Discussions: Strengthening health systems

Many developing countries have health systems that are ailing – and well-intentioned development aid is contributing to the problem. Between 2000 and 2010, annual development assistance for health surged from US$10.5 billion to US$27 billion. Most of this was channelled through donor-driven programmes targeted at specific diseases, most prominently HIV/AIDS. Such ‘vertical’ programming has undermined the development of strong national health systems and drawn resources away from countries’ other health priorities. District governments have a key role in coordinating the activities of all local health players, including those running vertical programmes.