If there is any hope of achieving the Millennium Development Goals by 2015, developing countries must take the lead and chart their own course of development in a process of "country ownership", and without delay, argues Tedros Adhanom Ghebreyesus, Minster of Health for Ethiopia and Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, in a Comment published Online First in The Lancet.
Minister Tedros uses the experiences of Ethiopia to outline four practical but simple steps that countries should take towards "country ownership" to ensure that the effect of development aid is maximised.
According to Minister Tedros, countries must start with a clear development vision and detailed plan for realising it: "Development partners must allow countries the space to identify their own needs and priorities, and develop plans as they see fit. But countries should be open to ideas and seek to tailor proven practices to their own particular circumstances."
Key to resourcing the plan is to allow countries greater control of resources through flexible and predictable funding that promotes accountability and the space to pursue their most pressing health priorities. In Ethiopia, for example, even funding allocated to disease-specific services has been used to benefit the whole health system, writes Minister Tedros: "About 25-30% of HIV/AIDS grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria and 15% of resources from the US President's Emergency Plan for AIDS Relief have been used to build system capacities in many areas, including an information system for health management, a supply-chain management system, and major improvements in human resources."
Minister Tedros believes that it is vital countries are fully involved in the implementation of the plan. Fundamental to this will be for partners to strengthen existing capacities within the country and to help countries fix any national systems and procedures that are inadequate. Finally, he says, partners must help countries track performance and ensure mutual accountability between countries and partners based on clear outcome targets that are agreed from the start.
He concludes by acknowledging that fundamental to the success of "country ownership" will be development partners' full commitment: "Partners have a wide range of interests that hinder them from fully embracing country-led processes. But a decisive shift has to happen now if the MDG targets are to be reached."
Dr Tedros Adhanom Ghebreyesus, Minister of Health for Ethiopia and Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Via Hareya Fassil, International Affairs Advisor to the Minister
T) +1 202 446 6414 or +41 793 628 132 E) moh.vmo@ethionet.et
For full Comment see: http://press.thelancet.com/MDGs.pdf
Journal
The Lancet