THE CHALLENGE OF THE HEALTH MDGs IN FRAGILE STATES

1
THE CHALLENGE OF THE HEALTH MDGs IN FRAGILE
STATES

• Suma Chakrabarti,
• Permanent Secretary
• DFID

2

• What is the scale of the challenge in fragile
  states?
• We know that fragile states are home to about 15
  of the population of developing countries. Yet
  they account for
• 1/3 of the worlds poor
• 1/2 of children dying before 5
• 1/3 of maternal deaths
• 1/3 of people with HIV/AIDS
• BUT
• Receive only 25 total global aid

3

• Why does health in fragile states matter?
• Disease epidemics are fuelled by the collapse of
  health systems in fragile states
• Health interventions are an entry point in
  fragile states

4

• What are we doing to tackle the challenge of
  fragile states?
• Piloting Principles of Good International
  Engagement in Fragile States
• DAC Service Delivery Workstream

5

• Tackling the health crisis in fragile states
  requires more attention to
• Addressing under-funding of health in fragile
  states
• Making health a priority for harmonisation and
  alignment
• Reducing volatility and improving predictability
  of financing for health

6

• Address under-funding of health in fragile
  states
• Increase our support for health where we can work
  effectively
• Improve our understanding of how to work better
  where there is less consensus

7

• Make health a priority for harmonisation and
  alignment in fragile states
• Make health a priority area for strengthened
  partnerships between bilateral and multilateral
  agencies
• Strengthen coordination mechanisms, including
  pooled funding
• Set agreed standards
• Adopt pre-PRSP planning instruments to link
  health to other aspects of development

8

• Reduce volatility and increase predictability of
  financing for health in fragile states
• Strike the right balance between short term
  humanitarian objectives and long term development
  relationships
• .
• Employ instruments that can provide long term,
  predictable support to the health sector

9

• Meeting the challenge of the health MDGs in
  fragile states
• Address under-funding for health in fragile
  states
• Two concrete actions 1) Increase our
  support in those environments where we know that
  we have a reasonable chance of working
  effectively generally the weak but willing. 2)
  Learn lessons where there is less agreement the
  unwilling and the chronic underperformers.
• Make health a priority area for harmonisation and
  alignment in fragile states
• Four concrete actions 1) Strengthen bilateral
  and multilateral partnerships. 2) Develop
  stronger coordination mechanisms, including
  pooled funding. 3) Set agreed operating standards
  in the health sector. 4) Adopt pre-PRSP planning
  instruments to link health to other aspects of
  development.
• Reduce volatility and improve predictability of
  financing for health
• Two concrete actions 1) Consider how agency
  structures can strike the right balance between
  short term humanitarian and longer term
  development objectives. 2) Commit to instruments
  that can deliver aid for the long term in fragile
  states.