Ana B. Amaya, DrPH MPH
Assistant Professor at Pace University
Global Health Policy Expert and Researcher | Assistant Professor @PaceUniversity | Associate Research Fellow @UNU-CRIS | Board Member @HealthSystemsGlobal | Module Organizer @LSHTM
Pace University
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New York, NY
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Assistant Professor
United Nations University - CRIS
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Honorary Associate Research Fellow
London School of Hygiene and Tropical Medicine
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Issues in Global Health Policy Module Organizer and Tutor
Since COVID-19 was first discovered, it exploded into a pandemic resulting in devastating effects on human lives and a global recession. While there have been discussions that COVID-19 will accelerate the ‘end of globalization and multilateralism’, we have already seen the high costs of non-cooperation in responding to the virus resulting in sub-optimal use of resources, rapid spread of the virus between countries, and, ultimately, significant loss of life. In spite of their favorable demographic structures and relatively young populations, countries in the Global South are still harshly affected in both epidemiological and economic terms. Nations must find innovative ways to address health concerns and regional bodies are possible mechanisms for facilitating international cooperation on health. We delineate how regional organizations can support how countries address health threats namely by serving as a bridge between the global and national policy levels; strengthening disease surveillance; mobilizing supply chains and facilitating trade; supporting the production and procurement of medicines and supplies; and coordinating policies and work with other actors. We finalize by arguing that mechanisms for regional cooperation must be strengthened themselves in order to effectively contribute to positive health outcomes within member states.
Regional cooperation is essential to combatting health emergencies in the Global South
Globalization and Health
https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00659-7
This introduction to the special section explores the nexus between global health governance and international health diplomacy. In these dynamic governance spaces, particular attention is paid to the multi-level and multi-actor character of global health governance and how health diplomacy functions in such a complex context. It is pointed out that the regional level plays both vertical (i.e., as an intermediary between the global and national levels) and horizontal (i.e., interregional) roles. The contributions to the special section develop the conceptual understanding of those interactions and analyze a number of concrete cases, including the African Union, ASEAN, the European Union, SADC, and UNASUR.
Multi-level health governance and health diplomacy
Regions & Cohesion
https://www.berghahnjournals.com/view/journals/regions-and-cohesion/9/1/reco090107.xml
Health governance has become multi-layered as the combined result of decentralization, regional integration and the emergence of new actors nationally and internationally. This this has enhanced the installed capacity for health response worldwide, this complexity also poses serious challenges for health governance, health diplomacy and health policy-making. This article focuses on one of these challenges, namely the organization of statistical information flows at and between governance levels, and the emerging role that regional organizations play therein. Regional to national-level data flows are analyzed with the use of two case studies focusing on UNASUR (Bolivia and Paraguay) and SADC (Swaziland and Zambia). The results of the analysis lead to several policy recommendations at the regional and national levels.
The role of regional health diplomacy on data sharing
Regions & Cohesion
https://www.berghahnjournals.com/view/journals/regions-and-cohesion/9/1/reco090108.xml
There is a growing understanding that strong health systems are crucial to sustain progress. Health systems, however, are complex and much of their success depends on factors operating at different levels and outside the health system, including broader governance and political commitment to health and social development priorities. Recognizing these complexities, this article offers a pragmatic approach to exploring the drivers of progress in maternal and child health in Mozambique, Nepal and Rwanda. To do this, the article builds on a semi-systematic literature review and case study findings, designed and analysed using a multi-level framework. At the macro level, governance with effective and committed leaders was found to be vital for achieving positive health outcomes. This was underpinned by clear commitment from donors coupled by a significant increase in funding to the health sector. At the meso level, where policies are operationalized, inter-sectoral partnerships as well as decentralization and task-shifting emerged as critical. At micro (service interface) level, community-centred models and accessible and appropriately trained and incentivized local health providers play a central role in all study countries. The key drivers of progress are multiple, interrelated and transversal in terms of their operation; they are also in a constant state of flux as health systems and contexts develop. Without seeking to offer a blueprint, the study demonstrates that a 'whole-system' approach can help elicit the key drivers of change and potential pathways towards desirable outcomes. Furthermore, understanding the challenges and opportunities that are instrumental to progress at each particular level of a health system can help policy-makers and implementers to navigate this complexity and take action to strengthen health systems.
Drivers of health system strengthening: learning from implementation of maternal and child health programmes in Mozambique, Nepal and Rwanda
Health Policy and Planning
https://www.ncbi.nlm.nih.gov/pubmed/28481996
The Association of Southeast Asian Nations, the European Union, the Southern African Development Community and the Union of South American Nations have increasingly been involved in health diplomacy in the past decade, yet little is known about how they frame health as a foreign policy issue and how this has an impact on their prioritisation of policies. For this, we conducted a review of existing grey and peer-reviewed literature that address regional integration and health, as well as a documentary review according to security, development, trade, human rights, moral/ethical reasonings and global public goods frames identified in the literature. The policy frames identified responded to the challenges these regions currently face. The Association of Southeast Asian Nation’s struggle with re-emerging diseases has led to favouring a securitisation approach to health, the European Union approaches health as a cross-cutting policy issue, the Southern African Development Community presents health as a driver for development, and while the Union of South American Nations emphasises health as a human right and addresses the social determinants of health as an ethical imperative. Overall, these policy frames were useful in analysing the framing of health in foreign policy at the regional level. However, within our analysis, we identified a new frame that approaches health as an intersectoral issue. The impact of regional organisations’ forward will depend on their ability to harness their convening power and speak in a coherent voice on health matters
What’s in a word? The framing of health at the regional level: ASEAN, EU, SADC and UNASUR
Global Social Policy
https://www.ncbi.nlm.nih.gov/pubmed/26635496
This article examines the nature of the engagement between the European Union and the Global Fund created to combat HIV/AIDS, tuberculosis and malaria. The authors reveal that in relations between the EU and the Fund, influence is reciprocal although asymmetrical with the EU commanding more leverage. They also contend that the EU considers its engagement with the Global Fund as successful to the extent that the success of this interaction is contingent on the Global Fund's capacity for implementation. They conclude that the relationship between the EU and the Fund will continue for the foreseeable future.
The European Union and transnational health policy networks: a case study of interaction with the Global Fund
Contemporary Politics
http://www.tandfonline.com/doi/abs/10.1080/13569775.2015.1061245?journalCode=ccpo20
Peru has received around $70 million from Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund). Recent economic growth resulted in grant ineligibility, enabling greater government funding, yet doubts remain concerning programme continuity. This study examines the transition from Global Fund support to increasing national HIV/AIDS funding in Peru (2004-2012) by analysing actor roles, motivations and effects on policies, identifying recommendations to inform decision-makers on priority areas. A conceptual framework, which informed data collection, was developed. Thirty-five in-depth interviews were conducted from October to December 2011 in Lima, Peru, among key stakeholders involved in HIV/AIDS work. Findings show that Global Fund involvement led to important breakthroughs in the HIV/AIDS response, primarily concerning treatment access, focus on vulnerable populations and development of a coordination body. Nevertheless, reliance on Global Fund financing for prevention activities via non-governmental organisations, compounded by lack of government direction and weak regional governance, diluted power and caused role uncertainty. Strengthening government and regional capacity and fostering accountability mechanisms will facilitate an effective transition to government-led financing. Only then can achievements gained from the Global Fund presence be maintained, providing lessons for countries seeking to sustain programmes following donor exit.
After the Global Fund: who can sustain the HIV/AIDS response in Peru and how?
Global Public Health
https://www.ncbi.nlm.nih.gov/pubmed/24499125
Peru has applied to six of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) rounds for funding, achieving success on four occasions. The process of proposal development has, however, been criticised, especially concerning the use of evidence, relevance/consistency and performance indicators. We aimed to analyse the Peruvian Global Fund proposals according to those dimensions, providing feedback to improve future local efforts and inform global discussions around Global Fund procedures. We analysed the content of four HIV-focused proposals (rounds 2, 5, 6 and 8) regarding epidemic context, needs identification and prioritisation and monitoring and evaluation systems. Peruvian proposals submitted after round 1 were described as resulting from collaborative inputs involving formerly unrepresented sectors, principally 'vulnerable populations'. However, difficulties arose regarding the amount and quality of evidence about the epidemiological context; limited consideration of social determinants of the epidemic; lack of theory-driven interventions, and little synergy across projects and the inclusion of weak monitoring and evaluation systems, with poor indicators and measurement procedures. Prioritising the development of analytical and technical skills to generate Global Fund proposals would enhance the country's capacity to produce and utilise evidence, improve the technical-political interface, strengthen information systems and lead to more informed decision making and accountability.
A Critical Analysis of Peru's HIV Grant Proposals to the Global Fund
Global Public Health
https://www.ncbi.nlm.nih.gov/pubmed/24329168
https://www.linkedin.com/in/kevin-wang-266424106
San Jose, CA
Kevin Wang
Education Specialist at Compass Education
https://mx.linkedin.com/in/anitaalanis
Mexico City, Mexico
Ana Alanis
Migrant Protection ~ Researcher  ~ Translator ~ Data Science Padawan
https://th.linkedin.com/in/praewa-kulatnam-77071b16b
Bangkok Metropolitan Area
Praewa Kulatnam
Program Coodinator, HITAP | Global Health Fellow, MoPH, Thailand
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Boston, MA
Takemi Program HSPH
Takemi Program in International Health at Takemi Program in International Health
https://www.linkedin.com/in/sachin-a-silva-50701229
Cambridge, MA
Sachin A. Silva
Principal, IQVIA; Research Scholar, University of California San Francisco; Former Doctoral Fellow, Harvard University
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Metro Manila
Kyung Hyun Oh
World Health Organization Regional Office for the Western Pacific Technical Officer
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Seoul, South Korea
Hyeon (Ellie) Park
Consultant at World Health Organization
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South Korea
Jae Kyoun Kim
Technical Officer at World Health Organization
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London
Isaac Yenhao Chu
DrPH Candidate at LSHTM, MSc and M.D.
https://www.linkedin.com/in/antoncastellanosusigli
New York, NY
Antón Castellanos Usigli, MPH
Healthcare Consultant | DrPH Candidate, Harvard University | Member, PFLAG National Board of Directors | Member, Durex Global Advisory Board.
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New York, NY
Patricia Moscibrodzki
Research Consultant at Microsoft | DrPH Candidate at LSHTM
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Honolulu County, HI
Victoria Fan
Associate Professor of Health Policy
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New York, NY
Karin Källander
Senior Health Adviser, UNICEF & Co-lead of the Digital Health Centre of Excellence (DICE)
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Boston, MA
Courtenay Sprague
Associate Professor, Global Health, University of Massachusetts Boston
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Santa Monica, CA
Jakub P. Hlávka
Executive Director of Healthcare Markets Initiative, Assistant Research Professor in Health Policy & Management, University of Southern California
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New Orleans, LA
Tyra Gross
Educator | Researcher | Mentor | Coach | Consultant | Speaker |
Maternal & Child Health Champion | Women's Wellness Advocate
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Los Angeles, CA
Shervin Assari
Director of Research, Public Health, Charles R. Drew University of Medicine and Science
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Boston, MA
Dr. Ndidiamaka A.
Associate Professor, Dept of Public Health and Community Medicine at Tufts University School of Medicine, Assistant Dean of Diversity, Equity, and Inclusion,  Founder and Director of MOTHER Lab