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World Bank says we must pay more attention to health systems

18 Nov 2008

Maryke Steffens

Source: TropIKA.net

While a lot of attention is paid to vertical programmes for malaria, TB and HIV/AIDS, said Senior Health Advisor to the World Bank, Ok Pannenborg, at the Global Ministerial Forum on Research for Health in Bamako, Mali yesterday, and “there is too little research into how these diseases programmes could work better”.

Health systems research, he said, is too often dismissed as “amorphous, abstract and vast”.

Pannenborg gave the example of HIV: while the cost of antiretrovirals has fallen, HIV continues to plague many developing countries around the world. This is because of “systemic weaknesses” that must be addressed, he said.

One of these weakness is the lack of skilled health workers in the developing world. He described the situation in a country like Ethiopia as like “living in Paris with only 60 physicians for the entire population”.

Pannenborg said that research can offer a solution to weak health systems in several ways: by providing evidence of the problem, by providing results that can feed into innovative solutions, and by evaluating the impact of any interventions.

He emphasized that multidisciplinary research in particular - that addresses a wide range of areas such as housing, women’s education, transport, and energy - could offer the best range of solutions. “All these areas shape human health,” he said. “Around 40 to 60% of health outcomes are shaped by factors outside of health.”

The success of research in improving health systems lies in building country capacity to carry out this research. “Research must also not be a substitute for action,” he said. “We need commitments to implementing policies as a follow-up to research.”

He listed Singapore and South Korea as examples of countries that have already succeeded in carrying out and implementing the findings of health systems research. “Ghana and Nigeria are two other hopeful examples,” he said.

Pannenborg stated that the Bamako forum could help solidify commitments from countries to invest in this area.

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