Achieving a “Grand Convergence” in Global Health by 2035: Rwanda Shows the Way; Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives From Rwanda”

Document Type : Commentary

Authors

Evidence to Policy initiative (E2Pi), Global Health Group, University of California, San Francisco, CA, USA

Abstract

Global Health 2035, the report of The Lancet Commission on Investing in Health, laid out a bold, highly ambitious framework for making rapid progress in improving global public health outcomes. It showed that with the right health investments, the international community could achieve a “grand convergence” in global health—a reduction in avertable infectious, maternal, and child deaths down to universally low levels—within a generation. Rwanda’s success in rapidly reducing such deaths over the last 20 years shows that convergence is feasible. Binagwaho and Scott have argued that 5 lessons from this success are the importance of equity, quality health services, evidence-informed policy, intersectoral collaboration, and effective collaboration between countries and multilateral agencies. This article re-examines these lessons through the lens of the Global Health 2035 report to analyze how the experience in Rwanda might be generalized for other countries to making progress towards achieving a grand convergence.

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  1. Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world converging within a generation. Lancet. 2013;382:1898-1955. Doi:10.1016/S0140-6736(13)62105-4
  2. Gwatkin DR, Ergo A. Universal health coverage: friend or foe of equity? Lancet. 2011; 377(9784):2160-2161. Doi:10.1016/S0140-6736(10)62058-2
  3. Horwitz A. Comparative public health: Costa Rica, Cuba, and Chile. http://archive.unu.edu/unupress/food/8F093e/8F093E04.htm. Accessed May 10, 2015. Published September 1987.
  4. Binagwaho A, Scott KW. Improving the world’s health through the post-2015 development agenda: Perspectives from Rwanda. Int J Health Policy Manag. 2015;4(4):203-205. doi: 10.15171/ijhpm.2015.46
  5. Farmer PE, Nutt CT, Wagner CM, et al. Reduced premature mortality in Rwanda: lessons from success. BMJ 2013;346:f65.
  6. Verguet S, Norheim OF, Olson ZD, Yamey G, Jamison DT. Annual rates of decline in child, maternal, HIV, and tuberculosis mortality across 109 countries of low and middle income from 1990 to 2013: an assessment of the feasibility of post-2015 goals. Lancet Glob Health. 2014;2(12):e698-e709. Doi:10.1016/S2214-109X(14)70316-X
  7. Kruk ME. Universal health coverage—a policy whose time has come. BMJ 2013;347:f6360
  8. Reddy KS. Building a better India: health beyond healthcare. Hindustan Times, 2013 November 28. http://www.hindustantimes.com/hindustantimesleadershipsummit2013/building-a-better-india-health-beyond-healthcare/article1-1156866.aspx
  9. Nicholson D, Yates R, Warburton W, Fontana G. Delivering universal health coverage: A guide for policymakers. Report of the WISH Universal Health Coverage Forum 2015. http://wish-qatar.org/summit/2015-summit/forumsandpanels/universal-healthcare-coverage/universal-healthcare-coverage. Published 2015.
  10. Whitworth J, Sewankambo NS, Snewin VA. Improving implementation: building research capacity in maternal, neonatal, and child health in Africa. PLoS Med. 2010;7(7):e1000299. Doi:10.1371/journal.pmed.1000299
  11. Organisation for Economic Co-operation and Development (OECD). Better Aid. Aid Effectiveness 2011. Progress in Implementing the Paris Declaration. http://www.oecd.org/dac/effectiveness/2011surveyonmonitoringtheparisdeclaration.htm
  12. Desalegn H, Solberg E,  Kim JY. The Global Financing Facility: country investments for every woman, adolescent, and child. Lancet. 2015;386:105-106. Doi:10.1016/S0140-6736(15)61224-7