MAXIMIZING POSITIVE SYNERGIES - World Health Organization

funds and more funding focused on improving the system as whole. GHI funding has introduced a
tension in the health system by empowering NGOs while at the same time constraining somewhat
the Haitian government’s ability to coordinate GHI activities within a national plan and set of
healthcare priorities. As a result, there is a desire for the funding to help strengthen the MOH and
support its role as the primary coordinator for health action in the country. To achieve complete
integration, improved coordination will be needed between the government, the Global Fund and
PEPFAR. For example, in Haiti, the Principal Recipient for Global Fund funds is not the government,
a fact that perpetuates the lack of coordination.
Although initially both the Global Fund and PEPFAR were considered vertical programmes by both
the government of Haiti and by implementing NGOs, data showed that certain implementers were
willing to challenge the vertical approach of these GHIs from the beginning and to push the
funders to allow a more diagonal approach to health system strengthening. This approach, over
time, became more accepted by local GHI officials and has also become more acceptable for GHI
objectives and programming. The Global Fund, for example, now encourages applications for
funding for health system strengthening, and PEPFAR, particularly in its second phase, is described
by interviewees as being more open and encouraging of an integrated approach.
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