The Struggle to Make Sustainable Change in Global Health

Abstract

In light of the current global economic crisis, the concept of promoting sustainability as part of public health efforts has reemerged as a major focus of the global health community. Historically, however, health efforts have not been focused on sustainability. Rather, efforts have focused on disease-specific intervention programs. These programs do not support systematic change to healthcare delivery systems and in many instances have taken away medical personnel from struggling local health systems to administer disease-specific short-term interventions. Aid for global health is donated by many state and private actors in a largely uncoordinated manner, directed overwhelmingly to specific high-profile diseases – rather than toward the general health of the public. Uncoordinated aid makes things worse on the ground. Often sustainability is mentioned in passing as a project goal without the discussion of specific endpoints and strategies, but in order to achieve true long-term change, clear targets need to be at the center of any effort. Charity is easy; transformation, however difficult, is the far preferable goal.