What a “joint platform” for health aid should look like

Here in Hanoi at the GAVI Partners’ Forum, we have been discussing the Joint Platform for Health Systems Financing – a proposed mechanism whereby GAVI, the World Bank and the Global Fund to Fight AIDS TB & Malaria put their funding together instead of duplicating processes. There are various ideas floating around, but they are are depressingly unambitious.

If the plans don’t get to the real problems and the real principles, the risk is that it will follow a familiar pattern: a big plan announced by donors, leading to very little extra money and even more bureaucracy for the stretched governments of developing countries.

Save the Children has already set out what we want to see, but it is clear that much more lobbying is needed to get donors to be more ambitous.

Firstly, it must not insist that governments write proposals for money from this platform. Developing country governments should concentrate on getting their national plans for health sorted, following the best advice from the World Health Organisation and by involving citizens and civil society organisations in setting priorities.

It should use the processes that are being developed for everyone to review that national plan. Then all the governments and donors involved should agree what the funding gap is over the next years to implement this plan. But instead of walking away and waiting for the developing country government to request some money, all the players should then announce how that gap will be actually be filled. This should include:

1. How much money the developing country government has already allocated to health and how much extra they will raise through fair taxes and national insurance schemes
2. How much money the Joint Platform of GAVI, the Global Fund and the World Bank will commit
3. How much extra money donor governments will promise
4. Any additional financing from the “innovative” sources.

It is nearly 2010. The global health targets which all governments have signed up to have an end date of 2015. The idea that developing countries can wait to set up yet another new mechanism, jump through the hoops that are set up and then apply for extra funding only to find out that what they get is inadequate is a joke. Save the Children will continue to try to get donors to live up to their ambitions.