#egn13
Innogen has a decade long track record in
seeking to understand how innovation and capacities become sustainable in
national health systems, and this session on Global Health and Development broke down some of its thinking.
The message Julius Mugwagwa (Innogen OU)
wanted you to take away from his opening presentation was: decision making
matters. As he explained, evidence shows that health care is in need of
strengthening, but a paradox exists given recent medical advances, increasing
funding and expanded range of actors and institutional innovations. As a
result, policy and decision-making systems will play a large role in health
system strengthening.
Using the examples of the Zimbabwean and
South African national health systems and the International AIDS Vaccine
Initiative, Julius explored innovative options for building long-term health
system resilience and delivery capacity, including: sustaining and embedding
projects, programmes and capacities in a health system that is viewed as
important by all stakeholders; understanding that while more money is needed,
so too are innovative ways of deploying it in health systems; and recognising
that policy plays a crucial role.
Rebecca Hanlin (Innogen OU) continued the
discussion on capacity building. Focusing on global health partnerships, she
began by defining capacity building at its micro (individual skills training
and infrastructure support), meso (networking, learning and knowledge exchange
opportunities), and macro (creation of a wider policy level enabling
environment) levels. But why is this important? As Rebecca explained: there is
a return to wider notions of healthcare, health systems strengthening and
horizontal programmes; there are funding shortfall by donors and scientific
hold ups; and a recognition of the growth potential more widely of local
capacity.
Ultimately, PDPs are a way of providing
capacity building. By operating as ‘new’ institutional forms, they have the
ability – but also the need – to: build crucial individual level skills in the
scientific arena within developing countries, but also building meso level
institutional and macro level enabling environment capacity.
Geoff Banda (Innogen OU) also seized upon
the issue of capacity by exploring a forgotten one. As he explained, academic
and professional discourses tend to focus on technological capabilities,
technology transfer, economies of scale, human capital, and markets for drugs;
however, the capabilities surrounding the financing of working capital and
capital investment and the role of financial institutions remain
neglected.
Drawing on the financing of antiretroviral
drugs manufacture in Zimbabwe, Geoff sought to rectify the previous lack of
discourse in this area by addressing sources of finance for working capital
requirements and capital investment to import technologies, as well as the
technological capabilities surrounding access to finance at pharmaceutical
companies and technological capabilities surrounding loan origination at
finance institution. His argument: finance is just as important as investment,
production and linkage capabilities.
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