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Healthy Development:
The World Bank strategy for health, nutrition and population results

World Bank

24 April 2007

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Executive Summary

Healthy Development: The World Bank Strategy for Health, Nutrition, and Population Results for the next decade updates the 1997 World Bank Health, Nutrition, and Population (HNP) Strategy in light of the momentous changes of the past decade in the international architecture of development assistance for health (DAH)1 and of persisting and new HNP challenges worldwide. Ten years ago, the Bank was the main financier of HNP. Today, in addition to the Bank, new multilateral organizations, initiatives, and foundations have assumed a prominent role in financing HNP, among them the Global Fund,2 GAVI,3 GAIN,4 and the Bill and Melinda Gates Foundation. Bilateral aid has also increased substantially. Much of this new funding is earmarked for combating priority diseases such as HIV/AIDS, malaria, tuberculosis, and some vaccine-preventable diseases; less for health system strengthening at country level, for maternal and child health, for nutrition, and for population priorities.

The ultimate objective of World Bank work in HNP, reinforced by this new Strategy, is to improve the health conditions of the people in client countries, particularly the poor and the vulnerable, in the context of its overall strategy for poverty alleviation. To achieve this objective, this new Strategy states the vision and the Action Plan necessary to strengthen Bank capacity to better serve client countries by excelling in areas of Bank comparative advantages and by improving its collaboration with global partners.

The increased awareness and expanded international financing for HNP constitute a great opportunity for the Bank to help client countries and global partners improve HNP results on the ground, particularly for the poor and the vulnerable. However, the new environment also poses significant challenges for the Bank, requiring important changes in the way the Bank operates in HNP to be able to rise to the challenges. This 2007 HNP Strategy outlines the Bank vision for improving its own capacity to respond globally and with a country focus to the urgent issues posed by these challenges.

Throughout this Strategy, the case is made for sharpening Bank focus on results on the ground; for concentrating Bank contributions on its comparative advantages, particularly in health system strengthening, health financing, and economics; for supporting government leadership and international community programs to achieve these results; and for exercising selectivity in engagement with global partners. This focus is not intended to constrain what the Bank does—country circumstances must drive Bank programs. However, a selective and disciplined framework is advocated, particularly for policy advice and knowledge generation, to ensure that the Bank is appropriately staffed and ready to support country efforts and requests for assistance in a core set of key areas where the Bank can play a major role. This framework is also essential for the Bank to collaborate with global partner efforts to ensure aid effectiveness.

This Strategy Paper is organized in nine sections, including this summary. Additional information is presented in 15 annexes. All figures referred to in the text are presented in annex A. Annexes B, C, D, E, F, G and H include, respectively, the regional and HNP Hub Action Plans for implementing the HNP Strategy; the acknowledgments; the list of individuals interviewed; the list of participants in the country and global partner consultations leading up to this new Bank HNP Strategy; the initial regional survey for strategic orientations and the CODE Chairman Summary Note to the Background Note on the World Bank Strategy for HNP Results, discussed with CODE on June 21, 2006.

  1. Development Assistance for Health (DAH) consists of all resources aimed at providing financial support to developing countries to improve the HNP conditions of their populations. DAH includes multilateral organizations such as the Bank, bilateral aid, and private philanthropic aid. Annex I presents an overview of actors and trends in DAH in the last decade.
  2. Global Fund to Fight AIDS, Tuberculosis and Malaria.
  3. Global Alliance for Vaccines and Immunization.
  4. Global Alliance for Improved Nutrition.

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