Blog Posts by Jon Jay

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

This post originally appeared on Devex.com.

Worldwide, there are severe shortfalls in the health workforce—not just in the quantity of doctors, nurses and other health workers, but in their management, performance and geographical distribution.

These shortfalls are particularly glaring in light of the global movement for universal health coverage, progress toward which will require a high-functioning workforce.

This month’s third Global Forum on Human Resources for Health, which convened global health policymakers in Recife, Brazil, trumpeted the need for political commitment to health workforce strengthening. With UHC a top priority of conference sponsors like the World Health Organization, conference discussions were framed as seeking solutions—such as improving retention and performance, or health workers’ advocacy—“toward UHC.”

{Photo by Warren Zelman.}Photo by Warren Zelman.

This post also appeared on Gates Foundation's Impatient Optimists Blog and on Frontline Health Workers Coalition's website.

In a week and a half, as a team of our colleagues arrive in Ethiopia for this year’s International Conference on Family Planning, others will already be in Brazil for the Third Global Forum on Human Resources for Health. This year’s HRH Forum addresses universal health coverage (UHC), a concept which continues to gain momentum as the focus of global health efforts from institutions like the World Bank and World Health Organization (WHO).

It’s symbolic that these two meetings are happening half a world apart: as movements around family planning, health workforce and UHC have advanced, there has been too little dialogue and collaboration across these communities.

 {Photo credit: Paula Champagne/MSH}Jeffrey Sachs speaking at "A Healthy Future for All: Making UHC a Post-2015 Priority".Photo credit: Paula Champagne/MSH

After last Monday’s event launching a report on equity in universal health coverage (UHC), I observed that the global UHC movement can gain broader support by refining its messages to connect with the core values of civil society and provide reassurance that UHC is feasible for low-income countries. It was clear after last Tuesday’s event in New York—hosted by MSH, the Rockefeller Foundation and the Thai UN mission—that to gain support among disease-specific advocates in post-2015 discussions, the UHC movement must also clarify how a UHC goal would relate to disease-specific priorities in the new development framework.

Put another way: what exactly would UHC cover as a post-2015 goal?

{Photo credit: Pan American Health Organization}Photo credit: Pan American Health Organization

As the United Nations General Assembly kicks off general debate on the post-2015 development agenda this week, advocates of a universal health coverage (UHC) target are rallying other organizations to build and showcase support around UHC. These efforts include high-profile events on Monday and Tuesday, both hosted by the Rockefeller Foundation with partner support. On Wednesday, Johnson & Johnson hosts an event on the key role of frontline health workers to efforts like these. 

In a three-part series, MSH bloggers expand on the themes raised by these events and consider the road ahead for UHC in post-2015 discussions. Readers can participate through their organizations—which can sign on to a joint letter to UN Member States supporting a post-2015 UHC target—or as individuals: by urging their organizations to sign the joint letter, adding comments on this blog post, or on Twitter with the hashtag.  

{Photo credit: Reavis/MSH, Malawi}Photo credit: Reavis/MSH, Malawi

The World Health Organization (WHO) made waves at the International AIDS Society conference in Kuala Lumpur when it issued revised guidelines for HIV treatment. The new guidelines—WHO’s first major update since 2010—recommend an earlier start to treatment, from a CD4 threshold of 350 cells/mm3 to 500 cells/mm3. While most patients don’t show symptoms of disease at these higher CD4 counts (a measure of immune system strength), the new guidelines responded to evidence that an earlier start improves long-term clinical outcomes and that ARV treatment dramatically reduces patients’ likelihood of transmitting the virus to sexual partners.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Originally posted on Devex.

“If you want to go fast, go alone,” says an African proverb. “If you want to go far, go together.”

It’s been thirteen years since the international community adopted the Millennium Development Goals, an ambitious, self-imposed “report card” for global development that helped focus attention and resources on issues like HIV and AIDS. Since then, the global HIV response has gone fast. In 2002, just 300,000 people with HIV were receiving antiretroviral therapy in developing countries; today, UNAIDS reports, treatment reaches nearly 10 million.

 {Photo credit: MSH/Paula Champagne}Constance Addo-Quaye, Deputy Director of Quality Insurance at National Health Insurance Authority, Ghana.Photo credit: MSH/Paula Champagne

Universal health coverage (UHC) is the ultimate accomplishment in health systems strengthening: UHC is achieved when a health system is strong enough to deliver high-quality products and services in a reliable, comprehensive and affordable way to its entire population. For the leaders who govern health systems, UHC is an ambitious and worthy goal. And as MSH President and CEO Jonathan Quick explains, success starts with their vision.

But what comes next? UHC carries unique governance challenges and can exacerbate existing challenges surrounding healthcare financing and service delivery. To overcome these challenges, leaders and managers will benefit greatly from sharing lessons from other health systems that are pursuing UHC or have achieved it already.

Makasi after two months of tuberculosis treatment. {Photo credit: A. Massimba/MSH.}Photo credit: A. Massimba/MSH.

With less than 1000 days until the Millennium Development Goals expire, the process for setting post-2015 goals continues to ramp up.  We take this opportunity to reflect on the current state of community health systems in low- and middle-income countries and consider how the post-2015 agenda could reshape them—perhaps dramatically.

Community health systems today

Integration moves ahead

Poor and rural communities in low- and middle-income countries are leaving behind the “one clinic, one service” approach. So-called vertical programs, which organized resources according to single health conditions, created a patchwork of health services at the community level. You could get HIV care from one provider, but would have to go down the hall, down the street, or often much farther to get maternal health care or malaria care.

Over on the Humanosphere blog, global health blogger Tom Murphy reported recently on changes at the Global Health Council (GHC), a membership-based coalition of global health practitioners, researchers and organizations.

After closing its doors last April, the GHC has reemerged with a more sustainable approach---and a new name: Global Health Coalition.

Management Sciences for Health (MSH) has provided support throughout the transition, and Dr. Jonathan Quick, President and CEO of MSH, is serving as interim board chair of the new GHC. Numerous other organizations are involved in the revival, including the Seattle-based Washington Global Health Alliance and the DC-based Global Impact, which is serving as the interim Secretariat.

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