Debate

Reply: The slow catastrophe turns into a normal state

Much of Björn Ekman's criticism of global health assistance is correct, but one must see nuances beyond black and white. Anders Molin writes in a reply.

Björn Ekmans talks in his article about the failure of the rich countries' health aid, with special focus on bilateral aid and, "including what has been given by Sweden for several decades via the aid authority Sida". In my answer, I tried to give a picture of Swedish bilateral development assistance, not because it is “good” but because Sweden in its development assistance has systematically strived to strengthen the partner countries' health systems and national ownership.

Much of Björn Ekman's criticism of global health assistance is, as I also pointed out, correct, but one must see nuances beyond black and white. A good example is the Global Fund, which has historically acted independently and outside the “system” and thus did not contribute to integration with other actors or within the framework of national plans and budgets. In the Board, Sweden, together with other like-minded donors, has been a driving force for the Global Fund to be better adapted to the countries' plans and systems. However, a major reform process, called the new funding model, of the Global Fund's systems and structures has significantly changed the way the Global Fund works. Since 2013, national ownership, national frameworks and collaboration with other partners are now taken very seriously. The countries' applications to the Global Fund, for example, require that a dialogue has been conducted at country level regarding the focus of the programs and that the countries can show how the future programs to be financed by the Global Fund are adapted to national strategies and plans. Nowadays, countries can also apply for support for programs aimed at strengthening the health system in a broader sense, which was not possible before. Sweden will continue to monitor that the new financing model is implemented as intended and that the reforms that the Global Fund has undergone both contribute to combating the three diseases while contributing to health system strengthening.

What I was trying to formulate regarding the Ebola epidemic was the tendency of the international community to react more strongly the more acute a disaster is, from the tsunami over Ebola to HIV and AIDS. The slow catastrophe in which the poorest people in the world live turns into a normal state.

Anders Molin,
Sida's expert on health assistance

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"Reply: Serious shortcomings in the global handling of Ebola”(Björn Ekman 4 Nov, 2014)

"Reply: Nuanced criticism of health care”(Anders Molin 30 Oct, 2014)

"The Ebola epidemic is a sign of failed health care”(Björn Ekman 28 Oct, 2014)

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