaration on Aid Effectiveness and the Accra Agenda for Action
Partnership for Maternal, Newborn & Child Health
Roll Back Malaria Partnership (RBM)
UNITAID, the international drug purchase facility
United Nations Office for Partnerships
United Nations Post-2015 Development Agenda (also on the Sustainable development knowledge platform)