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Are global health leaders effectively strengthening local public health systems?

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Winner: Medical practioner category

Global health leadership is, presently and historically, inextricably linked with the provision of billions of dollars of aid (by bilateral aid programs such as the President’s Emergency Plan for AIDS Relief, multilateral agencies such as the Global Fund, and private donors like the Bill and Melinda Gates Foundation), through the work of large-scale global health non-government organisations (NGOs). This association became particularly evident to me while studying for the London School of Hygiene and Tropical Medicine’s locally taught East African Diploma in Tropical Medicine and Hygiene last year. Throughout the campuses of the school’s urban and rural public health care facilities, the proliferation of signposts declaring multiple partnerships and familiar logos denotes the heavy presence and involvement of these NGOs.

In general terms, most of this global health aid is distributed into “vertical programs”, which tend to focus on specific diseases (HIV and malaria being the most common), by a specialised health service using dedicated health workers, having cost-effective interventions with measurable results. These programs have, among their many laudable achievements, successfully…