The politics of health systems strengthening

Authored by: Katerini T. Storeng , Ruth J. Prince , Arima Mishra

Routledge Handbook on the Politics of Global Health

Print publication date:  December  2018
Online publication date:  December  2018

Print ISBN: 9781138238596
eBook ISBN: 9781315297255
Adobe ISBN:


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The 2014–2015 Ebola epidemic in Guinea, Liberia, and Sierra Leone brutally exposed the consequence of the neglect of national health systems. Historian of science Guillaume Lachenal describes the epidemic as the logical consequence of two decades of political choices and actions, starting with the systematic undermining of African health care systems by neoliberal reforms and perpetuated by the political and institutional landscape of global health (Lachenal, 2014). In the affected countries, and across many other poor countries, health care delivery has been left largely to a patchwork of nongovernmental organisations (NGOs), public–private partnerships (PPPs), and medical humanitarian organisations that sidestep the state (Prince and Marsland, 2013). In Liberia, for instance, the Ebola epidemic unfolded in a context where three quarters of government-owned health facilities were managed by NGOs (Moran, 2015).

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