MAXIMIZING POSITIVE SYNERGIES - World Health Organization

Clarity of GHI policies/guidelines/guidance for funding
The four GHIs provide different kinds of flexibilities, and also communicate their expectations, in
ways that may not be clear to host countries. Countries may benefit from more explicit guidance
on the range of issues for which they may request funds from each GHI. The proper balance must
be found between each GHI's mission, goals and overarching operating model, and the need to
provide countries with clarity on funding options for supporting health systems. Some GHIs
stressed the importance of being more explicit with countries, arguing it did not detract from the
GHI’s basic mission and purpose.
HRH as a barrier to successful implementation of programmes
The four GHIs recognize that the lack of sufficient HRH in countries constitutes a severe limitation
to achieving their policy goal and consequently are each pursuing initiatives to scale up HRH in a
number of countries. They also pursue these initiatives independently of each other in order to
address their own objectives. These separate approaches have resulted in duplication of GHIfunded
efforts at country and local levels or in inadequate alignment with national and local
priorities for the health system. While this study focused on the problem of HRH supply,
distribution, and capacity strengthening, other issues related to HRH and systems, e.g. the need to
beef up infrastructures, were also highlighted in interviews and country applications.
The effect of the global economic crisis on GHIs
The four GHIs are reportedly committed to their mission and purpose but also acutely aware of the
current reality of the financial markets and the effect this may have on the availability and certainty
of acquiring funds. They also acknowledge the importance of continuing to emphasize HSS
alongside disease-specific approaches.
Conclusion
In conclusion, GHI support for HSS can be communicated and coordinated more effectively, while
taking into account each GHI’s specific structure and political context, the types of flexibility each
GHI grants countries seeking funds for HSS (either separately or as part of a disease-focused plan),
and the degree to which GHI-funded programmes are harmonized and aligned with national and
local priorities. What is not well known other than anecdotally is how country officials applying
for funding perceive and understand the current way GHI funding operates and how they would
respond to improved communication and coordination, particularly within their own political and
legal framework. More research needs to be conducted to answer this key question.
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