Diapositive 1

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Human Capacity building for Global Health
EFC AGA and Conference Pre-conference
eventGlobal health What Role for
Foundations? May 31, 2007 Madrid, Spain
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Some facts on Global Health

• Developing countries carry 90 percent of the
  world's health burden, but account for only 12
  percent of spending.
• Poor countries can be described as the breeding
  ground for diseases infectious disease epidemics
  (mostly preventable with existing medical
  knowledge) are most likely to occur in the
  poorest 20 of the worlds population that lives
  in Asia and Sub-Saharan Africa.
• Infectious diseases are a neglected concern
  within this neglected sector. In 2002, bilateral,
  multilateral, foundation and NGO partners
  provided just over 800 million to help
  developing countries control infectious diseases.
  This represents less than 2 of total donor
  funds. This sum is considerably stretched since
  50 of deaths in low-income countries are caused
  by infectious diseases.
• Efforts to decrease the disease burden of
  developing countries create positive global
  externalities through indirect effects of
  improved health, such as poverty alleviation,
  fostered economic development, augmented
  political stability and decreased political
  unrest.

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Fondation Mérieux Global Health A long history
(1)
Marcel Merieux
Louis Pasteur
A familial foundation, it was granted charity
status, a non profit foundation
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Fondation Mérieux Global Health A long history
(2)

• Summer of 1974, in the midst of a meningitis
  outbreak in Brazil, Charles Mérieux kept his
  staff at work during the traditional August
  vacation break to produce 100 million doses of
  meningitis vaccine, with 90 million of those
  doses given over the next 6 months.

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Our Global Health Mission

• To fight infectious diseases affecting developing
  countries, with innovate approaches in
  prevention, diagnostics and therapeutics.

Health is a human right and a global public good
that needs to be protected and promoted by the
global community.
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Our contributions to Global Health
1. SUPPORTING APPLIED RESEARCH
2. KNOWLEDGE SHARING
3. STRENGTHENING HEALTH STRUCTURES
4. SUPPORTING MOTHERS AND CHILDREN
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Our activities in the field
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Contribution to the UNs Millennium Development
Goals (UNMDG)
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Prospects of Meeting Millennium Development Goal
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Reduce Child Mortality
Source World Bank Group, 2003
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Needs for Human Capacity Building

• "Unless we focus on the human component of health
  systems development, it seems fair to predict
  that the goals of the global health community and
  the large scale improvements reflected in the
  UNMDGs will not be met ". (Global Health Trust,
  Joint Learning Initiative)

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Distribution of health workers by level of
health expenditure and burden of disease, by WHO
region
Source WHO, World Health Statistics, 2006
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Countries identified human ressources as the area
of the health system most in need of investment
WHO, Opportunities for global health initiatives
in the health systems action agenda, 2005
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Key Challenges for human capacity building

• Global shortages of health professionnals (more
  than 4 million workers Sub-Saharian countries
  must nearly triple their current number of
  workers if they want to come close to MDGs)
• Skill imbalance countries must revamp their
  health plans toward a workforce that more closely
  reflects the health needs of their populations
• Labor migration / "brain drain"  
• Chronic underinvestment in human ressources
• Lack of motivation

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Fondation Mérieuxs contribution to human
capacity building on global health
2. International advanced training sessions
3. Electronic knowledge and experience sharing
1.Build local capacity
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1. Local capacity building

• MALI ACTION BIOMALI nationalwide capacity
  building for a network of gt80 biomedical
  laboratories via the Charles Mérieux Centre
  (national reference laboratory)

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Situation

• Project set-up in close collaboration with the
  Ministry of Health following a needs analysis
• The Ministry of Health of Mali is an official
  partner institution of the project and
  co-responsible for its implementation and
  sustainability
• Overall Objective improve diagnostic and
  biological follow-up of patients suffering from
  HIV/AIDS, tuberculosis, malaria all over the
  country of Mali relying on existing health
  structures (Infrastructure, Training, Networking)
• Correct diagnostic is an essential basis for
  treatment

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Levels of human capacity building

• Bachelor of Science of Biological and Applied
  Medical Science (in collaboration with ESTBB)
• Training of technicians at district level
  (South-South)
• Continuing training for trainers at regional
  level (North-South)

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Lessons from first experience

• Needs identified by local authorities
• Pedagogical staff from the North should transfer
  knowledge to the staff from the South
  (co-animation of training sessions)
• Mutual benefit from lessons learned
• Avoid ad-hoc and ensure long-term training
• Compensation essential for motivation
  (collaboration with local authorities
  indispensable for sustainability)

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2. International advanced capacity building

• Advanced course on vaccinology
• (co-financed by EC and BMG-Foundation)
• 2 weeks intensive training course with lectures
  and group work in Annecy
• Objective facilitate critical decision making in
  vaccinology
• Faculty international top experts in the field
• Participants government, industry, NGO and
  university representatives coming from
  developing and industrialised countries (50-50)

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Results of a long-term evaluation

• 91 said that the course helped them to
  strenghthen the mutual understanding in the field
  of vaccinology
• 65 of out of 160 respondants said that the
  course expanded their career opportunities
• 50 agreed that the course helped them to improve
  their professionnal position and even their
  income (20)
• For 50 of respondants, the course improved the
  immunisation policy in their country
• And.. 96 of respondants expressed their need for
  electronic knowlegde and experience sharing

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3. Electronic capacity building

• Electronic version of capacity building globally
  accessible to complement local and international
  capacity building
• Web-portal for professionnals giving access to
  relevant scientific information, e-learning,
  expert advice and electronic tools (software,
  forum, electronic conferences etc.)
• Starting with two domains vaccinology
  diagnostic
• Based on positive experience in the
  Euro-Mediteerranean region participants
  appreciated advantages of this type of learning
  as it allows flexibility in time and location,
  easy update of information (CD-Rom where Internet
  connection is not available), easy contact to
  international expertise
• Possibility of collaboration with other
  Foundations

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WHO Proposition from World Health Report

• An extraordinary global solidarity is needed to
  address issues on human ressources for global
  health International action necessites
• Coalitions around emergency national plans for
  health professionnals
• Catalyse knowledge and learning invest in
  development of better matrics and common
  technical frameworks
• Strike cooperative agreements to protect rights
  and safety of workers and avoid brain drain
• To respond to health workforce crisis donors
  must facilitate immediate and longer-term
  financing of human resources as health systems
  investment
• An annual increase of 1.60 US per capita
  expenditure on health needed for scaling up the
  workforce over a 20-year period
• GAVI (Global Alliance for Vaccines and
  Immunisation) supports health systems
  strengthening strategy inclusive health workforce
  through country applications 500 million US
  over 5 years
• Emergency Health Workforce Plan in Malawi has
  dedicated US 278 million over six years through
  a coalition of country and global partners

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Political will is considered as a key determinant

• The lack of robust sectoral strategies, plans and
  budgets
• Weak linkages between the health sector and
  broader development processes
• Limited attention to the staffing and systems
  issues that impede service delivery
• Inadequate monitoring systems for tracking
  resource flows, progress and outcome
• Limited progress in translating global
  commitments on aid effectiveness into concrete
  action at country level

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Conclusions

• Problems of corruption and necessity to follow
  actions on a field level
• Collaborate with local health actors (Ministries,
  NGOs, local initiatives)
• Written engagement with participating actors,
  assure regular follow-up and evaluation (local
  representatives)
• Creation of a network of interested actors with
  the need for catalysation

Efforts should consequently be made to facilitate
the dialogue between policy makers, civil
society, donors, workers, NGOs in order to better
match the needs of afflicted populations and to
help targeting actions more efficiently