health systems


Guest post: Global health needs to focus on health, not disease | 

This is a guest post from Wendy Johnson, a physician at the University of Washington with extensive experience working health issues in low-resource communities in Africa.


Wendy Johnson

The UN High-level Meeting on Non-communicable Diseases (NCDs) couldn’t come at a worse time.

While the delegates, disease experts and functionaries gather in New York to discuss how to create a more comprehensive global health agenda, political leaders in a smaller city to the south with much more power to set that agenda will likely be dismantling the infrastructure and funding needed to support the fundamental change needed – health systems improvement.

As this story from Reuter’s notes, all foreign aid, and especially the USAID budget, is under serious threat, both from the so-called “super-committee” on debt and the deliberations over current spending bills taking place in Washington D.C.  According to the article, House Foreign Affairs Committee Chairwoman Kay Granger is a proponent of deep cuts in aid who believes in limited programs that demonstrate quick impact and further U.S. national security.

This does not bode well for those at the UN meeting who will be arguing that the U.S. and other rich countries should make the long-term commitments necessary to address the disparities in NCDs such as diabetes, heart disease and cancer treatment in poor and middle-income countries.  Continue reading

UW global health researchers dodge political turmoil in Uganda | 



A week ago, the UW’s Amy Hagopian, Peter House and Bert Stover headed to Uganda to coordinate a study aimed at resolving a fierce debate in global health.

Since arriving in Uganda, the UW researchers and their co-workers have had to deal with escalating violence which most observers blame on the government’s attempt to quell public protests and calls for political reform.

As the BBC reports, eight people have been killed and about 250 people injured so far. Continue reading

A dumb way to measure Africa’s health | 

One of the international communities goals for poor nations is to get them to improve their health care. That’s a good thing. How you get there is another thing.

A decade ago, at about the same time the world launched the Millennium Development Goals, many African heads of state gathered together as members of the Organization of African Unity (now the African Union) in Abuja, Nigeria, to promise to increase health care spending to 15 percent of the Gross Domestic Product.

Whose dumb idea was that?


Health Spending in Africa

Apparently, one of the key ways we are continuing to evaluate progress in Africa is by measuring how much each country is spending on health care. (To the right is a bad screen capture — sorry — of an interactive map that is much better at the link above.)

Is spending really a good way to measure of how they’re doing at improving health? I don’t think so.

The U.S. spends much more than any other nation (about $8,000 per person per year, or about 17% of our GDP and our health performance is pretty bad, about where Slovenia ranks, and by some accounts getting worse).

Clearly, as we have demonstrated to the world, you can spend more on health care and not get better health.

Let’s find a better indicator for health progress in Africa than money.