National and global responsibilities for health

The World Health Organisation (WHO) perceives health to be “a shared responsibility”, but global health actors often act out of self-interest rather than adopting harmonised approaches. This article notes that the joint learning initiative on national and global responsibilities for health is being established to articulate a coherent framework for sharing the responsibility for health.

The document underscores the following findings:

• states hold the primary responsibility to fund and ensure all the essential goods and services under the right to health.
• states also have a responsibility to govern well – honestly, transparently and accountably – with the full participation of civil society.
• “aid” is not predictable, scalable or sustainable, and it undermines the host country’s “ownership” of – and responsibility for – health programmes.
  

The authors believe that global health governance is essential because states will not accept international norms without genuine partnerships, equitable burden sharing and efficient programmes that improve health outcomes.

Conclusions are that: 

• global collaboration requires a collective response to shared risks and fundamental rights, where all states have mutual responsibilities.
• finding innovative ways to ensure adequate and enduring funding, with agreed-upon priorities, will be vital in ensuring that poor countries gain the capacity to fulfill the right to health.
• a system of governance that fosters effective partnerships and coordinates initiatives to create synergies and avoid destructive competition is required.
• global governance should reinforce the leadership and normative role of WHO, which must have the legitimacy, authority and resources to support all countries in guaranteeing the right to health.