Posted by: blog4globalhealth | 06/15/2011


To secure a healthier future for all, do the diagonal tango and let countries lead

The diagonal tango was proposed as a policy approach to mitigate global health challenges in the imminent future. Council president Dr. Jeff Sturchio predicts a world with an increasing urban population suffering from more chronic illnesses and noncommunicable diseases (NCDs) over the course of the next two decades. Panelists shed light on the implications for health systems, noting a continued focus on communicable ailments and the increasing pressure to address NCDs.

Panelist Dr. Felicia Knaul from the Harvard Global Equity Initiative urged stakeholders in the global health community to adopt a diagonal approach in combating NCDs; instead of diverting valuable resources from other projects to design endeavors to address NCDs, integrate long-term efforts into existing disease-specific initiatives. For example, cancer prevention and detection can be added to maternal and child health initiatives.

Dr. Srinath Reddy from the Public Health Foundation of India went one step further and noted that health system transformation is a dance between sound research and appropriate policymaking, thus designating Dr. Knaul’s approach the diagonal tango.

With every partner dance, there must be a leader. Dr. Francis Omaswa, executive director for the African Center for Global Health and Social Transformation (ACHEST) and MLI senior advisor reminded the audience that possessing the capacity to lead is an iterative process. Leadership is often taught in management schools, but the best way to hone skills is in practice.

Liberia’s lead health policy maker, Minister Gwenigale, called for countries to set their priorities, and for the global health community to acknowledge and support these priorities. This is a message MLI countries echoed in its global call to action, Country-led Development in Health: Practical Steps Forward.

When asked how countries can learn from early practitioners of country leadership, Dr. Omaswa encouraged peer learning through country-to-country exchange, executive training programs, and documentation, such as Ethiopia Minister Tedros’ commentaryin the Lancet on country ownership. Managing various donors, like leading different tango partners, is an art that has a few basic guidelines.

While some acknowledged that they may not be alive to see the world Dr. Sturchio envisions, this year’s GHC conference plenary panelists urged global health stakeholders to let countries lead the diagonal tango in the coming decades.

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