International Health

Development

Professor Dr. Ejaz Ahmed Khan

Department of Community Medicine
Rahbar Medical and Dental College
 Learning objectives

 On Lecture completion you should be able to…..

 Describe History of International Health Assistance.

 Explain MDGs and SDGs with reference to Health

 Describe the Works, Functions and Strengths of World

Health Organizations and other Institutions.

 Describe International Health Assistants and Donors.

History of International Assistance
 The International involvement in health matters have
started since 1300s

 Preventing Plagues

 Safeguarding Global Commerce & Trade

 Protecting Soldiers

 Protecting Workers

 Promoting ‘Civilization’ in Less Developed Regions.

 Religious, Humanistic & Social Justice Motivations.

International Health Assistance

 World Health Organization (WHO)

 Established in 1948

 For Coordinate International Health Activities.

 Assist Governments in improving health services for their

Citizens

 Providing Best Practice Guidelines for Pandemics and

Disease Outbreaks
 International Health Assistance

 United Nation Infants and Child Emergency Fund

(UNICEF).
 Established in 1946.

 Addresses all sort of Emergencies related to Child

Health and Education.

 Provide Technical Support to Countries in Child and

Education Initiatives.
 International Health Assistance

 United States Agency for International Development

(USAID), 1961
 Established in1961.

 Provide Technical Assistance to Under Developed and

Developing Countries for:
 Economic Efforts

 Social Efforts

 Development Efforts
New Approaches to International Assistance

 More use of Partnerships (International, Public-Private)

 Increased Funding (Governments, Banks, Philanthropy)

 More Emphasis Humanitarian Motives

 Greater Recognition of the Global Nature of Disease

 Greater Recognition of Infrastructure & Workforce needs

 Greater Attention to Priorities of Recipient Countries

 Greater Emphasis on Transparency and Accountability

Milestones on Path to Global Health
 1796, Jenner discovers way to prevent smallpox
 1851, International Sanitary Conference, Paris
 1854, Discovery of cause of cholera
 1863, International Committee of the Red Cross
 1902, Pan American Sanitary Bureau, later PAHO
 1945, World Bank Group founded
 1946, U.N. Infant and Child Emergency Fund, UNICEF
 1948, World Health Organization founded
 1977, Eradication of smallpox
 2002, Global Fund to Fight AIDS, Tuberculosis and Malaria
 2005, Millennium Development Goals
 2016, Sustainable Development Goals
 Where is International Assistance Headed?
U.N. Millennium Development Goals, 2005
 A Multi-Sectoral Approach:

 Calls for Sustainable Development by improving systems

and processes:

 Utilization of Political Process for mobilization of resources

Provides Guidance:

 Provides Guidance to International donors and partners in

health sector:
 UN Millennium Development Goals
2005 at World Summit of UN General Assembly

 Eight goals for 2015 Three for Health-sector

1. Reduce by 2/3rds Child Mortality for < fives

2. Reduce by 3/4ths Maternal Mortality Ratio

3. Combat HIV/AIDS, Malaria & other Diseases

Millennium Development Goals
 Sustainable Development Goals (SDG)

 Sustainable Development Goals (SDGs)  January 2016

 Targets to be achieved by 2030 Agenda for Sustainable

Development

 SDG have 17 goals with 169 targets

 Goal No. 3 relates to Health

 SDG Goal No. 3
Ensure Healthy Lives and Promote Well-being
for all at all ages

 SDG 3 covers 5 Main Areas of Health Sector

 Reproductive, Maternal, Newborn and Child Health

 Infectious Diseases

 Non-Communicable Diseases and Mental Health

 Health Risks like Traffic Accidents and Poisoning

 Health Systems and Funding

Three Major Types of Global Health Actors

1. Multinational Organizations

1. Organizations within the UN system relevant to health

2. Organizations outside of the UN system relevant to health

2. Bilateral -- Government-to-Government or to Sub-

Government Levels

3. Non-Governmental Organizations (NGOs)

 Multinational
• Organizations within UN system relevant to health
• WHO (World Health Organization, 1948)
• UNICEF (U.N. Infant & Children’s Emergency Fund,1946)
• UNFPA (Population Fund, 1967)
• UNDP (U.N. Development Program, 1965)
• FAO (Food & Agricultural Organization, 1943)
• UNESCO (U.N. Educational, Scientific and Cultural
Organization, 1945)
• UNHCR (U.N. Refugee Agency, 1950)
• WFP (World Food Program, 1962)
• UNODC (U.N. Office on Drugs & Crime, 1997)
 WHO
WORLD HEALTH ORGANIZATION
Organizational Overview
 Director General: Elected by World Health Assembly.
 195 member states; Executive Board with 34 rotating members
 Organized in Three Levels:
 Geneva Headquarters;
 Regional Offices 6; (PAHO, WPRO, AMRO, AFRO, SEARO,
EURO)
 WHO Country Representatives (WRs) in most countries.
 Major areas of Work (www.who.int/en/):
 Malaria, HIV/AIDS, Tobacco, Nutrition, Mental Health,
Immunizations, etc.
 WHO: Divisions at Secretariat

 Epidemiological Surveillance.

 Communicable Diseases.

 Vector Biology and Control.

 Environmental Health.

 Public Information and Health Education.

 Mental Health.

 Strengthening of Health Services

 WHO: Divisions at Secretariat
 Family Health

 Non-Communicable Diseases

 Health Manpower Development

 Information Systems Support

 Personnel and General Services

 Budget and Finance

 Diagnostic Therapeutic and Rehabilitative Technology

 WHO: Functions

• Provides Technical Assistance, Training & Fellowships.

• Formulates & Disseminates Advice, Standards and

Guidelines.

• Convenes Expert and Technical Advisory Committees.

• Develops & Disseminates International Classification of

Disease (ICD-X) Codes.

 WHO: Functions

• Publishes Monographs, Reports and Manuals

• Assists & Organizes Projects as per Priorities set by

World Health Assembly

• Visit for an overview of

WHO Projects and Partnerships
 WHO: Priorities
 Reducing Maternal and Child Mortality by Aiming
 Universal Access and Coverage.
 Effective Interventions and Health Services
 Addressing Epidemic of Chronic Non-Communicable
Diseases,
 Emphasis on Reducing Risk Factors such as
 Tobacco,
 Poor Diet,
 Physical Inactivity
 WHO: Priorities

 Improving Health Systems,

 Focusing on Human Resources

 Financing

 Health Information

 Primary Health Care

 WHO: Priorities
 Implementing International Health Regulations to

 Respond to Outbreaks of Diseases and Emergencies.

 Building on Poliomyelitis Eradication.

 Develop Effective Surveillance and Response Infrastructure

 Improving performance of WHO through

 More Efficient Working and Building.

 Managing Partnerships for Best Results in Countries.

 WHO: Strengths

 Legitimacy , by Universal Membership & Support

 Representation, at Central, Regional and Country Levels

 Expertise, in Goals, Standards and Best Practices

 Cross-National, Collect, Compare, Analyze Data

 Collaborations, Organized, Sponsored, Facilitated

 Publications on Important Health Topics

 Training via Fellowship and Intern Programs

 UNICEF
United Nation Infant &Child Emergency Fund
 Established in 1946 by United Nations for Rehabilitation
of Children.

 UNICEF Headquarter is in New York.

 UNICEF closely working with WHO

 Comprehensive cover to Child Health through “Country

Health Programming” as an integral Package.
 UNICEF: Content of Services
 Child Health and Nutrition.
 Family and Child Welfare.
 Education; Formal and Non-formal.
 GOBIFFF Campaign
 G= Growth Chart for Child Monitoring.
 O= Oral Rehydration for Mild to Moderate Dehydration.
 B = Breast Feeding.
 I = Immunization
 F = Family Planning
 F = Female Education
 F = Female Nutrition
 Universal Basic Services (UBS) since 1976.
 UNDP
United Nation Development Program

 Established in 1966

 Main Source of Funds for Technical Assistance

 Assist Under develop and Developing countries

 Develop their Human and Natural ResourcesCovers all

Economic and Social Sector
 UNFPA
United Nation Fund For Population Activities
 Established to provide Funds for Population Activities
 UNFPA provides Funds for Health Department and
Population Welfare Department to
 Purchase Contraceptives
 Develop Population Education Programs
 Organize Population Sector Activities
 Strengthen Program Management
 Improve Grass Root Level Workers
 Innovative Approaches of Family Planning and MCH
 Multinational

• Organizations outside the UN relevant to Health

• U.N. Affiliated Programs

– Global Fund to Fight AIDS, TB and Malaria since 2002.

– UNAIDS (Joint U.N. Program on HIV/AIDS)
• World Bank Group,
• International Monetary Fund (IMF)
• World Trade Organization
 Types of Other Global Health ‘Actors’
Bilateral Aid Agencies

• Many of the “Rich” 34 OECD Countries

• USAID (U.S. Agency for International Development)

• DFID (Department for International Development U.K.)

• SIDA (Swedish International Development Cooperation
Agency)
• CIDA (Canadian International Development Agency)

• JICA (Japan International Cooperation Agency)

Non-Governmental Organizations (NGOs)

 NGOs defined by their Extraordinary Diversity

 Non-Profit and Profit-Based

 Religious and Secular

 Narrow and Broad Scope Programs

 Wealthy and Shoe-String Operations

 Big NGOs are called BINGOs

 Well paid, Marginally Paid and Volunteer staff

Non-Governmental Organizations (NGOs)

 Long- and Short-Term Commitments

 Single-Country, Multi-Country and Regional Focus

 Single Problem and Multi-Problem Focus

 Single Sector and Multi-Sector Focus

 Emergency Relief and Development Focus

Non-Governmental Organizations (NGOs)

Charitable (Secular) Organizations

 Oxfam

 CARE

 Save the Children/UK (& US)

 International Red Cross

 International Rescue Committee

 Child Family Health International

The Global Fund: Characteristics

 The GF differs from the more Traditional Assistance Institutions.

Four key Characteristics are:

 Demand-Driven

 Performance-Based Investments

 Administrative Transparency

 Anyone can Apply

THANK YOU