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Global Health Actors Claim To Support Health System Strengthening—Is This Reality or Rhetoric?

  • Bruno Marchal mail,

    bmarchal@itg.be

    Affiliation: Department of Public Health, Institute of Tropical Medicine–Antwerp, Antwerp, Belgium

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  • Anna Cavalli,

    Affiliation: Department of Public Health, Institute of Tropical Medicine–Antwerp, Antwerp, Belgium

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  • Guy Kegels

    Affiliation: Department of Public Health, Institute of Tropical Medicine–Antwerp, Antwerp, Belgium

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  • Published: April 28, 2009
  • DOI: 10.1371/journal.pmed.1000059

Reader Comments (2)

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Building on local competence

Posted by RCairns on 10 Jun 2009 at 08:29 GMT

Thanks for this most interesting article. I was, however, disappointed that although APOC was mentioned, the importance of local competence and local "buy-in" in building and strengthening health care systems was not highlighted.
For me, APOC is a fascinating example of how local competence and commitment in the most remote (and often war-torn) areas can actually help to build national health care systems from the "bottom up", by giving local people skills, training, and access to medicines that connect those remote areas and their people into the existing health care systems.
While it began as a way of distributing ivermectin to remote areas at low cost, to combat "river blindness", trials of how community-directed health care can be used to deliver other primary care interventions in Africa indicated positive results in other areas as well.

No competing interests declared.