Furthermore, new initiatives have the potential to complicate efforts at harmonizing and coordinating actions at the global level in support of maternal, newborn and child survival and health. Given their strong focus on achieving rapid, cost-effective and measurable results, the proliferation of GHPs risks entrenching the ‘vertical’ nature of health financing by focusing large amounts of new funding on disease-specific programmes and interventions, creating separate financing and delivery silos, and leaving recipient governments with little flexibility to reallocate funds according to their own priorities or to fund health-system costs and investments such as salaries and facilities. Creating conditions for increased unity in global health programmes and partnerships In response to the proliferation of global health partnerships and initiatives, a set of best practice principles for global health partnerships has been developed. Based on the Paris Declaration on Aid Effectiveness, the principles were endorsed by participants and have now been adopted by the boards of a number of GHPs. In addition, the OECD Development Assistance Committee has reviewed a ‘Good Practice Guidance for aligning global programs at the country level’. This responds to the need identified in the Paris Declaration for taking concrete and effective action to address insufficient integration of global programmes and initiatives into partner countries’ broader development agendas. On governance and implementation of global programmes, the good practices address the interlinked roles of financiers (bilateral donors, multilateral institu-
tions and private foundations), partner countries and global programmes. Global programmes in health, whether in partnerships or through individual actions of single organizations and donors, have become an important tool of development assistance, with bilateral donors, multilateral institutions and private foundations providing rapidly increasing levels of financing for service delivery at the country level. These programmes, which also attract strong public support, call international attention to issues of global importance, encourage innovation and the dissemination of best practices, and provide pooled multi-donor funding (upstream harmonization).
effectiveness of global programmes, current or proposed, that provide significant country-level financing. However, some of the good practices, including those on selectivity and governance, have implications for global programmes in general. Financiers, partner countries, global programmes and private donors are being invited to apply the guidance on a trial basis. Monitoring of a pilot of good practice application will be carried out as part of the use of health as a tracer sector to monitor the effective implementation of the Paris Declaration on Aid Effectiveness and will be reported at the High Level Forum on Aid Effectiveness to be held in Accra, Ghana, September 2008.
The principles of the Paris Declaration on Aid Effectiveness – with their focus on country ownership, harmonization and alignment, and mutual accountability – apply to global as well as country-based programmes. Country studies confirm that issues of implementation are similar for the two, but that many global programmes face specific challenges. These include lack of field representation and related absence from donor harmonization efforts, inconsistency with government priorities and budgets, parallel mechanisms for coordination, as well as for implementation, and a centrifugal pull on human and financial resources from related national programmes. The good practices take as their base the principles and related indicators of the Paris Declaration, applying and extending them to reflect the specific case of global programmes. They are intended primarily to improve the
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