An article by Robert Guth in the Wall Street Journal last week highlighted the theory that I posed in last Thursday’s post, that our global health system is designed to be reactionary and emergency-focused:
That question goes to the heart of one of the most controversial debates in global health: Is humanity better served by waging wars on individual diseases, like polio? Or is it better to pursue a broader set of health goals simultaneously—improving hygiene, expanding immunizations, providing clean drinking water—that don’t eliminate any one disease, but might improve the overall health of people in developing countries?
The article discusses the still-elusive quest to eliminate polio, and a change of strategy on the part of the Gates Foundation, UNICEF, Rotary International and the US CDC. Despite $8.2 billion and 2 decades of effort, polio is still ravaging large regions of the world, primarily Africa. The fight has recently faced particularly disheartening setbacks, including the first case of polio in Uganda in 12 years.
The WSJ article outlines the change in strategy as movement from a solely “vertical” approach (targeting a single disease) to a more “horizontal” approach (influencing the overall system). The new strategy is holistic, encompassing efforts to strengthen the overall health system and improve sanitation and hygiene measures.
The change in strategy echoes the shift in strategy for PEPFAR II and the trickle-down effect that is occurring in all HIV/AIDS initiatives currently. I think this is a harbinger of important strategic shifts to come, and I believe a positive evolution in our global approach to fighting disease.
