INCO-DEV project ‘GHIs in Africa’:
Experience of four African countries with Global Health Initiatives

The past five years have witnessed a proliferation of global health initiatives (GHIs), which have emerged as an alternative to traditional bilateral and multilateral health development funding.  GHIs are seen as an efficient and rational response to global public health threats, yet little is known about how the shift from traditional funding mechanisms toward global approaches has impacted health systems in recipient countries.

A four year EU-funded research project

This is a four year EU-funded research project (INCO-DEV) in four Southern African countries (Angola, Lesotho, Mozambique and South Africa) that aims to understand how the rise of GHIs has impacted the architecture of development partnerships and country-level health systems’ functions:

  1. To assess the impact of GHIs on country-level decision-making and planning processes
  2. To assess the impact of GHIs on human resource policies and on competition for human resources for programme planning, management and service delivery
  3. To evaluate how the proliferation of GHIs has influenced development assistance for health practices,
  4. And to identify lessons that can be useful to integrate new GHIs within existing partnerships and country systems in a way that improves the coherence of development assistance and the co-ordination and efficacy of the health system

The core of the study is to research how changes in development partnerships practices and the emergence of Global Health Initiatives have impacted on health systems at the global, national and district level. The study is focusing on the effects of several large global initiatives for health and HIV/AIDS control on aid recipient sub-Saharan African countries, such as the World Bank’s Multi-country AIDS Program (MAP), US President’s Emergency Plan for AIDS Relief (PEPFAR), Global Alliance on Vaccines and Immunisation (GAVI Alliance) and the Global Fund to Fight HIV/AIDS, TB and Malaria.

This project aims to generate policy-relevant knowledge on:

  • the activities of Global Health Partnerships (GHPs) and other GHIs at country level and their effectiveness;
  • donor harmonization initiatives;
  • the extent and effects of the integration of the GHIs in national strategic planning of sub-Saharan African countries and the potential for and benefits of a more effective integration;
  • the impact of GHIs on the development of health workforce policies and the performance of health workers.