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The GAVI Alliance and the ‘Gates approach’ to health system strengthening

Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative im...

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Autor principal: Storeng, Katerini T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Routledge 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166931/
https://www.ncbi.nlm.nih.gov/pubmed/25156323
http://dx.doi.org/10.1080/17441692.2014.940362
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author Storeng, Katerini T.
author_facet Storeng, Katerini T.
author_sort Storeng, Katerini T.
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description Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed ‘single-minded’ focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called ‘Gates approach’ to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of ‘holistic’ health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos.
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spelling pubmed-41669312014-09-30 The GAVI Alliance and the ‘Gates approach’ to health system strengthening Storeng, Katerini T. Glob Public Health Original Articles Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed ‘single-minded’ focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called ‘Gates approach’ to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of ‘holistic’ health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos. Routledge 2014-09-14 2014-08-26 /pmc/articles/PMC4166931/ /pubmed/25156323 http://dx.doi.org/10.1080/17441692.2014.940362 Text en © 2014 The Author(s). Published by Taylor & Francis. This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted.
spellingShingle Original Articles
Storeng, Katerini T.
The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title_full The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title_fullStr The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title_full_unstemmed The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title_short The GAVI Alliance and the ‘Gates approach’ to health system strengthening
title_sort gavi alliance and the ‘gates approach’ to health system strengthening
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166931/
https://www.ncbi.nlm.nih.gov/pubmed/25156323
http://dx.doi.org/10.1080/17441692.2014.940362
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