Beyond 2015: How Health Policy Can Help Countries Prepare for the Future

However, developing countries face a multitude of persistent and emerging health challenges, including unmet Millennium Development Goals, particularly those related to maternal and child health, and HIV and other infectious diseases. The landscape of global health is undergoing a transformation, driven by factors such as aging populations, socioeconomic changes, and the emergence of non-communicable diseases. Climate change is also having a profound impact on global health, with the health impacts of climate change becoming increasingly apparent. In this context, developing countries must address a series of pressing questions, including how to meet the growing needs for maternal and child health, family planning, and HIV prevention, treatment, and care, as well as how to address growing inequities and social exclusion. Weak health systems leave many countries poorly equipped to address these challenges. The Health Policy Project, funded by USAID and PEPFAR, has contributed to improved health by strengthening the efficiency, effectiveness, and equity of health systems. Lessons learned from this project suggest that health policy work should focus on five key areas to help developing countries prepare for the future: building strong, resilient health systems; promoting equity, inclusivity, and human rights; supporting localization; strengthening accountability; and ensuring sustainable financing. One example of successful health reform is India's Uttarakhand State, which has transformed its health sector through a series of policy reforms and programmatic innovations. The state's maternal mortality ratio has been cut in half, and 60% of deliveries now take place in health facilities. The introduction of holistic approaches to health reform has helped strengthen Uttarakhand's health system, including transformational leadership, ongoing collaboration across disciplines and organizations, and iterative learning. To build strong, resilient health systems, it is essential to maintain a holistic view by focusing health policy efforts on achieving systems-level change. This requires fostering responsive, people-centered policies and systems, supporting iterative learning, and applying systems-thinking approaches. A holistic view is essential when designing and implementing policy interventions, as health systems are complex systems that comprise the actions and interactions of myriad interconnected individual and institutional actors. Promoting equity, inclusivity, and human rights is also critical, as failure to address equity is recognized as the most serious shortcoming of the Millennium Development Goals. Equitable, inclusive policies are crucial for ensuring that program efforts and scarce resources are targeted to reach those most in need. Strong policies that safeguard human rights can enable disadvantaged populations to demand and gain equal access to high-quality health services. Supporting localization is another key area of focus, as local-level actors are assuming new roles and responsibilities in health financing, governance, and service delivery. Localizing health governance and generating detailed subnational health data can maximize the impact of scarce resources, improve equitable access to health services, and promote greater accountability. However, the extent to which localization delivers on its potential depends on the overall quality of local governance, the inclusivity of decision-making processes, and the capacity of local-level actors.