Human right health

The international commitment to health

Two oculists by a practice in front of a microscope.

Alongside the World Health Organization (WHO), numerous other inter­national and national institutions and non-governmental organisations have been working for decades to improve the health situ­a­tion in the de­vel­op­ing coun­tries.

All the organisations of the inter­national com­mu­ni­ty, such as the United Nations Children’s Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), are pursuing strategies to put in place nationwide health care. Germany supports many of these organisations and works with them in many different ways, especially in fields that are of supraregional significance.

In future, de­vel­op­ment policy will be faced with further challenges, for example the need to fight non-communicable diseases such as diabetes and cancer. Tackling the consequences of alcohol, cigarette and drug consumption is also becoming increasingly im­por­tant. Issues that are relatively new to de­vel­op­ment co­op­er­a­tion include environmental medicine, the impact of climate change on health, and the safe use of genetically modified organisms.

The concept of primary health care

In 1978 the WHO and UNICEF organised a conference in Alma-Ata (today Almaty) at which the concept of primary health care (PHC) was first presented.

PHC encompasses not only medical interventions, such as the treatment of diseases and their prevention by means of drugs, it also covers interventions that lead indirectly to an improvement in the health situ­a­tion: pov­er­ty reduction, health education, food security, drinking water supplies, sanitation etc. The goal of the PHC strategy is to ensure access to appropriate health care for all. An im­por­tant part of primary health care is participation and strengthening self-help.

Challenges facing the global health architecture

The sudden appearance of the hitherto unknown human immunodeficiency virus (HIV) and AIDS spawned awareness at inter­national level that health problems can become a global threat. As a result significantly more funding has been mobilised to improve health in de­vel­op­ing coun­tries since the early 1990s.

New financing instruments have been put in place, including the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). Parallel to this numerous private and civil society organisations have been founded in recent years, some with tremendous funds at their disposal. These include the Bill and Melinda Gates Foundation and a large number of other non-governmental organisations.

Today, well over 100 inter­national actors make up what is known as the global health architecture, which can roughly be divided into the following categories:

  • Multilateral organisations, such as the World Health Organization (WHO), the World Bank, UN special organisations such as the Joint United Nations Programme on·​HIV/AIDS (UNAIDS);
  • Bilateral donors and initiatives such as PEPFAR (The United States President‘s Emergency Plan for AIDS Relief) and donor groups such as the G8;
  • Global public-private partnerships (PPPs), such as the GFATM and the Global Alliance for Vaccines and Immunisation (Gavi);
  • Private actors, such as foundations, (inter­national) NGOs, individuals, faith-based groups and private businesses;
  • Coordination partnerships/initiatives, such as the Inter­national Health Partnership (IHP+) and the Partnership for Maternal, Newborn and Child Health (PMNCH).

The diversity of actors and structures helps mobilise new resources for the health sector. At the same time, however, it becomes more difficult to coordinate all stakeholders – especially for partner coun­tries that are confronted with extremely diverse application procedures and implementing modalities.

International Health Partnership

A number of different approaches exist to make support more effective, partly by implementing the aid effectiveness agenda adopted at inter­national level. Because the health sector is par­tic­u­lar­ly complex it was identified as a tracer sector within the scope of the aid effectiveness agenda. Lessons learned are, if possible, to be transferred to other sectors.

The Global Campaign for the Health Millennium De­vel­op­ment Goals initiated by the Norwegian Prime Minister in 2007 also has an im­por­tant role to play in this. The Inter­national Health Partnership (IHP+) was initiated in the context of this campaign and now comprises more than 60 members, including de­vel­op­ing coun­tries, donor coun­tries, and in­ter­national health initiatives and organisations.

Essentially, the IHP+ provides for:

  • Better division of labour between donors and large inter­national institutions in the health sector; the involvement of other im­por­tant initiatives in the health sector and improved coordination of activities.
  • Coordinated, coun­try-specific processes to support national plans to strengthen health systems in partner coun­tries.

Germany is one of the world’s biggest donor coun­tries in the health sector. To further enhance effectiveness the BMZ is involved in the above Inter­national Health Partnership (IHP+). The German govern­ment is also committed to improving aid effectiveness in the health sector in the context of its membership of the G8 and of steering committees (e.g. the Global Fund to Fight AIDS, Tuberculosis and Malaria, GFATM).

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