Interactions between critical health system functions and HIV/AIDS, tuberculosis and malaria programmes.

摘要

The devastating health and socio-economic impact of communicable diseases such as HIV, tuberculosis and malaria in low-and middle-income countries has served as a rallying point for global health communities, including donors, to mobilize around the health-related Millennium Development Goals (UNDP). The unprecedented scale and speed of these investments has prompted a healthy debate on the effects of disease-specific funding on national health systems. In particular, the debate has centred on: (i) the interaction of these targeted programmes with wider health systems; (ii) the nature and extent of integration of these programmes with health system functions; (iii) benefits and synergies realised as a result of these interactions; (iv) unintended adverse effects of these investments on health systems; and (v) whether this programmatic approach is an effective way of achieving long-term, sustainable health outcomes (WHO Maximizing Positive Synergies Collaborative Group 2009; Atun et al. 2010).