This paper is available upon request from IEG-World Bank.

IEG Working Paper 2008/3

2008

The World Bank Washington, D.C.

From Population Lending to HNP Results: The Evolution of the World Bank’s Strategies in Health, Nutrition and Population

Background Paper for the IEG Evaluation of World Bank Support for Health, Nutrition, and

Population

Mollie Fair

ENHANCING DEVELOPMENT EFFECTIVENESS THROUGH EXCELLENCE AND INDEPENDENCE IN EVALUATION The Independent Evaluation Group is an independent unit within the World Bank Group; it reports directly to the Bank’s Board of Executive Directors. IEG assesses what works, and what does not; how a borrower plans to run and maintain a project; and the lasting contribution of the Bank to a country’s overall development. The goals of evaluation are to learn from experience, to provide an objective basis for assessing the results of the Bank’s work, and to provide accountability in the achievement of its objectives. It also improves Bank work by identifying and disseminating the lessons learned from experience and by framing recommendations drawn from evaluation findings. IEG Working Papers are an informal series to disseminate the findings of work in progress to encourage the exchange of ideas about development effectiveness through evaluation. The findings, interpretations, and conclusions expressed here are those of the author(s) and do not necessarily reflect the views of the Board of Executive Directors of the World Bank or the governments they represent. The World Bank cannot guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply on the part of the World Bank any judgment of the legal status of any territory or the endorsement or acceptance of such boundaries. ISBN No. 13: 978-1-60244-088-3 ISBN No. 10: 1-60244-088-3 Contact: Knowledge Programs and Evaluation Capacity Development Group (IEGKE) e-mail: eline@worldbank.org Telephone: 202-458-4497 Facsimile: 202-522-3125 http:/www.worldbank.org/ieg

From Population Lending to HNP Results: The Evolution of the World Bank’s Strategies in Health,

Nutrition and Population

Mollie Fair

Independent Evaluation Group, World Bank Sector, Thematic and Global Evaluations Unit

Background paper for the IEG evaluation of World Bank support for health, nutrition, and population

February 2008 This paper was prepared as background for the forthcoming IEG evaluation of the World Bank’s support for health, nutrition, and population (HNP). The author wants to thank Martha Ainsworth for her invaluable guidance on this paper, and gratefully acknowledge Alan Berg, Ed Elmendorf, Bernhard Liese, Thomas Merrick, Keith Pitman, Meera Shekar, Richard Skolnik and Denise Vaillancourt for useful comments and suggestions. Any errors or omissions should be attributed to the author. Financial support for this work from the Norad Evaluation Department is gratefully acknowledged. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author and do not represent the views of the World Bank, its Executive Directors, or the countries they represent.

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Table of Contents

ABBREVIATIONS AND ACRONYMS...................................................................................................III EXECUTIVE SUMMARY ........................................................................................................................ VI 1. INTRODUCTION............................................................................................................................... 1 2. POPULATION LENDING: 1970-1979............................................................................................. 1 3. PRIMARY HEALTH CARE: 1980 - 1986 ....................................................................................... 5 4. HEALTH REFORM: 1987- 1996 ...................................................................................................... 8 5. HEALTH OUTCOMES AND HEALTH SYSTEMS: 1997-2000................................................. 14

1997 HNP SECTOR STRATEGY ................................................................................................................. 14 SHARPENING STRATEGIC DIRECTIONS....................................................................................................... 16 ACHIEVING GREATER DEVELOPMENT IMPACT .......................................................................................... 18 EMPOWERING BANK STAFF ...................................................................................................................... 19 STRENGTHENING PARTNERSHIPS .............................................................................................................. 19 POPULATION AND NUTRITION .................................................................................................................. 19 NEW INSTRUMENTS AND APPROACHES .................................................................................................... 20

6. GLOBAL TARGETS AND PARTNERSHIPS: 2001-2006........................................................... 23 MILLENNIUM DEVELOPMENT GOALS ....................................................................................................... 24 LEVELS OF DEVELOPMENT ASSISTANCE FOR HEALTH ............................................................................. 25 GLOBAL HEALTH PARTNERSHIPS ............................................................................................................. 26 POPULATION AND NUTRITION .................................................................................................................. 27 THE PLACE OF THE POOR .......................................................................................................................... 28

7. SYSTEM STRENGTHENING FOR RESULTS: 2007 ................................................................. 28 8. CONCLUSIONS ............................................................................................................................... 31 REFERENCES ........................................................................................................................................... 34 ANNEX A: OBJECTIVES, RATIONALE, AND STRATEGIES 1970 – 2007..................................... 42 ANNEX B: SUMMARIES OF KEY HNP DOCUMENTS AND STRATEGY PAPERS, 1997-2007. 43 ANNEX C: WORLD BANK HNP TIMELINE....................................................................................... 51 ANNEX C SOURCES ................................................................................................................................ 65 ANNEX D: GLOBAL HNP EVENTS TIMELINE................................................................................. 67 ANNEX D: SOURCES............................................................................................................................... 90 BOX 2-1: FACTORS IN THE 1970S LEADING TO INCREASED COMMITMENT TO HEALTH ........ 3 BOX 3-1: MAIN FEATURES OF HNP (PHN) PROJECTS 1980-1985....................................................... 5 BOX 4-1: THE BAMAKO INITIATIVE 1987............................................................................................ 11 BOX 4-2: MAJOR OBJECTIVES OF THE INTERNATIONAL CONFERENCE ON POPULATION

AND DEVELOPMENT (ICPD)......................................................................................................... 12 BOX 4-3: FINDINGS FROM OED’S 1999 EVALUATION OF THE HNP SECTOR.............................. 13 BOX 5-1: KEY ELEMENTS OF THE STRATEGIC COMPACT ............................................................ 14 BOX 5-2: FOUR PRINCIPLES OF THE COMPREHENSIVE DEVELOPMENT FRAMEWORK (CDF)

............................................................................................................................................................ 21 BOX 6-1: OED´S FINDINGS ON GLOBAL HEALTH PROGRAMS ...................................................... 27

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FIGURE 3-1: HNP (PHN) PROJECTS, SECTOR REPORTS AND LENDING APPROVED FY81- 85.... 7 FIGURE 4-1: PERCENT OF HNP (PHN) PROJECTS WITH “SYSTEMIC” OBJECTIVES ................... 10 FIGURE 5-1: WORLD BANK NEW AIDS COMMITMENTS BY FISCAL YEAR OF APPROVAL .... 23 FIGURE 6-1: TRENDS IN DAH FROM MAJOR SOURCES 1997- 2002 ................................................ 26 TABLE 5-1: THE BANK’S 1997 HNP SECTOR OBJECTIVES AND STRATEGIES ............................ 16 TABLE 5-2: ADVANTAGES AND DISADVANTAGES TO SINGLE-DISEASE/PRIORITY

PROGRAMS ...................................................................................................................................... 22 TABLE 6-1 THE HEALTH-RELATED MDGS ......................................................................................... 24

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ABBREVIATIONS AND ACRONYMS ACTafrica AIDS Campaign Team for Africa AAA Analytic and Advisory Activities AIDS acquired immune deficiency syndrome BNWPP Bank-Netherlands Water Partnership Program BSSA Basic Social Services for All CAS Country Assistance Strategy CDC Center for Disease Control and Prevention CDF comprehensive development framework CIDA Canadian International Development Agency CVI Children’s Vaccine Initiative DAH development assistance for health DALY disability-adjusted life year DANIDA Danish International Development Agency DHS Demographic and Health Survey DFID Department for International Development (United Kingdom) DOTS directly observed therapy, short course EAP East Asia and the Pacific ECA Eastern Europe and Central Asia EDI Economic Development Institute ESSD Environmentally and Socially Sustainable Development FAO Food and Agricultural Organization of the United Nations FPSI Finance, Private Sector and Infrastructure FWCW Fourth World Conference on Women GAIN Global Alliance for Improved Nutrition GAMET Global HIV/AIDS Monitoring and Support Team GAVI Global Alliance for Vaccines and Immunization GBD global burden of disease GFATM Global Fund for AIDS, Tuberculosis and Malaria GHP global health partnership GNP gross national product GOBI growth monitoring, oral rehydration, breastfeeding, and immunization GTT Global Task Team HDN Human Development Network HNP Health, Nutrition, and Population HIPC heavily indebted poor country HIV human immunodeficiency virus IAVI International AIDS Vaccine Initiative IBRD International Bank for Reconstruction and Development ICPD International Conference on Population and Development ICR implementation completion report IDA International Development Association IEG Independent Evaluation Group

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IFC International Finance Corporation IFFim International Finance Facility for Immunization IFPRI International Food Policy Research Institute IHR International Health Regulations IMCI Integrated Management of Childhood Illness IMF International Monetary Fund INDEPTH An International Network of field sites with continuous Demographic

Evaluation of Populations and their Health in developing countries IPPF International Planned Parenthood Federation IUD intrauterine device IWRM Integrated Water Resources Management KAP knowledge, attitudes and practices LAC Latin America and the Caribbean LIC low-income country LSMS living standards measurement survey M&E monitoring and evaluation MAP Multi-Country HIV/AIDS Program MCA Multisectoral Constraints Assessment MDG Millennium Development Goal MEASURE Monitoring and Evaluation to Assess Use and Results MIC middle-income country MMV Medicines for Malaria Venture MNA Middle East and North Africa MSF Médecins sans frontières MTEF medium-term expenditure framework NGO non-governmental organization OCP Onchocerciasis Control Program OED Operations Evaluation Department ODA official development assistance PAHO Pan-American Health Organization PEPFAR President’s Emergency Plan for AIDS Relief PHC primary health care PHN Population, Health, and Nutrition PHR Population and Human Resources PPFA Planned Parenthood Federation of America PREM Poverty Reduction and Economic Management PRS poverty reduction strategy PRSC poverty reduction support credit PRSP poverty reduction strategy paper PSI Population Services International QAG Quality Assurance Group RBM The Roll Back Malaria Partnership RPP Reaching the Poor Program SARS severe acute respiratory syndrome SIDA Swedish International Development Cooperation Agency SIP sector investment program

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SSA Sub-Saharan Africa SWAp sector-wide approach TB tuberculosis TFI Tobacco Free Initiative UN United Nations UNAIDS Joint United Nations Program on HIV/AIDS UNDP United Nations Development Program UNECA United Nations Economic Commission for Africa UNESCO United Nations Economic and Social Council UNF United Nations Foundation UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund UNITAID International Drug Purchase Facility USAID United States Agency for International Assistance WHO World Health Organization WDR World Development Report WFP World Food Program WSP Water and Sanitation Program WSS water supply and sanitation

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EXECUTIVE SUMMARY This paper reviews the evolution of the World Bank’s strategies in the Health,

Nutrition, and Population (HNP) sector in relation to both internal and global events, as background for the forthcoming evaluation by the Independent Evaluation Group (IEG) of the Bank’s support for HNP. It summarizes the objectives, priorities, and strategies in HNP as expressed in official documents and revealed implicitly by its lending and non-lending activities. Special emphasis is placed on analysis of the period since the release of the 1997 HNP Strategy, which has guided the sector over the last decade. However, the report also reviews the Bank’s earlier experiences in HNP, so as to provide a context for understanding the World Bank’s current strategies. Detailed timelines annexed to the paper help to put the Bank’s strategies and actions in the context of the evolution of global HNP themes.

The World Bank’s policies, strategies, and lending for HNP have evolved in phases over the past thirty-five years. During the 1970s, the emphasis was on improving access to family planning services, because of concern about the adverse effects of rapid population growth on economic growth and poverty reduction. A handful of nutrition projects were also approved. During the second phase, from 1980-86, the Bank directly financed health services, with the objective of improving the health of the poor by improving access to low-cost primary health care. However, systematic constraints were encountered in providing access to more efficient and equitable health services. The Bank nevertheless remained committed to the sector, as health increasingly was recognized both as an economic imperative and a desirable end in itself. During a third “health reform” phase, from 1987-1996, the Bank strove to improve health finance and reform entire health systems.

The strategy that has guided the sector for the past decade was issued in 1997 at the same time that the Bank was reorganized and the Human Development Network was formed. The 1997 Health, Nutrition and Population Sector Strategy Paper signaled the beginning of the “health reform and health outcomes” phase. It aimed to help client countries: (1) improve the HNP outcomes of the poor and protect the population from the impoverishing effects of illness, malnutrition, and high fertility; (2) enhance the performance of health systems; and (3) secure sustainable health financing. The sector sought to achieve greater impact through emphasizing strategic policy directions in Country Assistance Strategies, underpinning lending with analysis and research, increasing selectivity, improving client services, and stronger monitoring and evaluation.

By the late 1990s, the Bank was the largest financier of development assistance for health, and thus largely influential in setting priorities in global health. However, the international donor community’s commitments to reduce poverty and improve health outcomes surged at the end of the twentieth century. In the first years of the new century, in the “global targets and partnerships phase”, the objectives of the Bank’s HNP support remained the same, but the Bank has attempted to reposition itself in the changing global health landscape and redefine its role to participate in partnerships to meet global targets

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while maintaining support to client countries to improve HNP outcomes, especially for the poor.

The recently approved updated HNP strategy, Healthy Development: The World Bank Strategy for Health, Nutrition and Population Results (2007), embraces many of the same objectives and approaches of the 1997 strategy, while putting greater emphasis on results, but it was adopted without the benefit of evidence of the efficacy and lessons arising from the past decade of HNP support, totaling $15 billion. This suggests that an evaluation of the HNP support of the past decade is timely and relevant in pointing to ways of improving the effectiveness of the new strategy. Priority questions for the evaluation include: (1) To what extent has the Bank’s support contributed to improving HNP outcomes among the poor? (2) What lessons have been learned about the efficacy, advantages, and disadvantages of different approaches to improving health, such as sector-wide approaches, health system reform, multi-sectoral approaches, and the emphasis on communicable diseases that disproportionately affect the poor? (3) What has been the revealed ‘value added’ or comparative advantages of the Bank in supporting HNP, and how has that been changing? (4) To what extent has the Bank’s HNP support monitored results and used evaluation to improve the evidence-base for decision-making?

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1. INTRODUCTION 1.1 The World Bank’s lending and non-lending activities in the Health, Nutrition and Population (HNP) Sector can be divided into six distinct phases, each with clear rationale, objectives, and strategy to guide its lending and non-lending activities. Whereas thirty-five years ago the World Bank’s HNP lending was focused narrowly on population activities with a demographic rationale, it is currently involved in nearly all areas of health to improve HNP outcomes for the poor and vulnerable.

1.2 Drawing from HNP strategy and policy papers as well as evaluations of the Bank’s work, this paper traces the evolution of the World Bank’s strategies in the HNP sector. While it will focus on the decade since the release of the 1997 HNP Strategy, an overview of Bank’s earlier policies, strategies and experience is necessary to explain the context of its more recent strategies as well as to understand its comparative advantages in the sector. The phases were influenced significantly by external events in international health and development as well as internal Bank-wide events. Level of commitment to the sector and the Bank’s established priority areas have also been influenced heavily by the contemporary evidence concerning the relationship between health, economic growth, and poverty reduction. Annex A summarizes the objectives, rationale, and strategies of each the six phases of the Bank’s work in the HNP. Annex B provides summaries of the key objectives and strategies of key HNP documents and strategy papers from 1997-2006, as well as a summary of World Development Report 1993: Investing in Health, which was highly influential on the Bank’s work. Annexes C and D are timelines of important events in the World Bank’s work in the HNP sector and Global HNP events, respectively.

1.3 Although the World Bank’s mission and HNP policies continue to evolve and the global health architecture has changed dramatically in recent years, the need for the Bank to advocate evidence-based policies and employ the most effective approaches to facilitate and sustain improvements in HNP outcomes remains. This review aims to explain the evolution of the World Bank’s objectives and strategies in the HNP sector, providing a basis to evaluate its support over the past decade. The forthcoming IEG evaluation of the World Bank’s HNP support from 1997-2006 will provide valuable evidence on the efficacy and lessons of experience from the 1997 HNP Strategy. The evaluation’s conclusions will be highly relevant for improving the effectiveness of implementation of the new 2007 sector strategy and of the Bank’s support for achieving the Millennium Development Goals (MDGs).

2. POPULATION LENDING: 1970-1979 2.1 Dating back to the 1950s and throughout the 1960s, World Bank leadership expressed concern over the negative consequences of population growth on economic

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development.1 However, the Bank remained focused on its mission to promote economic growth primarily through investments for infrastructure and public utilities. As the family planning movement “flourished” in the mid-1960s, development economists “. . . played the critical role when they persuaded policy makers in the United States and some European governments, and soon thereafter in the World Bank, that rapid population growth was a major hindrance to economic development (Sinding 2007, p.1).2

2.2 By the late 1960s, the Bank committed itself to population control. In 1968, Robert McNamara, the Bank’s fifth president, argued that there was no alternative to the World Bank’s involvement in what he described as the “crisis” of population growth (World Bank Group Archives 2005). The first distinct phase of the Bank’s work in the HNP formally commenced in 1970 with the approval of the first population loan to Jamaica for $2 million to support a family planning program.3 The primary rationale for the Bank’s population and family planning lending was demographic: “. . . limited experience available has already shown that if an adequate service can be provided . . . the results will be demographically significant” (World Bank 1972a, p. 317). It was believed that population growth would limit social and economic progress. The objective of the Bank’s work in this new sector was to support governments to reduce rapid population growth through family planning programs that would lower high fertility.4

Beginning in 1972, Bank operations focused particularly on countries with large populations and high fertility rates where the effects of a reduction in fertility rates would be most significant. The Bank’s strategy for 1972-1975, as stated in the “Population Planning” chapter of the World Bank Operations: Sectoral Program and Policies, was to gather experience through its family planning programs to “establish the usefulness of its project approach in dealing with the population problem” (World Bank 1972a, p. 317). Fertility reduction was justified based on the premise that population growth thwarted efforts to increase per capita income and raise living standards.

2.3 Over the 1960s, the World Bank engaged in a broader range of activities, so that by 1970 it was lending for population, education and water supply, areas traditionally viewed as consumption sectors (as opposed to productive sectors). Given that economic growth was the World Bank’s overall objective, work in population was rationalized by emphasizing its contribution to productivity: “Lending for education and water supplies reflected a similar tension between their perceived “social” or not strictly productive nature and the continuing conviction that all Bank investments and advice should seek the maximum contribution to economic growth” (Kapur 1997). Due in part to this 1 Concerns over population growth were discussed at the Seventh Annual Meetings in Mexico City in 1952, yet there was significant resistance to the World Bank becoming involved in an area outside of its original mandate to support postwar reconstruction and economic development. 2 Throughout the 1960s developing countries established national family planning policies, the Second World Population conference focused on fertility as part of development planning policy, the United States Agency for International Development (USAID) began to finance family planning programs, the International Conference on Human Rights passed a resolution declaring family planning as a human right, and the United Nations Fund for Population Activities (UNFPA, now the UN Population Fund) began operations. 3 For a detailed description of the project in Jamaica and the process to approve the loan, see King 2007. 4 The total fertility rate (per woman) in developing countries dropped from an average of 5.4 between 1970- 1975 to 2.9 between 2000- 2005. In low income countries, the rates dropped from 5.7 to 3.7(UN 2003).

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tension, the first five years of the Bank’s work in population was characterized by “hardware” projects that emphasized the construction of urban maternity hospitals and development of postpartum programs as channels for recruiting family planning acceptors (World Bank 1975). However as the Bank’s objectives broadened to include poverty reduction throughout the 1970s, the need to justify lending in the social sectors purely with productivity arguments was reduced.

2.4 In fact, the World Bank’s commitment to address population occurred at a time when a new climate of development thinking was emerging and it became increasingly evident that stimulating economic growth alone was not sufficient to reduce absolute poverty (Gollard and Liese 1980) (Box 2-1). A need to focus more deliberately on the poor, redistribute growth, and meet people’s basic needs emerged. International organizations played an increasingly more prominent role in creating partnerships and programs to address health issues in developing countries, mainly with a basic services approach. The adoption of the Alma Ata Declaration at the International Conference on Primary Health Care in 1978, a major milestone, marks the point from which health was considered a fundamental human right, a social goal, and an economic imperative (Bloom and Canning 2003). Furthermore, it declared the rights of individuals and communities to participate in health care decisions, set a target for governments to ensure essential health care for their populations by the year 2000, and popularized the primary health care (PHC) approach by declaring it the means by which to ensure that the “health for all” target was met.

Box 2-1: Factors in the 1970s Leading to Increased Commitment to Health A background paper for the 1980 World Development Report (WDR), Health Problems and Policies in Developing Countries (1980), identified five changes in the 1970s that were critical to shifting development thinking and bringing increased interest to the health:

• Economic development and health improvement seen as necessary to lower fertility rates; • Focus shifted away from human resource development to improve productivity and toward distributing benefits from

economic growth; • Concern for human rights and meeting basic needs emerged in the mid-1970s “reorienting development programs to

alleviate further the symptoms of poverty”; • Evidence of low-cost and effective means to reduce disease; and • Support for basic health services emerged and supported broadly by the international community.

Source: Golladay and Liese 1980

2.5 As poverty reduction gained importance as a development goal, Bank President Robert McNamara emphasized the importance of addressing basic problems affecting the daily lives of the poor. Nutrition was one of the areas that most interested McNamara (Kapur and others 1997). A 1973 nutrition policy paper argued that while evidence for the economic justification for nutrition projects was still preliminary, better nutrition would “imply a more equitable distribution of income. . . encourage more effective population planning . . . [and] improve the level of well-being” (World Bank 1973). The Bank explored its potential role in human development issues, and throughout the decade, several reports, partnerships, and new initiatives signaled that the World Bank would

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expand its HNP activities.5 Although the Bank’s official focus in the early 1970s was on population, work related to nutrition and other health issues was dispersed throughout several of the World Bank’s departments. In addition to the Population Projects Department, there was a nutrition unit in the Agriculture and Rural Development Department, and the Office of Environment and Health Affairs under the Office of the Vice President of Policy focused on risk prevention and minimization which led to health concerns, particularly with respect to water projects.6 By 1972, health components were included in agriculture, population, and education projects (Kapur and others 1997); the number of projects containing health components increased from five to twenty between fiscal years 1969 and 1973 (World Bank 1975).

2.6 The 1975 Health Sector Policy Paper was the first formal policy statement specifically addressing health issues (World Bank 1975). It made a link between economic progress and improvements in health conditions. It also drew attention to the considerable differences in health levels at the international level, as well as noting equally substantial disparities between the rich and the poor within countries. The paper presented two policy options for the World Bank: (i) to increase health benefits within present patterns of lending; or (ii) to begin lending for basic health services. In both cases consideration for the health benefits of projects would increase. However, in the first case these benefits would be supplementary objectives, as opposed to the primary objectives in the second option. Although the policy acknowledged that health programs should be included in broad programs for socioeconomic improvement that reduce mortality and fertility, the Bank chose to pursue the first option in 1975. Perceived obstacles to lending for basic health services that initially deterred the Bank included: concerns over the feasibility of low-cost health care systems, the lack of governments’ political will to institute significant reforms, and questions related to the Bank’s proper role in the sector, (Stout and others 1997). Thus, the policy limited Bank operations in health to components of other projects, including population and family planning projects, yet did not preclude the adoption of the second option when the Bank felt prepared to move into financing basic health services (World Bank 1975).

2.7 Perhaps the decision to finance basic health services came sooner than expected, as the Board approved the first loan in nutrition for $19 million to Brazil in 1976.7 From 1975 -1978, “the Bank provided technical and financial assistance to forty-four countries for seventy health components of projects in other sectors . . . prepared seven health sector studies and several population sector studies and established working relationships with the World Health Organization and other major agencies working in the health sector” (Stout and others 1997, p. 30). In 1979, the Population Projects Department was renamed the Population, Health, and Nutrition (PHN) Department and shortly after a new

5 In 1971, the World Bank and WHO established a Cooperative Program to address issues related to water supply, waste disposal, and storm drainage. In 1973, the Bank took the lead in mobilizing international funds and cooperation to create the highly successful Onchocerciasis (River Blindness) Control Program. Furthermore, a 1972 paper, Possible Bank Actions on Malnutrition Problems, called for the Bank to play a more active role in nutrition (World Bank 1972b). The Bank was also instrumental in founding the UN Subcommittee on Nutrition in 1977. 6 Bernhard Liese, personal communication, October 2007. 7 This was the “Nutrition Research and Development Project” completed in 1983.

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policy paper was released to outline the changes to come in the Bank’s next phase of lending.

3. PRIMARY HEALTH CARE: 1980 - 1986 3.1 The second distinct phase of the Bank’s HNP activities, marked by the 1980 Health Sector Policy Paper, formally committed the Bank to direct lending in the health sector (World Bank 1980a).8 The policy paper recognized the importance of providing services to the poorest groups in the society and drew a tighter link between health sector activities, poverty alleviation, and family planning. The rationale for the 1980 policy was similar to that of the 1975 policy: due to market failures in the provision and financing of services, there was a justifiable need for government to ensure more equitable distribution of services (Stout and others 1997). Investment in costly tertiary facilities, inaccessible by the poorest, was deemed inappropriate and a reorientation towards PHC was pursued to bring about health gains as well as cost savings. The main objective of the Bank’s work during the PHC Phase was to broaden access to cost-effective health care. The strategy focused on meeting the need for basic health services, especially in rural areas, with projects to develop basic health infrastructure, train community health workers and paraprofessional staff, strengthen the logistics and supply of essential drugs, provide maternal and child health care, and improve family planning and disease control (Box 3-1).

Box 3-1: Main Features of HNP (PHN)9 Projects 1980-1985

According to the1986 Review of PHN Sector Work and Lending in Health, 14 of 19 (74 percent) of the “first generation” of HNP health projects shared the main features of the prototypical project. It sought to:

• Increase coverage, efficiency and effectiveness of basic health services (including family planning and nutrition) mainly in rural areas;

• Strengthen capacity to plan, implement, monitor and evaluate health services; • Improve human resource development in the health sector; • Strengthen the physical infrastructure, mainly at the primary level; and • Increase sector knowledge through studies.

The other projects types were: manpower (1) institutional development (1), urban health services (1), and tropical disease control (2).

Source: Measham 1986, p. v

3.2 Engaging in direct lending for health projects reflected a new commitment for the Bank to deal with “nearly all aspects of development . . . though (the World Bank) began with a primary focus on project promotion and selected inputs to GNP growth, the Bank has steadily broadened its own terms of reference” (Kapur and others 1997). The Bank’s outlook on development had evolved beyond solely economic growth to incorporate human development. In fact, The World Development Report 1980: Poverty and Human Development asserted that while growth is vital for poverty reduction, alone it is not

8 The first loan for health was approved in 1981 to Tunisia (World Bank 1997a). 9 The acronym PHN (Population, Health, Nutrition) was used for the sector and its activities 1980- 1997 when it was re-ordered to HNP.

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enough (World Bank 1980b). Human development, including health and education, complement poverty alleviation approaches and were seen increasingly as both morally and economically justifiable. The WDR maintained that human development programs must: increase political support for programs; address financial constraints; develop administrative strength; and ensure service usage (World Bank 1980b). Although Mexico’s 1982 default and the resulting economic crisis initially re-focused the Bank’s attention on market-oriented reforms and decreased emphasis on social programs, given the long-term timeframe necessary for recovery in many of the affected countries, it remained clear throughout the 1980’s that social sector policy was highly relevant to financial sustainability (Nelson 1999).

3.3 In the early 1980s, international organizations and private foundations launched several initiatives focused on providing basic services to promote PHC that received considerable support. 10 Recent success with the eradication of smallpox in the late 1970s, and approaching polio eradication in the Americas demonstrated that vertical and categorical programs could make a mark. The demand for health loans increased and by 1984, the World Bank’s lending for PHN reached 1.6% of its total lending, compared to the historical average for population and nutrition projects of one percent (Measham 1986). The World Bank, by now a key participant in several international health partnerships,11recognized that its areas of comparative advantage in engaging governments, programming, and sectoral analysis could contribute to the extension of health care coverage in developing countries. It is noted in a review of the Bank’s work in HNP from 1980-1985, that: “heavy investment in sector work has paid handsome dividends in sector knowledge and experience, in enhanced credibility within borrowing countries and the Bank, and increased lending.” (Measham 1986, p. iii) (Figure 3-1).

3.4 Population projects remained a prioritized item on the agenda, thanks to Bank experience in the area as well as the World Development Report 1984: Population and Development (World Bank 1984).Whereas the prior Phase emphasized the demographic rationale behind population programs, by 1984 the benefits of these programs were considered far more comprehensive: “(Family planning) benefits, moreover, do not depend on the existence of demographic objectives” (World Bank 1984, p.127). The report argued that appropriate public policies existed to affect decision-making on family size and that there was evidence that those policies were effective. WDR 1984 made the case that the benefits of family planning included: improved health, particularly for women and infants; greater availability of choices and opportunities, especially for women; and offered the greatest potential benefits to the poorest, who have higher mortality and fertility rates. While noting the recent expansion of family planning services, WDR 1984 pointed out that most services fail to reach rural populations and

10 These include the declaration of the International Drinking and Water Supply and Sanitation Decade (1981-1990); UNICEF’s Child Survival and Development Revolution that introduced GOBI, a program focused on four components: growth monitoring, oral rehydration, breastfeeding, and immunization (1982); the Task Force for Child Survival and Development to achieve universal child immunization by 1990 (1985); and Rotary International’s PolioPlus Program (1985). 11 By the mid-1980s, the Bank was a partner of the Onchocersiasis Control Program and the Task Force for Child Survival and Development, a co-sponsor of the WHO Special Programme for Research and Training in Tropical Diseases (TDR) , and had initiated the UNDP-World Bank Water and Sanitation Program,

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that quality is often poor. It went beyond considering only policy and poverty as the factors influencing fertility, and paid considerable attention to the influence of decision-making at the family level as one of the ultimate determinants of fertility. This had important implications for the roles of social values and norms, and educational opportunities (particularly for girls) as well as knowledge and information on family planning programs. Additionally, it supported the integration of basic health services with family planning and other programs, such as immunization.

3.5 Promotion of food supply and proper nutrition were included as basic elements of PHC by the Declaration of Alma Ata. Nutrition projects could serve as catalysts to bring policy attention to the issue, and reinforce efforts in the sector as they contribute to the development of primary health care and family planning programs (Berg 1987a). Although the sub-sectors of population, health and nutrition were more separate at this time within the Bank structure and operations than they are currently, there was increased recognition, such as in the WDR 1980, that a “seemless web” of interrelations connected them at the core to increasing the incomes of the poor (World Bank 1980b). The Bank’s early rationale for investing in nutrition programs was that malnutrition had adverse effects on development, that most governments were not reaching the poor (especially the rural poor) with nutrition benefits, and that few central ministries had the resources or the organizational capacity do so (Berg 1980). The Bank’s early work in nutrition was described as “learning by doing” (Berg 1987a). It financed high-priority experimental

Figure 3-1: HNP (PHN) Projects, sector reports and lending approved FY81- 85

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Source: Adapted from Measham 1986

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projects and focused heavily on evaluation and analysis to identify effective interventions. Each of the four freestanding nutrition projects approved between 1976 and 1980 was designed to test a different approach, although they shared common features; they included institution-building and several operational components among them, usually nutrition delivery through primary health care services, some form of supplementary feeding or food subsidy program, and a nutrition education components (Berg 1987a). “Nutrition Review” (Berg 1987a), a review of the Bank’s early experiences in nutrition, argued that the projects, particularly those implemented by the PHN Department had been successful in general, yet that overall, projects had been too complex and attempted to deal with too many of the causes of nutrition.12 It advised that the Bank continue to pay more attention to institution-building to address poor management, which was identified as a factor limiting project achievement (Berg 1987a).

3.6 Shortcomings identified in the Bank’s nutrition work were representative of overall weaknesses in the sector. The combination of fairly complex projects with the frequently weak administrative capacities of recipient governments led the Bank to invest more in capacity building. However, the capacity building provided was often not sufficient to bridge the gap between project expectations and requirements, and the reality on-the-ground, and did not address broader sectoral issues (Nelson 1999). Despite increased commitment to global health and important achievements during this phase, the health systems necessary to sustain and support such gains were “seriously deficient and often deteriorating” (Berman and Bossert 2000, p. 11). While the Bank could address some of the project-specific concerns with improved internal Bank policies to ensure greater attention to project design and context, many of the weaknesses identified demonstrated the limitations of introducing an approach dependent on weak health systems and unstable financing.

4. HEALTH REFORM: 1987- 1996 4.1 The Health Reform Phase began with the 1987 internal reorganization of the World Bank under which PHN became a division of the Population and Human Resources (PHR) Department,13 and with the release of Financing Health Services in Developing Countries: an Agenda for Reform. 14 The Bank established two new objectives in this phase: to improve health finance by making it more efficient and equitable, and to reform health systems. A rationale emerged that systemic constraints 12 The Population Projects Department began to implement nutrition projects in 1976, but due to the productive elements within nutrition projects, they were shifted to Agriculture and Rural Development. When direct health lending was established in 1980, most of the activities and staff were transferred to the PHN Department. The “Nutrition Review” found freestanding nutrition projects managed by the PHN Department to be successful overall, but those undertaken as components and sub-components in other sectors less successful. This justified recommendations that: “nutrition components should only be considered for non-PHN projects if they are directly related to basic project objectives, can compensate for changes caused by the project that may be nutritionally negative, can be used to prepare for a future free-standing nutrition project, or can contribute to expanding programs already developed in country” (Berg 1987a, p. 80). 13 This reorganization decentralized the formerly centralized PHN Department. 14 Financing Health Services in Developing Countries was published December 31, 1986 and is thus relevant to this phase.

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needed to be addressed in order to provide access to more efficient and equitable health services. Although no official sector strategy was released, the new objectives were evident through key policy papers and lending: “the Bank is now broadening that dialogue, both with borrowers and other lending agencies, to encourage consideration of new financing approaches to rethink prevailing strategies and the concepts on which they are based” (World Bank 1986a, p. 49). As the World Bank’s emphasis on the social sectors continued to grow, its spending on health, nutrition and population increased sevenfold from the late 1980s to the late 1990s (Nelson 1999).

4.2 As efforts to expand PHC in the previous Phase coincided with slow economic growth and budget deficits in the 1980s, increasing concern arose over how to ensure adequate financing for human development. The emergence of the AIDS epidemic along with evidence of changing health needs attributed to the demographic transition promised to radically change the scenario for disease control in middle income countries (MICs), making the case for health reforms to strengthen the capacity of health systems to deal with such challenges. The focus on reform was also stimulated by evidence that different regions and countries needed health care systems with different features (OED 1999a).

4.3 Policy dialogue with governments on health system strengthening and health financing were maintained to be a comparative advantage of the Bank. Throughout this Phase, the Bank sponsored sector studies on health financing (OED 1999a). Debate over the role of governments, markets, and the private sector became the focus of World Bank policy dialogue and lending for health sector reform. Whereas in the early 1980s less than one fifth of health projects included explicit reform or “systemic” objectives, this number quickly multiplied to approximately one third of all health projects in the late 1980s and continued to grow to nearly one half of all health projects in the late 1990s (OED 1999b) (Figure 4-1).15 This pattern was very much aligned with the Bank’s overall focus at the time on fiscal decentralization, privatization and improving the effectiveness of public sector management (Stout and others 1997).

4.4 Financing Health Services in Developing Countries: An Agenda for Reform, addressed a policy theme identified but not prioritized in the 1975 and 1980 Policy Papers. It argued that: “Fostering improvements in health sector finance is among the most valuable contributions the World Bank can make to better health care in low income countries” (World Bank 1986a, p. 51). The paper proposed four policies to improve the efficiency and equity of health care: (i) implementing user fees at government health facilities; (ii) promoting insurance or risk coverage to mobilize resources while protecting households from health shocks; (iii) utilizing nongovernmental resources more effectively; and (iv) decentralizing planning, budgeting and purchasing. The Bank’s promotion of user fees came under substantial attack and continues to fuel debate in health financing (Gottret and Schieber 2006). At the time, expansion of user fees was proposed to improve service delivery efficiency, improve access for the poor by

15 Objectives classified by the study as “systemic” were those including objectives related to major organizational change of system-wide financial reform. Projects with “non-systemic” objectives may have included elements of institutional and/or organizational change but typically approached them on a smaller-scale (OED 1998).

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substituting public services at modest fees for higher-priced and less-accessible private services, and generate revenue to improve health care quality; the paper provided several alternatives to safeguard the poor from unaffordable costs (World Bank 1986a). The World Bank was not alone in its support for cost recovery. In fact, The Bamako Initiative, launched in 1987 by African Ministers of Health at the WHO Regional Assembly, advocated many of the same principles promoted by the World Bank during this phase (Box 4-1).

4.5 The World Development Report 1993: Investing in Health evaluated the roles of governments and markets in health, as well as ownership and financing arrangements to improve health and reach the poor (World Bank 1993). The Report advocated a three-pronged approach to guide policies to improve health in developing and formerly socialist countries. First, it recognized the importance of health decision-making at the household level, arguing that governments should pursue economic growth policies that benefit the poor and permit improved decision-making through economic empowerment. Second, it promoted redirecting government spending on health toward cost-effective programs, including prevention, promotion and outreach, in addition to a minimal package of essential clinical services that particularly benefit the poor. Last, it encouraged greater diversity and competition in health finance and service delivery. Acknowledging the growing influence of the international community on setting health priorities, it called for improved coordination to shift donor money toward public health, essential clinical care, and health research.

Figure 4-1: Percent of HNP (PHN) Projects with “Systemic” Objectives

0

10

20

30

40

50

60

70-74 75-79 80-84 85-89 90-94 95-97

Fiscal Year

Perc

ent o

f HN

P Pr

ojec

ts

Source: Adapted from analysis of HNP (PHN) portfolio as reported in OED 1998, table 3.2

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Box 4-1: The Bamako Initiative 1987 The Bamako Initiative’s main principles: • Bottom-up action by communities is needed to complement top-down health policy reforms where public institutions are

weak; • Community financing of health centers can generate sufficient income to cover the recurrent, non-salary costs of basic

health units; • Even poor households will pay modest charges for health care, provided they perceive the services to be of good

quality, which they usually gauge in terms of the availability of essential drugs and positive health worker attitudes; • Governments can make a package of affordable essential health services of reasonable quality available to the

majority of the population if the package is cost-effective, a well functioning district health system exists and a community financing scheme is in place

• Active participation of users is decision-making and control of health system resources increases public accountability of health services, improves management and enables communities to identify with the health system, all of which generates a feeling of ownership and belonging essential to mobilizing community resources and ensuring sustainability

Source: UNICEF 1995 , p. 5

4.6 Disease Priorities in Developing Countries, a highly influential publication from this Phase, provided information on disease control interventions for the most common diseases and injuries in developing countries (Jamison and others 1993). A companion publication to the WDR, it was a timely contribution presenting evidence on the most cost-effective interventions for essential health service packages. Evidence-based decision-making was an important current that emerged during the Health Reform Phase and implied more sector studies and analysis. It also required improved systems for monitoring and evaluation (M&E) to collect data at the project and sector levels.

4.7 These publications were seminal to the transition from the PHC to the Health Reform Phase, the most dramatic transition in terms of shifting the Bank’s objectives, rationale, and strategies. Although there was a surge in the funds available for HNP, population and nutrition had to compete for centrality in projects.16 This had to do in part with at least three factors: (i) the trend in increased lending for health reform objectives; (ii) decentralization of the PHN Department into the regions which to some degree reduced the institutional space for the population and nutrition sub-sectors and staff; and (iii) population and nutrition strategies that advocated for comprehensive approaches that went beyond the health sector and health systems. 17

4.8 Although slowing population growth rates and reducing unwanted fertility remained objectives, the Bank’s population agenda did become far more comprehensive as a response to the international community’s adoption of a Program of Action to improve women’s sexual and reproductive health at the International Conference on Population and Development (ICPD) in Cairo in 1994 (Box 4-2). Whereas population policy had formerly meant policy to reduce population growth through family planning and demographic targets, the ICPD “was a move toward a holistic approach to

16 According to the 1997 HNP Strategy document, cumulative HNP lending increased from less than one percent of the World Bank’s total cumulative lending in FY86 to over three percent in FY96. Eleven percent of the annual lending for FY96 was to the HNP sector, although this was extremely high do to approval of five abnormally large loans. 17 As lending for more comprehensive programs increased, it became more difficult to track.

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reproductive health” (White and others 2006, p. 3). A 1994 policy paper on population prepared for the ICPD, Population and Development: Implications for the World Bank supported “an emerging consensus . . . that population policy objectives should be integrated with broad social development goals and that population program strategies should build on linkages between demographic behavior and social and economic progress” (World Bank 1994a, p. 1). The World Bank emphasized the need to focus on providing the poor with access to high-quality and user-oriented services, improve educational opportunities for women, and raise the economic and social status of women. The policy paper argued that population strategies must be country-specific, and linked to other complementary policies and to the core development agenda; it also recommended that the Bank conduct research and engage in policy dialogue to consider the significance of other demographic issues besides population growth. According to a 1997 report by Population Action International (PAI), the Bank’s lending for population and reproductive health had increased in recent years but had not kept pace with overall growth of the sector. In fact, new loan commitments for family planning activities alone dropped below $100 million a year in fiscal years 1995 and 1996 compared to annual averages roughly twice as much in the early 1990s.18 As projects became more comprehensive, “reproductive health and family planning activities [became] small and often marginalized components” (Conly and Epp 1997, p. vii).

Box 4-2: Major Objectives of the International Conference on Population and Development (ICPD) The following are five of the major development objectives expressed at the ICPD: • Bridge the gender gap in education; • Promote equity for women; • Reduce maternal mortality and morbidity; • Increase universal child survival; and • Provide universal access to reproductive health and family planning services.

Source: World Bank 1997a,Annex B

4.9 By 1987, some 55 nutrition-related research studies had been undertaken or financed by the Bank (Berg 1987a). They demonstrated that improvements in nutrition were possible even without major increases in income and that several efficacious and affordable means existed by which Bank projects could contribute to addressing malnutrition. The 1987 publication, Malnutrition: What Can Be Done? Lessons from World Bank Experience, proposed that the Bank pursue three types of projects, those that: (1) alleviate critical short-term nutritional needs; (2) improve food distribution and make expenditure on food and the food marketing system more efficient; and (3) fortify food staples with vitamins and minerals or provide these micronutrients through food supplementation projects (Berg 1987b). The WDR 1993 recognized micronutrient programs as among the most-cost effective of all health interventions. Enriching Lives: Overcoming Vitamin and Mineral Malnutrition in Developing Countries (World Bank 1994c), a follow-up to WDR 1993, argued that poverty alleviation and strengthening health systems alone were not sufficient to solve micronutrient deficiency problems. It advocated a comprehensive approach that focused on social mobilization, using market incentives and regulation to encourage fortification of foodstuffs and water, and

18 The PAI report used data provided by the World Bank for its calculations.

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distribution of pharmaceutical supplements through public and private channels when necessary. Despite evidence of the cost-effectiveness of these interventions and a series of conferences in the early 1990s that set nutrition-related targets,19 lack of strong leadership among the international organizations and political commitments among governments remained central challenges to the World Bank and international community’s progress in addressing nutrition (Chen 1986, World Bank 2006).

4.10 The Bank reaffirmed its focus on poverty with the 1990 WDR. The report identified a two-fold strategy to reduce poverty by focusing on broad-based growth and addressing basic social services, including health and education, to ensure that the poor are able to take advantage of income-generating activities. The report was recognized to have played an important role in highlighting the social dimensions of poverty following the “lost decade” of the 1980s, yet it was noted that “. . . many of the details of how the Bank could disaggregate social groups, reach and engage the poor, and help overcome the social and institutional barriers to participation in the economy and society, had yet to be fully articulated” (Davis 2004, p. 10). However, by the end of this phase and into the next, important evidence was gathered on the extent to which public spending on health actually reaches the lowest income groups (Yazbeck and others 2005). The development of a wealth index that uses household assets as a measure of relative economic status instead of consumption or income (which are more time-consuming and expensive to collect) facilitated this research and allowed for greater analysis of the distribution of health outcomes and health system outputs (Filmer and Pritchett 1998,Yazbeck and others 2005). This made measuring the effectiveness and equity of health interventions that target the poor much more feasible.

4.11 A review of the World Bank’s completed projects from 1970- 1995 showed that the HNP Sector’s average rating for the portfolio was lower than the averages of projects managed by other sectors (Box 4-3). Moreover, the HNP Sector’s embrace of Bank-wide

Box 4-3: Findings from OED’s 1999 Evaluation of the HNP Sector The Operations Evaluation Department (OED), now the Independent Evaluation Group (IEG), recognized the value of the Bank’s support for HNP to raise awareness of health reform and finance, to develop reform strategies, and to improve donor coordination. However, a review of the HNP portfolio showed that only 61 percent of completed HNP projects from FY 1970-1995 were rated moderately satisfactory or better compared to 79 percent of projects managed by other sectors. Main findings:

• The Bank was more successful expanding health service delivery systems than improving service quality and efficiency or promoting institutional change

• Projects were too complex, particularly in counties with the least capacity • The Bank did not focus enough on determinants of health outside the medical care system, such as behavioral

change and cross-sectoral interventions • Most HNP projects identified key performance indicators, but the gap between intentions for M&E actual

implementation and collection of data was particularly problematic Recommendations for internal processes and interactions with borrowers:

• Enhance quality assurance and results orientation • Intensify learning from lending and non-lending services • Enhance partnerships and selectivity Source: OED 1999a

19 These included the World Summit for Children (1990), International Conference on Nutrition (1992), and the World Food Summit (1996). The World Bank also helped to establish the Micronutrient Initiative in 1992.

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priorities to increase participation, partnerships and focus on the client signaled a need for an updated strategy. At the conclusion of this Phase, unprecedented international attention was on the World Bank and donor community to address debt relief, HIV/AIDS, and the effectiveness of development assistance.

5. HEALTH OUTCOMES AND HEALTH SYSTEMS: 1997-2000

1997 HNP SECTOR STRATEGY

5.1 In 1996, President James Wolfensohn outlined a Strategic Compact to renew the World Bank and promote a more comprehensive framework to strengthen its mission to reduce poverty and promote economic growth (Box 5-1).20 A reorganization of the World Bank in 1997 intended to promote better Bank-wide balance between maintaining both a “country-focus” and “sectoral excellence,” created the Health, Nutrition and Population Sector Board (OED 1999a). 21 The start of a new phase was marked by this reorganization, along with the release of the 1997 Health, Nutrition, and Population Sector Strategy Paper.

Box 5-1: Key Elements of the Strategic Compact During the so-called “Compact period” (1997-2000) the following key elements became the framework for reshaping the Bank’s activities and reinforced the use of new approaches in the HNP sector:

• Improving resource mobilization; • Promoting increasingly integrated approaches; • Building partnerships and sharing knowledge; and • Restructuring the Bank to be closer to clients through responsive and high-quality products.

Sources: World Bank Group Archives, Wolfensohn Timeline

5.2 The central premise of the 1997 Health, Nutrition, and Population Sector Strategy Paper was that: “Investing in people is at the center of the World Bank’s development strategy as it moves into the 21st century, reflecting the fact that no country can secure sustainable economic growth or poverty reduction without a healthy, well nourished, and educated population” (World Bank 1997a, p. 10). The strategy identified the Bank’s strengths in the sector vis-à-vis the international community as its global expertise from the developing world, its multisectoral, macro-level country focus, and its ability to mobilize large financial resources, either directly or through partnerships.

5.3 The three stated objectives of the 1997 Health, Nutrition, and Population Sector Strategy Paper were to help client countries: (i) improve the health, nutrition, and 20 Launched in April 1997, the Strategic Compact was a compact “between the Bank and its shareholders; to invest $250 million in additional resources over a three-year period to deliver a fundamentally transformed institution—quicker, less bureaucratic, more able to respond to continuously changing client demands and global development opportunities, and more effective and efficient in achieving its main mission—reducing poverty” (World Bank 1997b, p. 1). 21 In 1997, the PHN Department was renamed HNP. Although the three components remained the same, their order reflected the shift in the sector’s priorities.

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population outcomes of the poor, and protect the population from the impoverishing effects of illness, malnutrition and high fertility; (ii) enhance the performance of health care systems by promoting equitable access to preventive and curative HNP services that are affordable, effective, well-managed, of good quality, and responsive to clients; and (iii) secure sustainable health care financing by mobilizing adequate resources, broad risk-pooling mechanisms, and effective control over public and private expenditures.

5.4 The strategy has been described as one of the measures taken by the Bank to “gear up to promote institutional reform” in order to better support the long-term process of health reform in partner countries (Nelson 1999, p. 56). The objectives did not depart drastically from priority areas established in the previous Phase (health systems and finance reforms). However, the effects of the Bank’s more comprehensive approach to development and poverty reduction during this phase were evident by the inclusion of improving health outcomes for the poor as a strategic objective, and experimentation with new approaches and tools, such as sectorwide approaches and the Poverty Reduction Strategy (PRS). “Focusing on health outcomes in policy dialogue and planning is one way to ensure that the best buys in public health and clinical services are identified and made available. Optimally, health reform and sectorwide approaches provide the context for such policy dialogue and priority settings” (Claeson and others 2000).

5.5 The advance of survey methods described above, including more widespread use of Demographic and Health Surveys (DHS), and greater availability of data provided further evidence that health outcomes and service use were closely related to economic status (Wagstaff 2000).22 This sparked increased recognition that inequalities in health outcomes between rich and poor were unjust—not only between countries but within countries: “Closing inter-country and intra-country gaps between the poor and better of by securing greater proportional improvements amongst the poorer groups, is not simply a poverty issue- it is also a question of social justice and equity” (Wagstaff 2000). Thus, consistent with the World Bank’s overall reinforced commitment to reducing poverty, the HNP sector responded by establishing improvement of HNP outcomes for the poor as an “absolute priority”.

5.6 In addition to the prioritization of health outcomes for the poor, this strategy departed from previous phases in its emphasis on: stimulating demand for health services; promoting client-generated and driven strategies; intersectoral collaboration; and greater flexibility and responsiveness by the Bank to respond to client countries. Furthermore, the HNP sector’s strategy to achieve its three objectives was far more explicit than previous strategies (Table 5-1). The following four sections summarize the plans outlined by the strategy paper in four action areas: (i) sharpening strategic directions; (ii)achieving greater impact; (iii) empowering Bank staff; and (iv) building more strategic partnerships23 22 In 2000, Gwatkin and others published a series of 44 country reports on Socio-Economic Differences in Health, Nutrition and Population analyzing DHS data disaggregated by wealth quintiles based on an asset index (Gwatkin and others 2000). 23 The strategies and recommendations that follow were those laid out by the strategy paper but do not necessarily represent the course taken; evidence from the IEG evaluation will shed light on the Sector’s actual lending and non-lending trends, and results over the last decade.

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Table 5-1: The Bank’s 1997 HNP Sector Objectives and Strategies Objective Strategies 1. Improve the HNP outcomes of the poor and protect the population from the impoverishing effects of illness, malnutrition, and high fertility.

Greater use of targeting mechanisms;a emphasis on the most vulnerable; support for preventive public health activities with large externalities

Stimulate demand for health services among the poor Improve population policy, family planning, and other reproductive health services to increase

the demand for smaller family size and reduce unwanted fertility In low-income countries, make food more affordable, increase the efficiency of food markets,

provide nutrition safety nets. Address multisectoral issues affecting health indirectly support social policies for greater gender

equality, improved status of women. Improve donor coordination/harmonization in very low income countries via sector-wide

approaches Support inter-country and regional approaches to HNP issues

2. Enhance the performance of health care systems by promoting equitable access and use of population-based preventive and curative services that are affordable, effective, well managed, of good quality, and responsive to clients

Raise efficiency in use of scarce resources (through better policymaking, governance, market incentives, public-private mix of services, management, decentralization, accountability)

In low-income countries, where most health care is provided by the private sector: provide health services with large externalities (preventive public health services), essential clinical services for the poor, and more effective regulation of the private sector.

In middle-income countries and low-income countries in which health care is predominantly provided by the public sector: promote greater diversity in service delivery by funding civil society and non-governmental providers on a competitive basis; use quasi-market mechanisms to improve public sector performance and quality participation by the private sector.

Improve the effectiveness of government policymaking, sectoral management, outcome evaluation and regulation, to generate knowledge about improving access, the effectiveness of interventions, efficiency in managing services, quality control, and responding to client needs.

3. Secure sustainable financing

Help countries secure sustainable recurrent financing for HNP, using a mix of taxation instruments and co-payments tailored to each country.

In low-income countries, complement public resources with community-based and international assistance.

In middle-income countries, use taxation instruments to mobilize financial resources and expand risk pooling.

Help governments to maintain effective expenditure control Ensure that the HNP budget envelope is used on effective and quality care that benefits those

who need it the most; develop improved budget allocation processes at the national and local level

Notes: a. For example, targeting: the poorest individuals and households; poor regions or vulnerable groups; HNP problems that mainly affect the poor (communicable diseases, childhood illness, high fertility, maternal and prenatal conditions); services and/or providers used by the poor. (World Bank 1997a p.. 6-7). b. For example, food and agriculture policies, environment, water supply, sanitation, transportation. c. For example, vouchers, contracting out service provision to the private sector, and obtaining greater client feedback.

Source: World Bank 1997a, pp. 17-19.

SHARPENING STRATEGIC DIRECTIONS

5.7 Each of the strategy’s objectives were associated with specific recommendations for policy at the country-level, as well as strategies for the Bank to more effectively support implementation of these policies and programs. Use of targeting mechanisms, providing equitable access to quality services, and promoting multisectoral collaboration were the primary country-level strategy areas recommended to achieve the first objective. The use of targeting was advocated to reach low-income groups, vulnerable populations and specific geographic locations, and to address poverty-related diseases, and services used by the poor. The strategy encouraged governments to promote high-impact activities, particularly basic health services and public health activities with large externalities, including investments is communicable disease control. While an emphasis on providing basic health services was somewhat reminiscent of the PHC approach, a fundamental difference was the focus on demand-side factors. The strategy argued that while targeting would help to promote more equitable access to services, improving the quality of services was fundamental to stimulate demand among the poor and ensure

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service use. The third critical dimension of this strategy was its emphasis on maintaining policy oversight in sectors outside of health, including areas such as rural and urban development, social policy, education, agriculture and the environment.

5.8 To do its part to contribute to achievement of the first objective, the strategy committed the Bank to working closely with governments to encourage them to provide or mandate affordable and cost-effective services for the poor. It would also work with other sectors to encourage “healthy” policies across sectors, such as tobacco and alcohol control and taxation, appropriate food subsidies, road safety and environmental issues. At the Bank, the strategy indicated that Human Development Network (HDN) would pursue closer working relationships with two newly formed networks, the Poverty Reduction and Economic Management (PREM) Network and the Environment and Socially Sustainable Development (ESSD) Network, to promote the inclusion of pro-poor HNP interventions into poverty alleviation and rural development programs.

5.9 To achieve the strategy’s second objective, enhancing the performance of health care systems, the 1997 document recommended sector-wide reforms and more effective use of non-governmental resources. A high-performing system would be one that ensured equitable access to preventive and curative health services that were affordable, cost-effective, efficient, of good quality, and responsive to consumer choice. While sector-wide reform was deemed necessary for countries with systemic problems, the new approach emphasized that reforms would vary between countries, particularly between low and middle-income countries. Moreover, emphasis on promoting cooperation across several ministries to enhance the sustainability and comprehensiveness of reforms was encouraged. While the previous phase encouraged governments to work with nongovernmental providers, in this phase, harnessing the resources of private and nongovernmental providers was a fundamental means to promote greater diversity in service delivery systems. Incentives would be used to encourage public and private sectors to improve efficiency and effectiveness, and quality through competition. Working increasingly with nongovernmental resources necessitated increased attention to regulations, monitoring, and licensing.

5.10 The 1997 strategy committed the Bank to work increasingly with governments, NGOs and civil society to strengthen policymaking, governance, accountability, management and M&E. It also committed the Bank to foster partnerships with nongovernmental providers and help to encourage an environment in which they could contribute knowledge regarding strategies to improve access, the effectiveness of certain interventions, control quality, and response to client needs. To improve its understanding of divestiture of social assets, described by the paper as the final phase of successful reform experiences, and to improve financing to nongovernmental recipients, the HNP sector proposed to collaborate with the International Finance Corporation (IFC) as well as the Finance, Private Sector, and Infrastructure (FPSI) Network, which was formed in 1996.

5.11 The strategy to help countries secure sustainable recurrent financing for HNP, the third objective, included using a mix of taxation instruments and co-payments tailored at the country level. In low-income countries, the emphasis was on complementing public

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resources with community-based and international assistance. Use of taxation instruments to mobilize financial resources and expand risk pooling was promoted for middle-income countries. The sector recommended that governments maintain effective expenditure control and ensure that the HNP budget envelope was used on effective and quality care that benefited those who most needed it. Furthermore, the need to develop improved budget allocation processes at the national and local levels was a priority. Once again, the need for multisectorality was echoed in the recommendation that multiple ministries, particularly ministries of finance and social security, cooperate at the country-level to implement the country-driven health finance strategies.

5.12 The strategy paper advocated that the Bank work with governments to strengthen their policymaking role and involvement in health care financing, especially in countries where health care expenditures were less than three percent or greater than seven percent of GDP. It would also encourage the incorporation of national health accounts and other relevant data in policymaking processes. At the country level, the Bank would work with ministries of social security, finance, and health to pursue this objective, as well as with the PREM Network within the Bank.

ACHIEVING GREATER DEVELOPMENT IMPACT

5.13 The 1997 strategy indicated that the sector would aim to achieve greater development impact by: emphasizing the strategic policy directions in Country Assistance Strategies (CAS)24; underpinning lending with analysis and research; increasing selectivity; improving client services; and improving both Bank and borrower capacity to monitor and evaluate progress.

5.14 The CAS was promoted as “a key instrument for delivering the Bank’s message about HNP priorities during high-level country dialogue,” particularly in countries with systemic HNP problems (World Bank 1997a, p. 19). As noted in the strategy, the use of CASs was intended to contribute to increased selectivity by focusing dialogue on HNP issues that require broad systemic and multisectoral interventions, the Bank’s areas of comparative advantage. Most importantly, use of the CAS was consistent with the country focus emphasized by the strategy paper and reflective of the Bank’s broader efforts to “get closer” to the client with new tools and instruments.

5.15 As the Bank’s global expertise and ability to mobilize financial resources were also identified as areas of comparative advantage, it was logical that the Bank would want to underpin lending with analysis and research to strengthen its HNP knowledge base. The strategy advocated that the research agenda be linked to operational priorities in order to facilitate the systemic application of lessons learned and to improve the project design process. This was closely related to the “renewed effort” to strengthen and integrate monitoring and evaluation into project design. Other efforts highlighted by the 1997 strategy to achieve greater impact included improving supervision of projects,

24 A Bank-wide reform of the Country Assistance Strategy, a major document for policy dialogue and strategy formulated at the country team level, was undertaken in 1997 to increase their client focus and strategic selectivity.

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streamlining procedures, and conducting client satisfaction surveys to ensure responsiveness and maintain close relationships with clients.

EMPOWERING BANK STAFF

5.16 As the World Bank pushed for client-driven strategies and responded to calls for increased accountability, it paid greater attention to the impact of factors at the Bank that influenced HNP outcomes in developing countries. The 1997 strategy described the HNP Sector’s plan to streamline processes, empower staff, and recruit staff with an appropriate skill mix in order to be most responsive to the client countries. It did not provide a detailed breakdown of the types of staff members to be recruited, but indicated that those sought would have “broad skills needed to deal with a wider range of products” and practical experience in the HNP sector, along the ability to work effectively on policy issues, including a solid understanding of political economy and reform (World Bank 1997a, p. 21).

STRENGTHENING PARTNERSHIPS

5.17 At the time the strategy paper was written, the Bank was the single largest external source of HNP financing in LICs and MICs, had experienced positive results from partnerships (such as river blindness control), and sought to enhance its contributions through HNP through new relationships and approaches . Thus, one of the objectives of the 1997 strategy was to build relationships with partners based on comparative advantages both at country and global levels. Priority areas for strengthening partnership included: research and development (R&D); knowledge sharing in nutrition and reproductive health; pharmaceutical, vaccine and biotechnology research; and searching for an AIDS vaccine. The strategy also sought to ensure that clients were included in, and benefited from such collaborative efforts.

POPULATION AND NUTRITION

5.18 The 1997 strategy identified high fertility and malnutrition as key health and social challenges in low-income countries. It described a broad range of needed social policies, and noted that traditional values and attitudes may need to be addressed in order to stimulate demand for services to lower fertility and improve nutrition. In terms of population, it emphasized the need for effective population policies to improve family planning and reproductive health services to increase demand for smaller families and reduce unwanted fertility. Subsequently, Population and the World Bank: Adapting to Change (1999), argued that the Bank’s work in population should increasingly take advantage of policy dialogue to address demographic concerns (World Bank 1999b). It identified countries in which attention to population and reproductive health was expected to have a critical impact on poverty and development, and argued that population perspectives should be included in those countries’ CASs. The Bank’s work remained guided largely by the ICPD Program of Action.

5.19 In the case of nutrition, the 1997 HNP strategy paper recognized that strengthening health systems would not be sufficient to reduce malnutrition. The next

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generation of nutrition action plans needed to include: comprehensive food policy reforms, heavy investment in communications for behavioral change in nutrition, greater involvement of private food industry, and reduced reliance on untargeted, stand-alone food distribution programs (World Bank 1997a). Encouraging governments to address “often-neglected multisectoral issues such as food and agricultural policies, environment, water supply, sanitation and transportation” would have a direct impact on health (World Bank 1997a, p. 18).

5.20 Given widespread recognition of the development impact of population and nutrition interventions at a time of increased support for multisectoral approaches, channeling population and nutrition into high-level dialogues and CASs was promoted. However, there was one basic, yet critical challenge to the efficiency and effectiveness of mainstreaming these issues into broader development strategies: limited resources and competing priorities at a time when support for HIV/AIDS soared and new partnerships and arrangements to address global health were sought. Although population and nutrition remained central to the Bank’s HNP strategy, high-level specialist positions in the anchor, those of Senior Nutrition Adviser and Senior Population Adviser, were eliminated when the advisers left their positions in the late nineties and in 2005, respectively, and were not replaced.25

NEW INSTRUMENTS AND APPROACHES

5.21 While the 1997 strategy paper committed the sector to new approaches, increased international attention to and debate over the effects of globalization and development assistance helped to cement both sectoral and Bank-wide commitment to new approaches. Financial crises in East Asia, Russia and Brazil, a new initiative to provide debt relief (Heavily Indebted Poor Countries (HIPC) Initiative), and protests at the World Trade Organization Annual Meetings in Seattle in 1999 brought unprecedented attention to the Bank’s work and role in international development and finance. The World Bank and other international financial institutions were pressured to continue efforts to enhance accountability and to implement approaches that altered traditional donor-client relationships. Nearly a decade later, many of the approaches and instruments developed in the late 1990s are at the core of the HNP sector’s work today.

5.22 The HNP sector’s approach to “mainstreaming” HNP targets and reforms into broader development strategies became a focus, given: (i) the Bank’s perceived comparative advantage in engaging governments in high-level policy dialogue; (ii) emphasis on participation and ownership; (iii) the HNP strategy’s focus on multisectoral interventions; and (iv) HNP sector’s goals to build partnership and improve donor coordination. Use of the CAS was advocated in the 1997 strategy as the main country-level vehicle for ensuring that HNP issues were discussed in national-level dialogues and planning, and promoting a multisectoral approach to achieving HNP outcomes.

25 The Senior Nutrition Adviser was replaced by a Senior Nutrition Specialist, a lower staff grade level position, and has never been upgraded. In 2005, when the Adviser for Population and Reproductive, Maternal and Child Health left the position, she was not replaced.

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5.23 Another important policy instrument, implemented two years after the release of the HNP strategy, was the Poverty Reduction Strategy (PRS). Strong commitment to poverty reduction led to the PRS which was developed jointly by the World Bank and the International Monetary Fund (IMF).26 It was designed as a tool for client countries to promote dialogue and consensus on a country-formulated development agenda, an important building block for the operationalization of the Comprehensive Development Framework (Box 5-2). Intended to strengthen country ownership and accountability for development strategies while enhancing the poverty focus of country programs, the PRS serves as comprehensive and coordinated framework for the Bank and IMF, as well as other development partners (Gottret and Schieber 2006). Beginning in 1999, Poverty Reduction Strategy Papers (PRSPs) intended to integrate HNP objectives into broader, country-led development strategies for the Bank’s poorest client countries, promoting ownership and accountability.

Box 5-2: Four Principles of the Comprehensive Development Framework (CDF) Whereas the Strategic Compact was an internal strategy, the CDF was articulated in 1999 to redefine the Bank’s approach to development and its relationship with client countries. The CDF’s four inter-related principles are:

• Long-term holistic development agenda; • Broad-based country ownership; • Country-based partnership; and • Accountability for development results.

Source: World Bank Web site. http://intresources.worldbank.org/CDFINTRANET/Resources/10things.pdf

5.24 Several alternative approaches to traditional project funding also gained prominence in the 1990s. Among them, the Sectorwide Approach (SWAp) was widely supported both within in the Bank and among the international donor community. The SWAp emerged over the 1990s as a response to two parallel trends: (i) a shift in macroeconomic dialogue from structural adjustment to public expenditure management, with a focus on government provision of core public services; and (ii) heightened recognition that project effectiveness was often limited by policies, institutions, and economic environments (Cassels 1997). The approach was designed to: “improve a country’s overall policy-making processes and budget and public expenditure management by capturing all funding sources and expenditures and putting resource allocation decisions into a medium-term budget and expenditure framework based on national priorities” (Gottret and Schieber 2006, p.152). Given these features, the approach seemed very relevant to the HNP sector’s goals of strengthening health systems, improving regulation, and making health financing more sustainable.

5.25 Improving aid effectiveness through donor coordination was a core reason that the HNP sector identified building partnerships as a goal in 1997 (World Bank, 1997a, p. 22). As the single largest external source of HNP financing in LICs and MICs in the 1990s and at a time when the Bank was attempting to work more strategically in its areas of comparative advantage, the Bank felt it had a lot to offer and gain from international

26 From 1999, in order to qualify for debt relief under the Heavily Indebted Poor Countries (HIPC) initiative, governments of low-income countries were required to prepare PRSPs.

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initiatives and partnerships. In fact, the strategy paper advocated strengthening partnerships to “enhance” the Bank’s contribution to global health in the 21st century (World Bank 1997a).

5.26 By 2000, the HNP sector increasingly used new approaches, some of which did not exist only a few years earlier, to pursue the objectives established in 1997. For example, the Bank embraced participation in global health partnerships, many of them single-disease or single-priority in scope. There is a continuing debate over the extent to which such initiatives contribute to or detract from the objective of health system strengthening and sustainable finance (Table 5-2). Although fighting communicable diseases was prioritized by the 1997 HNP strategy given that they disproportionately affect the poor, this provided to be a challenge considering substantial opportunity costs in terms of resources and staff time dedicated to strategies to strengthen entire systems and other priorities.

Table 5-2: Advantages and Disadvantages to Single-disease/priority Programs

Advantages:

• Highly effective in increasing awareness of global health concerns;

• Significantly increase the funds available for their area of focus;

• More effective in delivering services to targeted populations than government;

• Not limited by systemic constraints.

Disadvantages:

• Disrupt country’s health system; • Expenditures not sustainable within country’s

budget; • Not accountable to recipient country; • Fragment outreach.

Source: Lewis 2005

5.27 Another example of the rapid changes that occurred over the first few years of the 1997 strategy’s implementation, is the Bank’s support for HIV/AIDS, an issue hardly mentioned in the Health, Nutrition and Population Strategy Paper. In 1998, less than one year after the strategy’s release, high-level Bank management broadened its commitment to fighting HIV/AIDS and raising demand for HIV/AIDS support by borrowers (OED 2005); Bank financial commitments to HIV/AIDS rose dramatically (Figure 5-1). This led to even higher levels of support for HIV/AIDS in the following phase and influenced the framing of other single-theme health issues such as malaria and malnutrition in subsequent strategies in terms of broad threats to development.

As the Bank was undergoing significant institutional change in the late 1990s, the context of the international community’s work in HNP changed quickly and demanded even greater flexibility and innovation on the Bank’s part. There were several challenges to adopting new instruments and approaches: administrative requirements that could limit the intended flexibility of new instruments; performance criteria that were, in some cases, inappropriate for measuring institutional reform; some managers accustomed to more traditional projects who may have been reluctant to approve projects with more open and undefined budgets; and concern that shifts in decision-making responsibilities and cuts in regular staff that could lead to increased use of younger and less experienced consultants (Nelson 1999).

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Figure 5-1: World Bank New AIDS Commitments by Fiscal Year of Approval

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6. GLOBAL TARGETS AND PARTNERSHIPS: 2001-2006

6.1 Throughout the most recent phases of the World Bank’s work in HNP, its objectives have remained largely consistent: improving health outcomes, especially among the poor; systems strengthening; and securing sustainable financing. However, the Bank’s approach to working with client countries and its relationships with global partners have changed in response to changes in global health, including endorsement of the Millennium Development Goals (MDGs) and large increases in development assistance for health (DAH). During the Global Targets and Partnerships Phase (2001- 2006), the Bank’s objectives and rationale for HNP activities remained unchanged from the previous phase. The 1997 strategy continued to guide the sector, but major external events and the Bank’s commitments to specific targets and working in partnerships caused the Bank to alter its strategy in practice to reach those objectives. This phase highlighted tensions over the role of heavily-financed single-priority and single-intervention programs within weak health systems.

6.2 Several key challenges facing the Bank and international community prompted this shift in strategy. First, the international community’s adoption of the MDGs established new explicit targets for international health and development (Table 6-1). Second, DAH increased substantially from the late 1990s to the early 2000s due largely to the third factor, the proliferation of global partnerships (World Bank 2006a). These

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global partnerships, created to address global public goods in health, significantly increased the need for donor coordination and the flow of resources. In addition to the unprecedented global commitment to reducing poverty and the intensification of efforts to fight HIV/AIDS, the beginning of the 21st century was a time in which vulnerability to epidemics and pandemics was heightened. With the emergence of Severe Acute Respiratory Syndrome (SARS), and then Avian Influenza, health became an incontestable priority high on the global agenda. Both the Bank and the international community looked for new approaches to address persisting and emerging health issues.

Table 6-1 The Health-Related MDGs Goal 1 Eradicate extreme poverty and hunger: Halve the proportion of people who suffer from hunger between

1990 and 2015, with progress measured in terms of the prevalence of underweight children under five.

Goal 4 Reduce child mortality: Reduce the under-five mortality rate by two-thirds between 1990 and 2015

Goal 5 Improve maternal health: Reduce the maternal mortality ratio by three-quarters between 1990 and 2015.

Goal 6 Combat HIV/AIDS, malaria, and other diseases: Halt and begin to reverse the spread/ incidence of these diseases by 2015.

Goal 7 Ensure environmental sustainability: Halve the proportion of people without sustainable access to safe drinking water by 2015.

Source: United Nations. 2004. Millennium Development Goals. www.un.org/millennium goals.

MILLENNIUM DEVELOPMENT GOALS

6.3 The Bank-wide commitment to the MDGs had significant implications for the HNP sector: “The goals are increasingly providing the strategic underpinning of Bank assistance to countries in programs in health and multisectoral budget support” (Wagstaff and Claeson 2004). The MDGs have been integrated into sectorwide and programmatic instruments, loans and grants have been reoriented to achieve the MDG outcomes, and the MDGs have been used to build M&E capacity. The Bank has highlighted the importance of comprehensive strategies to achieve the targets and has identified institutional weakness as a major factor limiting progress. This has allowed the Bank to contribute to the achievement of the MDGs while adhering, to some degree, to its system-wide approach (Wagstaff and Claeson 2004).

6.4 The World Bank’s commitment to achieving the health MDGs was entirely consistent with the 1997 strategy’s objective to improve health outcomes for the poor. However, the MDGs address only average outcomes, not their distribution. Average health outcomes can improve while they worsen absolutely for the poor, or improve at a slower rate for the poor than for the non-poor (Gwatkin 2002). There was thus a risk that the new emphasis on achieving the MDGs would weaken the Bank’s prior commitment

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to ensuring that health outcomes also improve among the poorest groups within countries.27

LEVELS OF DEVELOPMENT ASSISTANCE FOR HEALTH

6.5 Official development assistance (ODA) declined during the 1990s. However DAH rose in real terms and as a proportion of ODA over the same decade.28 By 2002, DAH commitments from external sources rose from an annual average of US $6.7 billion in 1997-99 to about US$9.3 billion in 2002 (Jamison and others 2006) (Figure 6-1). This jump is a result of the priority given to health by the international community, which has led new actors to become involved in global health. Over the past decade, bilateral organizations played increasingly important roles in contributing to international health programs through UN organizations, technical assistance, and government-to-government agreements. Furthermore, the funding and priorities of non-governmental organizations and foundations, as well as corporations have become increasingly influential (Walt and Buse 2006).

6.6 Priority areas also changed. HIV/AIDS, immunization and new health product development have received higher priority (Jamison and others 2006). Important areas that have not benefited substantially from recent funding include shortages and low productivity of health workforces, and weaknesses in health management information systems and in supply chains for drugs and commodities (Jamison and others 2006).

6.7 The role of the Bank relative to other donors has also been affected. The World Bank is no longer the top funder of DAH in developing countries in the aggregate,29

which brings increased attention to the contributions of its non-lending activities, such as policy dialogue, sector and economic analysis. Improving Health, Nutrition and Population Outcomes in Sub-Saharan Africa: The Role of the World Bank exemplifies the World Bank’s heightened attention to its areas of comparative advantage (World Bank 2004a). It emphasizes the need to integrate macroeconomic and health policy, promote multisectoral policies, and strengthen health systems, including innovative approaches to achieve sustainable health finance. Furthermore, it focuses on the importance of improving M&E capacities to provide an expanded knowledge base for evidence-based decision making. The preface notes that to the extent that the Bank limits its work to its areas of comparative advantage, international and national partners are critical to ensuring a comprehensive effort to assist countries to develop strategies to improve health outcomes for the poor.

27 One issue that could be examined in a review of the Bank’s lending portfolio is whether the commitment in projects to improve HNP outcomes among the poor has been in any way weakened as a result of the emphasis of MDGs on average outcomes. 28 ODA includes grants from bilateral government channels and UN agencies plus net flows from development banks. 29 It remains the major funder of DAH in some countries, however.

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Figure 6-1: Trends in DAH from Major Sources 1997- 2002

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Source: Adapted from Jamison 2006; data from Michaud 2005 and OECD 2004

GLOBAL HEALTH PARTNERSHIPS

6.8 The proliferation of global health partnerships (GHPs) over the past decade peaked in 2001making them an important feature in the global health architecture (Brugha 2005). Maximizing its strategic advantages and engaging in selective partnerships were key elements of both the Strategic Compact and 1997 HNP strategy. By 2004, the Bank supported eleven GHPs which varied in their objectives, from financing mechanisms to advocacy, research, and technical cooperation (Lele and others 2004) (Box 6-1).30 Although GHPs were promoted to better focus health aid and to simplify the aid architecture in health, concerns have arisen that recently created global institutions with overlapping and unclear mandates complicate donor harmonization (Caines 2005, OED 2004).

30 These included: the Research and Development in Human Reproduction Program; the Special Programme for Research and Training in Tropical Diseases; the Joint United Nations Program on HIV/AIDS (UNAIDS); the Global Forum for Health Research; Roll Back Malaria (RBM); the Population and Reproductive Health Capacity Building Program; the Stop TB Partnership; the Global Alliance for Vaccines and Immunization (GAVI); Medicines for Malaria Venture (MMV); the Global Alliance to Eliminate Lymphatic Filariasis; and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM).

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Box 6-1: OED´s findings on Global Health Programs31 The underlying conclusion of a two-phase evaluation of the World Bank’s approach to global programs carried out by the OED, including evaluation of six health partnerships, was that the Bank had not been selective enough in its engagement. A case study of the six World Bank supported GHPs prepared for the evaluation found that:

• All six programs were consistent with the Bank Management’s declared criteria for involvement in global programs.

• The synergy between global programs and Bank country assistance strategies and experience on the ground was weak in all but a few countries and programs.

• There was an imbalance between resources for specific health initiatives and for building the long-term health delivery system in developing countries.

Sources: OED 2004, Lele 2004

6.9 The Bank’s high level of participation in GHPs has led it to reassess the costs and benefits of participation, especially in terms of meeting the HNP sector’s objectives. Further, because many GHPs are single-disease or single-intervention in focus, a question lingers over how best to balance the value added of these programs with the Bank’s systems approach. Participation in GHPs has also been criticized as detracting from the poverty emphasis of the Bank: “most GHPs claim to be pro-poor, although they lack specific indicators for equity aims” (Caines 2005, p. 2).

POPULATION AND NUTRITION

6.10 During most of this phase, the Bank’s work in population continued to be guided by the pre-MDG publication, Population and the World Bank: Adapting to Change. Whereas the ICPD shifted the international community’s attention toward a broad view of reproductive health, competition from other health issues, particularly HIV/AIDS, and the exclusion of reproductive health from the MDGs are major challenges to ensuring adequate funding and advocacy. Reproductive health was the only International Development Goal not included as an MDG, despite the fact that many of the MDGs can not be achieved without population and family planning activities and outcomes. Reproductive Health: the Missing Millennium Development Goal (2006) evaluates many of the changes since the ICPD and insists that “the reproductive health community needs to better understand these changes to assess their impact on ICPD implementation and to develop the capacity and skills to take advantage of the changes and mitigate any negative impacts that they have already produced” (White and others 2006). It argues that the ICPD rights-based approach has been ineffective overall, and promotes a new focus on expected outcomes and the extent to which investments in reproductive health services

31 In the literature on GHPs, the concept of GHP is broad and its main criterion is a “collaborative relationships among multiple organizations in which risks and benefits are shared in pursuit of a shared goal” (Buse 2004). The World Bank’s definition of a global program (not specific to global health programs) as set forth in OED 2004, is similar but more narrow in stipulating that the initiatives must cut across more than one region of the world. In a case study (Lele 2004) of “global health programs” that contributed to the OED’s 2004 evaluation, the six “global health programs”evaluated and the other five cited are also referred to as “partnerships.”. Annex G of the 2007 HNP strategy includes separate lists of the 19 “Global Health Partnerships and Initiatives” in which the Bank is involved and a separate list of fifteen “Process/Programs without Financial Participation.” This would indicate that currently within the HNP Sector at the World Bank, “partnership/initiative” is used to refer to programs which are directly financed. This paper adopts the broad definition of global health partnership.

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save lives, reduce suffering and help to address problems that challenge societies and cultures. Building the weak evidence base is a critical component of the approach, which recognizes the power of advocacy to affect change and improve health outcomes, particularly for poor women.

6.11 Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action uses the inclusion of nutrition in the MDGs as a platform to advocate increased investment in nutrition programs (World Bank 2006). The justification for Bank engagement remained unchanged since the mid 1980s: substantial evidence that malnutrition undermines economic growth, and the existence of well-tested and cost-effective approaches to reduce it. More recent research provides further evidence related to the most effective program targeting. The paper is consistent with the HNP sector strategy, as it prioritizes approaches that reach the poor and vulnerable at strategic stages in their development, working intesectorally, supporting action research and learning-by-doing, and “mainstreaming” nutrition into development strategies. The paper argues that funding should come through normal financing channels instead of a special nutrition fund, and it provides the framework for making policy choices in nutrition and a methodology to identify priority countries for action.

THE PLACE OF THE POOR

6.12 While the Bank’s underlying objective in this phase remained to improve health outcomes for the poor, the effects of its pursuit of a strategy shaped largely by the MDGs and GHPs despite concerns over their lack of pro-poor orientation are yet to be seen. The strategy of this phase was also influenced by the WDR 2004: Making Services Work for Poor People, which highlighted the importance of accountability of public policy and public services to the poor. The WDR 2004 argues that services for the poor work when we curtail corruption and take a comprehensive view of development, and thus, supports the need for institutional changes to strengthen relationships of accountability (World Bank 2003a). Although this is somewhat similar to the rationale of the Health Reform Phase, the critical difference is that the WDR 2004 stresses the importance of the accountability between the poor and providers, the poor and policymakers, and between policymakers and providers. This focus on the role of the poor themselves in “making services work for the poor” is critical, especially to improve health outcomes and on the importance of information which has been commonly underplayed in much of the Bank’s work, although it is reminiscent of principles from both Alma Ata and the Bamako Initiative.

7. SYSTEM STRENGTHENING FOR RESULTS: 2007 7.1 Healthy Development: The World Bank Strategy for Health, Nutrition and Population Results sets forth the Bank’s objectives for the next decade and the strategies to achieve them (World Bank 2007a). The document emphasizes that the dramatic changes in the global health architecture require the Bank to reposition itself to more

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effectively support countries to improve health outcomes, yet adheres closely to the objectives and strategies to achieve them established in the 1997 strategy.32

7.2 In the midst of the new global health architecture described by the paper, the strategy identifies the Bank’s comparative advantages as: providing policy and technical advice to both countries and partners, particularly to address “structural and health systems constraints”; its economic and evaluation analytic capacity; its intersectoral approach; and its capacity to implement large-scale programs, among others (World Bank 2007, p. 43). The Bank’s rationale for its next phase of activity in the HNP sector is that, given these areas of comparative advantage, it has a unique role to respond at the global level while maintaining its country-level focus and improving collaboration with partners.

7.3 The strategy’s four stated objectives are to: (i) improve the level and distribution of key HNP outcomes, outputs, and system performance at the country and global level in order to improve living conditions, particularly for the poor and vulnerable; (ii) prevent poverty due to illness; (iii) improve financial sustainability in the HNP sector and its contribution to sound macroeconomic and fiscal policy, and to country competitiveness; and (iv) improve governance, accountability and transparency in the health sector. To reach these objectives, the strategy advocated that the Bank engage with partners within a disciplined framework to support client countries to implement comprehensive, intersectoral approaches that focus on achieving results.

7.4 The sector’s current focus on results distinguishes it from previous strategies, as “results” is used to encompass HNP outcomes, outputs, and system performance. This shift away from focusing exclusively on HNP outcome indicators (e.g., MDGs), is a response to the complexity, and long-term nature involved in making sustainable improvements in HNP (World Bank 2007a, p. 14). The strategy argues that linking non-lending and lending activities is fundamental to improving results on the ground. This entails scaling-up output-based lending, implementing up-front M&E, providing support to strengthen national surveillance and monitoring, partnering with countries to learn more about the results of reforms, and implementing a detailed HNP Results Framework to guide M&E in Bank and global partner strategies. The Results Framework includes outcome indicators for each of the four objectives along with measures to track multisectoral contributions along with the Bank’s contributions to results, and process indicators for both countries and the Bank. The “common global” framework was designed to guide the development of results-based regional strategies and business plans as well M&E activities, and to be adaptable. The development of the Framework and its centrality in the new strategy demonstrates that M&E remains a priority despite the sector’s chronic difficulty in implementing effective M&E (OED 1999, Subramanian and others 2006).

32 In 2006 the World Bank’s Committee on Development Effectiveness (CODE) noted that the 1997 HNP Strategy was out of date given that it did not account for changes in the global health architecture and DAH; this prompted the sector to draft Healthy Development.

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7.5 Reconfirming the commitment to multisectorality made in 1997, the 2007 strategy recognizes that bottlenecks in critical sectors must be addressed in order for any multisectoral initiative to be effective. A new line of economic and sector work (ESW), the Mutlisectoral Constraints Assessment (MCA) tool, will be introduced to identify constraints in the relevant sectors, provide a framework to prioritize actions, and assess the best means to facilitate coordination between sectors. The MCA is intended to systematically deepen country-level analysis of institutional and technical constraints in order to guide the development of multisectoral approaches in Country Assistance Strategies.

7.6 Strengthening health systems remains central to the 2007 strategy. However, whereas system strengthening was formerly an objective, in 2007 it is viewed as the primary means to achieve the objective of improving the health conditions of people in client countries, particularly the poor and vulnerable. The HNP Sector’s continued emphasis on the centrality of health system strengthening will affect the staff and resources dedicated to single-disease and single-intervention issues, as well as population and nutrition. In contrast to the 1997 strategy, however, the 2007 strategy directly addresses the tensions between single-disease and systems strengthening approaches. It asserts that the two approaches can be complementary if they are well implemented, but does not provide a detailed strategy or recommendations on how this can be achieved or how it can be measured. The strategy does, however, provide a five-year plan that advocates hiring additional staff that are experts in health system issues and creating a health system policy team to provide analysis and advice to country teams (World Bank 2007a, p.75).

7.7 Notwithstanding some uncertainty on the priority assigned to population and reproductive health leading up to the 2007 strategy, Healthy Development confirms the Bank’s “strong” commitment to continue its work in this area. It prioritizes lowering high fertility in 35 countries with total fertility rates over five, most of them in Sub-Saharan Africa, maintaining that population growth is a constraint for economic growth and poverty reduction. Although it declares a “renewed commitment for population policy” adhering to the Bank’s commitments to the 1994 ICPD, the strategy does not consider how changes since 1994 have affected the likelihood of achieving results through this framework. It argues that other agencies, such as WHO and the United Nations Population Fund (UNFPA), have comparative advantage in providing technical assistance in this area, that the Bank’s role will be to increase demand for population and reproductive health services and information multisectorally, by strengthening education and economic opportunities for girls and women, and addressing gender disparities.

7.8 The Bank’s most recent publication dedicated to population, Population Issues in the 21st Century: The Role of the World Bank (2007b) differentiates between the two main areas under the population umbrella: (i) reproductive, maternal and sexual health, and the services that address them; and (ii) factors that determine population and age structure, including births, deaths, and migration. The technical discussion paper provides an overview of the demographic context globally, trends by region, and issues in high, medium and low-fertility countries, giving emphasis to Sub-Saharan Africa. It is a call for the Bank to broaden its focus and recognize its comparative advantage in addressing

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the demographic and non-medical side of population: “. . . [the World Bank’s] involvement in many sectors can produce synergies that will allow faster progress than a more narrow focus on family planning services” (World Bank 2007b).

7.9 The 2007 strategy’s rationale for continued investment in nutrition is that: “improving nutrition is at least as much of an economic issue as one of welfare, social protection, and human rights” (World Bank 2007a, p. 70). The Bank’s work in nutrition will be guided by the 2006 Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action. Malnutrition is problematic in both poor and non-poor countries; diet related non-communicable diseases present new challenges to health systems and financing. The 2007 strategy paper describes that the Bank will contribute to “repositioning” nutrition by generating country-specific knowledge, improving its capacity to identify structural issues, integrating multisectoral approaches (upon country demand), improving M&E, and incorporating nutrition as a dimension of the MCA tool. Similar to the population subsectors reliance on specialized partners for technical assistance, the Bank will consult with specialized global partners for advice beyond structural and systemic issues as the Bank’s comparative advantage in nutrition does not include technical aspects of nutrition interventions.

7.10 The 1997 HNP strategy explicitly sought to improve outcomes for the poor, while the 2007 strategy aims to improve both average outcomes (given its focus on the MDGs) and outcomes among the poor. Thus, commitment to improve outcomes for the poor is reaffirmed but the scope is broadened, which could affect the focus on and resourced dedicated to reaching the most vulnerable. Furthermore, although accountability is one of the strategy’s core objectives and the strategy recognizes the critical need articulated by the WDR 2004 to empower the poor to improve accountability in order to improve service delivery, it does not explore strategies to empower patients given its difficulty in practice. Although it is true that “. . . everyone is still struggling to find the best ways of reaching the poor with these proven interventions in low-income countries,” the importance of the poor in determining their own health outcomes has diminished in the 2007 strategy (World Bank 2007a, p. 51). The HNP sector appears to have returned to many of the strategies of the Health Reform Phase, most evident through its emphasis on the central role of strengthening health systems along with promoting improved financial protection to improve health outcomes. While these are critical aspects to ensure the delivery of services, the strategy de-emphasizes the individual or household decisions as the fundamental determinants of health outcomes, relative to the importance of health systems.

8. CONCLUSIONS 8.1 Throughout the recent phases, the World Bank’s objectives remained largely consistent: improving health outcomes, especially among the poor; strengthening health systems; and securing sustainable financing. The Bank’s approach to achieving those objectives changed more dramatically. Work with client-countries has become more participatory and client-driven; the World Bank has pursued more coordinated relationships with other donors; and the emphasis on multisectoral approaches has increased. While Healthy Development’s (2007) close adherence to the 1997 strategy

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would appear to validate the strategies and approaches that the sector introduced in 1997, no systematic evaluation of the efficacy of HNP support has been undertaken since OED’s 1999 evaluation, Investing in Health. In other words, the most recent strategy was not built on evidence of the efficacy or lessons from the past decade of experience in achieving similar objectives.

8.2 This review of the Bank’s objectives and strategies, particularly over the past decade, suggests four priority areas of investigation for an evaluation of the Bank’s HNP support.

8.3 First, how effective has been the Bank’s support in improving HNP outcomes among the poor? To what extent have Bank projects and analytic work explicitly addressed HNP outcomes in general and particularly among the poor? In projects with this objective, how have they gone about targeting the poor? To what extent have the Bank’s country strategies taken into account the potential contribution of sectors beyond HNP to improve HNP outcomes? What has happened to population and nutrition policies and interventions that go beyond the health system? What strategies or approaches have been used in different settings? Have they succeeded in improving the access of the poor to HNP services? Have they improved HNP status on average, or among the poor?

8.4 Second, what lessons have been learned about the efficacy, advantages, and disadvantages of various approaches in different settings? In particular: (a) programs to reform the health system, including through decentralization, health insurance, regulatory frameworks and contracting with the private sector, and health finance reform; (b) sector-wide approaches, designed to improve ownership, reduce transactions costs and improve the allocation of resources; (c) control of communicable diseases that disproportionately affect the poor; and (d) approaches relying on inter-sectoral contributions or collaboration. Which of these approaches have worked, which have not, and why, in different country contexts? Clearly, context is a very important part of understanding this, and thus, developing this understanding will help to identify the validity and best contexts for using specific approaches.

8.5 Third, what have been the revealed “strengths”, “valued added”, or “comparative advantages” of World Bank support for HNP in developing countries over the past decade, and how is that changing? The areas in which Bank’s contributions have had the most impact should be determined based on evidence of effectiveness from the last ten years. This is particularly relevant in light of the Bank’s objective of building partnerships, as well as the rapid expansion of GHPs, the number of donors and the resources currently available for international health. What has been the contribution of the Bank’s HNP support, in terms of policy dialogue, analytic work and lending, relative to the counterfactual of no Bank support? How effective has the Bank used its support to leverage policy reform? How, if at all, has the Bank’s contribution changed over the past decade in light of the surge in DAH, most of it in grant form, the emergence of new actors, and the emphasis on working through country-level partnerships? Has the latter helped to highlight or mute the Bank’s comparative advantages and potential contributions?

33

8.6 Finally, to what extent has the Bank’s support monitored results and used evaluation to improve the evidence-base for decision-making in HNP? The new HNP strategy emphasizes results, but OED’s 1999 evaluation of HNP support found M&E to be very weak. A recent review of projects completed over the past three fiscal years found that the sector has been overwhelmingly unsuccessful in tracking its own progress (Subramanian and others 2006, p. iii). Particularly given the World Bank’s emphasis on improving HNP outcomes, including MDG targets, as well as its new push for “results,” the evaluation needs to address: What share of projects have been designed in the absence of baseline information on outputs, financing or outcomes that are an objective of the project? Has the share of Bank projects with baseline data improved over time, and if so, why? How often are relevant outputs and outcomes traced over time in a manner that allows an analysis of trends? Are pilot projects being evaluated before they are implemented on a larger scale? Are evaluation results being used as a management tool? What are the main constraints to better M&E in the context of HNP support?

8.7 Evaluation of these issues, central to the World Bank’s recent objectives and approaches, would provide valuable evidence on the efficacy and lessons of experience from the 1997 HNP strategy. Moreover, it would provide useful lessons for the HNP sector’s implementation of the 2007 strategy, as well as broader ones to influence the global health community’s future strategies and approaches. The World Bank’s experiences over the past thirty-five years show that innovation, flexibility and selectivity are critical to ensure that the Bank maintains or builds strong and effective relationships with client countries and partners while keeping a close eye on achieving results in the priority areas that it establishes.

34

REFERENCES Berg, Alan. 1987a. “Nutrition Review.” Population, Health and Nutrition Technical

Note, no.8721. Population and Human Resources Department, World Bank, Washington, D.C.

_____1987b. Malnutrition: What can be done? Lessons from World Bank Experience.

Baltimore: Johns Hopkins University Press for The World Bank. _____1980. Nutrition, Basic Needs and Growth. Washington, D.C: The World Bank. Berman, Peter, and Thomas Bossert. 2000. “A Decade of Health Sector Reforms in

Developing Countries: What Have We Learned?” Paper presented at Data for Decision Making Symposium, March 15, 2000. Washington, D.C.. Retrieved February 19, 2007 from http://www.yourhealthrisk.harvard.edu/ihsg/publications/pdf/closeout.PDF

Bloom, David, and David Canning. 2003. “The Health and Poverty of Nations: From

Theory to Practice.” Journal of Human Development 7(2003): 47-71.

Brugha, R. 2005. Engagement and Support to Global Health Partnerships: A Review for Development Cooperation Ireland. (draft April 10, 2005).

Bryce, Jennifer, Cesar G. Victora, Jean-Pierre Habicht, Robert E. Black and Rocter W.

Scherpbier. 2005. “Programmatic pathways to child survival: results of a multi-country evaluation of Integrated Management of Childhood Illness.” Health Policy and Planning 20: 5- 17.

Buse, Ken. 2004. Global Health Partnerships: Mapping a Shifting Terrain. London:

DFID Health Resource Centre. Caines, Karen. 2005. “Background Paper: Key evidence from major studies of selected

Global Health Partnerships.” Paper prepared for High Level Forum on the Health MDGs Working Group on Global Health Initiatives and Partnerships, April 25-26, 2005. DFID Health Resource Center.

Carr, Dara, Davidson Gwatkin, Dianne Fraguiero, and Rohini Pande. 1999. A Guide to Country-level Information about Equity, Poverty, and Health Available from Multi-Country Research Programs. Washington, D.C: The World Bank.

Cassels, Andrew. 1997. A Guide to Sector-Wide Approaches for Health Development: Concepts, Issues, and Working Arrangements. WHO/ARA/97.12, World Health

Organization, Geneva: Danish International Development Assistance, Copenhagen; DFID, London; European Commission, Brussels.

35

Chen, Lincoln C. 1986. “Nutrition in Developing Countries and the Role of International Agencies: In Search of a Vision”, in Nutrition Issues in Developing Countries for the 1980s and 1990s: Proceedings of a Symposium (1986). Food and Nutrition Board Commission on Life Sciences National Research Council. Washington, D.C.: National Academy Press.

Claeson, Miriam, Tazim Mawji, and Christopher Walker. 2000. Investing in the Best

Buys: A Review of the Health, Nutrition, and Population Portfolio, FY 1993-99. HNP Discussion Paper Series, departmental working paper. Health, Nutrition and Population anchor, Human Development Network, World Bank, Washington, D.C.

Conly, Shanti R. and Joanne E. Epp. 1997. Falling Short: The World Bank’s Role in

Population and Reproductive Health. Washington, D.C.: Population Action International.

Crisp, Nigel. 2007. Global Health Partnerships: The UK Contribution to Health in

Developing Countries. London: DFID. Davis, Gloria. 2004. “A History of the Social Development Network in TheWorld Bank,

1973-2002.” Social Protection Discussion Paper Series, no.56. Social Development Family, World Bank, Washington, D.C.

Demery, Lionel and Michael Walton. 1998. Are Poverty Reduction and Other 21st

Century Goals Attainable? Poverty Reduction and Economic Management Network, World Bank, Washington, D.C.

Dollar, David and Lant Pritchett. 1998. Assessing Aid: What Works, What Doesn’t and Why. A World Bank Policy Research Report. New York: Oxford University

Press.

Filmer D. and L. Pritchett. 1998. “Estimating wealth effects without expenditure data -- or tears: An application to educational enrolments in States of India.” World Bank Policy Research Working Paper, no. 1994. World Bank, Washington, D.C..

Gillespie, Duff G. 2004. “Whatever Happened to Family Planning, And, for That Matter, Reproductive Health?” International Family Planning Perspectives 30(1): 34-38.

Golladay, Frederick and Bernhard Liese. 1980. “Health problems and polices in

developing countries.” World Bank Staff Working Paper, no. 412. Washington, D.C.: The World Bank.

Gottret, Pablo and George Schieber. Health Financing Revisited: A Practitioner’s Guide.

Washington, D.C.: The World Bank.

36

Grosh, Margaret and Juan Muñoz. 1996. “A Manual for Planning and Implementing the

Living Standards Measurement Study Surveys.” LSMS Working Paper, no.126. Washington, D.C.: The World Bank

Gwatkin David. 2002. “Who Would Gain Most from Efforts to Reach the Millennium

Development Goals for Health?” HNP Discussion Paper. Washington, D.C.: The World Bank.

Gwatkin, Davidson R., Kiersten Johnson, Adam Wagstaff, Shea Rutstein, and Rohini Pande. 2004. Initial Country Level Information about Socio-Economic Differences in Health, Nutrition and Population. Washington D.C.: The World Bank, 2nd Edition.

Inter-American Development Bank. 2004. Health Strategy: Framework for Bank Action

in the Sector Profile. Sustainable Development Department. Social Development Division. Washington, D.C.: Inter-American Development Bank.

Jamison, Dean T., W. Henry Mosley, and Anthony R. Measham, eds. 2006. Disease Control Priorities in Developing Countries. Second Edition. New York: Oxford University Press and The World Bank

______1993. Disease Control Priorities in Developing Countries. New York: Oxford

University Press. Jha, Prabhat and Frank Chaloupka, eds. 2000. Tobacco Control in Developing Countries.

World Bank and World Health Organization. Oxford: Oxford University Press.

Kapur, Devesh, John Lewis, and Richard Webb. The World Bank: It’s First Half Century. Washington, D.C.: The Brookings Institution.

King, Timothy. 2007. “Family Planning and the World Bank in Jamaica.” The Global

Family Planning Revolution; Three Decades of Population Policies and Programs. Warren C. Robinson and John A. Ross, eds. Washington, D.C.: The World Bank.

Lele,Uma, Naveen Sarna, Ramesh Govindaraj, and Yianni Konstantopoulos. 2004.

“Global Health Programs, Millennium Development Goals, and the World Bank’s Role.” Case Study for the OED evaluation of the Bank’s Global Programs. Operations Evaluation Department, World Bank, Washington D.C.

Lewis, M. 2005.“Addressing the Challenges of HIV/AIDS: Macroeconomic, Fiscal, and

Institutional Issues.” Working Paper 58, Center for Global Development, Washington, D.C.

Measham, Anthony R. 1986.“Review of PHN Sector Work and Lending in Health,

1980- 1985.” PHN Technical Note No. 86-14. Population, Health and Nutrition Department. Washington, D.C.: The World Bank.

37

Merrick, Tom. 2006. “Mobilizing Resources for Reproductive Health.” World Bank

Institute, Washington, D.C. Michaud, C. M. 2003. “Development Assistance for Health (DAH): Recent Trends and

Resource Allocation.” Paper prepared for the Second Consultation of the Commission on Macroeconomics and Health, World Health Organization, Geneva, October 29–30.

Narayan, Deepa and Patti Petesch, eds. 2002. Voices of the Poor from Many Lands. Oxford: Oxford University Press for the World Bank.

Nassim, Janet. 1991. “Special programme of research, development and research training

in human reproduction.” Policy Research Working Paper, no. 779. Washington, D.C.: The World Bank.

Nelson, Joan M. 1999. Reforming Health and Education: The World Bank, The IDB, and

Complex Institutional Change. Policy Essay, no. 26. Washington, D.C.: Overseas Development Council.

OED (World Bank Operations Evaluation Department). 2005. Committing to Results:

Improving the Effectiveness of HIV/AIDS Assistance. Washington, D.C.: The World Bank.

______2004. Addressing the Challenges of Globalization: An Independent Evaluation of the World Bank’s Approach to Global Programs. Washington, D.C.: The World Bank.

______1999a. Investing in Health: Development Effectiveness in the Health, Nutrition, and Population Sector. Washington, D.C.: The World Bank.

______1999b. Development in Health, Nutrition and Population: Lessons from World Bank Experience, Report 19266. Washington, D.C.: The World Bank.

______1998. Lessons from Experience in HNP. Washington, D.C.: The World Bank. OPEV (African Development Bank Operations Evaluation Department). Review of Bank

Assistance Effectiveness to the Health Sector (1997-2005). Ruger, Jennifer Prah. 2005. “The Changing Role of The World Bank in Global Health.”

American Journal of Public Health 95(1): 60-70. Schieber, George J. 1997. “Innovations in health care financing: proceedings of a World

Bank conference, March 10-11, 1997.” Washington, D.C.: The World Bank.

38

Sinding, Steven. 2007. “Overview and Perspective.” The Global Family Planning Revolution: Three Decades of Population Policies and Programs. Warren C. Robinxon and John A. Ross, eds. Washington, D.C.: The World Bank.

Stout, Susan, Evans, A., Nassim, J., Raney, L. 1997. “Evaluating health projects:

Lessons from the Literature.” World Bank Discussion Paper 356. Washington, D.C.: The World Bank.

Subramanian, Savitha, David Peters, and Jeffrey Willis. 2006. “How are Health Services, Financing and Status Evaluated? An Analysis of Implementation Completion Reports of World Bank Assistance in Health.” HNP Discussion Paper. Washington, D.C.: The World Bank.

United Nations. 2003. World Population Prospects 1950-2050: The 2002 Revision.

Database. Department of Economic and Social Affairs, Population Division. New York: United Nations.

UNICEF (United Nations Children’s Fund). 1998. "The Addis Ababa Consensus on

Cost-Sharing in Health and Education." New York: UNICEF. ______1995. “The Bamako Initiative: Rebuilding Health Systems.” The Bamako

Initiative Management Unit. New York: UNICEF. USAID (United States Agency for International Development). 1994. "USAID's Strategy

for Stabilizing Population Growth and Protecting Human Health." Population and Development Review 20(2): 483- 487.

Wagstaff, Adam. 2000. “Research on Equity, Poverty, and Health Outcomes:

Lessons for the Developing World.” HNP Discussion Paper Series, Departmental Working Paper. Development Research Group and Human Development Network. Washington, D.C.: The World Bank.

Wagstaff, A., and M. Claeson. 2004. Millennium Development Goals for Health: Rising

to the Challenge. Washington, D.C.: The World Bank. Walt, Gill and Kent Buse. 2006. "Global cooperation in international public health", in

M. Merson, R. Black and A. Mills, eds. International Public Health: Disease, Programs, Systems and Policies. Sudbury, MA: Jones and Bartlett. 2nd Edition.

White, Arlette C., Thomas W. Merrick, and Abdo S. Yazbeck. 2006. Reproductive Health: The Missing Millennium Development Goal. Washington, D.C.: The World Bank.

World Bank. 2007a. Healthy Development: The World Bank Strategy for Health,

Nutrition and Population Results. Human Development Network, World Bank, April 24, 2007.

39

______2007b. Population Issues in the 21st Century: The Role of the World Bank.

Technical Discussion Paper. Washington, D.C.: The World Bank. ______2006. Repositioning Nutrition as Central to Development: A Strategy for Large-

Scale Action. Directions in Development. Washington, D.C.: The World Bank.

______2005a. Rolling Back Malaria: The World Bank Global Strategy and Booster Program. Washington, D.C.: The World Bank

______2005b. The World Bank’s Global HIV/AIDS Plan of Action. The Global HIV/AIDS Program. Washington, D.C: The World Bank.

______2004a. Improving Health, Nutrition and Population Outcomes in Sub-Saharan

Africa: The Role of The World Bank. Washington, D.C.: The World Bank. ______2004b. Addressing HIV/AIDS in East Asia and the Pacific. HNP Series, Human

Development Network, Washington, DC. ______2004c. Water Resources Sector Strategy: Strategic Direction for World Bank

Engagement. Washington, D.C.: The World Bank. ______2003a. World Development Report 2004: Making Services Work for the Poor.

New York: Oxford University Press.

______2003b. Averting AIDS in Eastern Europe and Central Asia: A Regional Support Strategy. Washington, D.C.: The World Bank.

______2001a. “Strategic Directions for FY02-FY04: Implementing the World Bank’s Strategic Framework.” Board Report, March 21, 2001.

______2001b. “HIV/AIDS in the Caribbean: Issues and Options.” Washington, D.C.:

The World Bank. ______2000a. World Bank Strategy for Health, Nutrition and Population in the East

Asia and Pacific Region. Washington, D.C.

______2000b. World Development Report 2000/2001: Attacking Poverty. New York: Oxford University Press.

______2000c. Intensifying Action against AIDS in Africa: Responding to a Development

Crisis. Africa Region, Washington, D.C.: The World Bank.

______1999a. A Health Sector Strategy for the Europe and Central Asia Region. HNP Series, Human Development Network, World Bank, Washington, D.C.

40

______1999b. Population and the World Bank: Adapting to Change. Washington, D.C.: The World Bank.

______1997a. Health, Nutrition and Population Sector Strategy. Human Development

Network. Washington, D.C.: The World Bank.

______1997b. “The Strategic Compact: Renewing the Bank’s Effectiveness to Fight Poverty.”

______1997c. Confronting AIDS: Public Priorities in a Global Epidemic. World Bank

Policy Research Report. New York: Oxford University Press. ______1994a. Population and Development: Implications for the World Bank. Policy in

Practice. Washington, D.C.: The World Bank. ______1994b. “Better Health in Africa: Experiences and Lessons Learned.” Africa

Technical Department, Washington, D.C.: The World Bank.

______1994c. Enriching Lives: Overcoming Vitamin and Mineral Malnutrition in Developing Countries. World Bank Development in Practice Series, Washington, D.C.: The World Bank.

______1993. World Development Report: Investing in Health. New York: Oxford

University Press. ______1989. Sub-Saharan Africa: From Crisis to Sustainable Development. Washington,

D.C.: The World Bank. ______1988. “Acquired Immunodeficiency Syndrome (AIDS): The Bank's Agenda for

Action in Africa.” Technical Paper, Africa Technical Department, World Bank, Washington, D.C.

______1986a. Financing Health Services in Developing Countries: An Agenda for Reform. Washington, D.C.: The World Bank.

______1986b. “Poverty and Hunger: Issues and Options for Food Security in Developing Countries.” A World Bank Policy Study. Washington, D.C.: The World Bank.

______1984. World Development Report 1984: Population and Development. New

York: Oxford University Press.

______1980a. Health Sector Policy Paper. Washington, D.C.: The World Bank. ______1980b. World Development Report 1980: Poverty and Human Development. New

York: Oxford University Press.

41

______1975. Health Sector Policy Paper. Washington, D.C.: The World Bank.

______1974. “Population Policies and Economic Development.” A World Bank Staff Report. Washington, D.C.: The World Bank.

______1973. “Nutrition Policy: Policy Guidelines for Bank Nutrition Activities,” Sector Program Paper. Washington, D.C.: The World Bank.

______1972a. “Population Planning.” World Bank Operations: Sectoral Program and Policies. Baltimore and London: The Johns Hopkins University Press.

______1972b. Possible Bank Actions on Malnutrition Problems. Washington, D.C.: The World Bank.

______1971. “Education.” Sector Working Paper. Washington, D.C.: The World Bank. World Bank Group Archives. 2005. “World Bank Group Historical Chronology.”

(http://siteresources.worldbank.org/EXTARCHIVES/Resources/WB_Historical_Chronology_1944_2005.pdf.).

______World Bank Group Staff Telephone Directories. 1970- 2002. Available at World

Bank Group Archives, Washington, D.C. ______ “James D. Wolfensohn Timeline of Major Developments.”

(http://web.worldbank.org/WBSITE/EXTERNAL/EXTABOUTUS/ORGANIZATION/EXTOFFICEPRESIDENT/EXTPASTPRESIDENTS/PRESIDENTEXTERNAL/0,,contentMDK:20091752~menuPK:232058~pagePK:139877~piPK:199692~theSitePK:227585,00.html).

______ Sector Department Chart. Available at World Bank Group Archives,

Washington, D.C. World Health Organization (WHO). 1974. Handbook of Resolutions . Vol. 1, 1.8. World

Health Assembly, Fourteenth plenary meeting, 23 May 1974. Geneva: WHO. Yazbeck, Abdo S., Davidson R. Gwatkin, and Adam Wagstaff (eds.). 2005. Reaching the

Poor with Health, Nutrition and Population Services: What Works, What Doesn’t, and Why. Washington, D.C.: World Bank.

Zavier, Francis and Sabu S. Padmadas. 2000. “Use of a Spacing Method before Sterilization among Couples in Kerala, India.” International Family Planning Perspectives. 26(1): 29-35.

42

AN

NEX

A: O

BJEC

TIV

ES, R

ATI

ON

ALE

, AN

D S

TRA

TEG

IES

1970

– 2

007

Po

pula

tion

Phas

e 19

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Prim

ary

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lth C

are

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e 19

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lth

Syst

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e 19

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bal T

arge

ts a

nd P

artn

ersh

ips

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e 2

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6 H

NP

Res

ults

Pha

se

2007

Objectives

To re

duce

rapi

d po

pula

tion

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th: T

o im

plem

ent p

roje

cts

that

su

ppor

t gov

ernm

ents

to

redu

ce ra

pid

popu

latio

n gr

owth

thro

ugh

fam

ily

plan

ning

pro

gram

s th

at

low

er h

igh

ferti

lity.

To b

road

en a

cces

s to

PH

C:

emph

asis

on

prov

isio

n of

uni

vers

al,

low

-cos

t bas

ic h

ealth

car

e.

To im

prov

e he

alth

fina

ncin

g, "a

fu

ndam

enta

l cau

se o

f poo

r ap

proa

ches

" to

key

chal

leng

es in

the

heal

th s

ecto

r (W

orld

Ban

k 19

86a)

. To

impl

emen

t hea

lth p

olic

y re

form

s th

at: (

i) fo

ster

an

envi

ronm

ent t

hat

enab

les

hous

ehol

ds to

impr

ove

heal

th, (

ii) im

prov

e go

vern

men

t sp

endi

ng o

n he

alth

; and

(iii)

pro

mot

e di

vers

ity a

nd c

ompe

titio

n (W

orld

B

ank

1993

).

To (i

) im

prov

e H

NP

outc

omes

for

the

poor

and

pro

tect

the

popu

latio

n fro

m th

e im

pove

rishi

ng e

ffect

s of

illn

ess,

mal

nutri

tion,

and

hig

h fe

rtilit

y;

(ii) e

nhan

ce th

e pe

rfor

man

ce o

f he

alth

sys

tem

s, e

spec

ially

thei

r ca

paci

ty to

pro

vide

equ

itabl

e ac

cess

to

ser

vice

s; a

nd (i

ii) s

ecur

e su

stai

nabl

e he

alth

fina

ncin

g (W

orld

B

ank

1997

a).

Obj

ectiv

es d

o no

t cha

nge,

but

are

fra

med

by

the

com

mitm

ent t

o ac

hiev

e M

DG

s. O

bjec

tives

for s

peci

fic is

sues

ar

e es

tabl

ishe

d by

act

ion

plan

s fo

r H

IV/A

IDS

, mal

aria

, and

nut

ritio

n.

To:

(i) im

prov

e le

vel a

nd

dist

ribut

ion

of k

ey H

NP

outc

omes

(e

.g M

DG

s), o

utpu

ts, a

nd s

yste

m

perfo

rman

ce a

t cou

ntry

and

glo

bal

leve

ls in

ord

er to

impr

ove

livin

g co

nditi

ons,

par

ticul

arly

for t

he p

oor

and

vuln

erab

le; (

ii) p

reve

nt p

over

ty

due

to il

lnes

s (b

y im

prov

ing

finan

cial

pr

otec

tion)

; (iii)

impr

ove

finan

cial

su

stai

nabi

lity

in th

e H

NP

sec

tor a

nd

its c

ontri

butio

n to

sou

nd

mac

roec

onom

ic a

nd fi

scal

pol

icy

and

to c

ount

ry c

ompe

titiv

enes

s; (i

v)

impr

ove

gove

rnan

ce,

acco

unta

bilit

y, a

nd tr

ansp

aren

cy in

th

e he

alth

sec

tor (

Wor

ld B

ank

2007

a).

Rationale

Dem

ogra

phic

: "In

the

long

ru

n, fe

rtilit

y re

duct

ion

can

be a

chie

ved

only

with

the

right

com

bina

tion

of s

ocia

l an

d ec

onom

ic d

evel

opm

ent,

cultu

ral a

nd p

oliti

cal

attit

udes

, and

eas

y av

aila

bilit

y of

con

trace

ptiv

e fa

cilit

ies.

. . H

owev

er, t

he

limite

d ex

perie

nce

avai

labl

e ha

s al

read

y sh

own

that

if a

n ad

equa

te s

ervi

ce c

an b

e pr

ovid

ed, i

nclu

ding

pub

lic

info

rmat

ion

and

a va

riety

of

acce

ptab

le m

etho

ds, t

he

resu

lts w

ill be

de

mog

raph

ical

ly s

igni

fican

t ev

en if

inad

equa

te to

ac

hiev

e th

e de

sire

d re

duct

ion

in fe

rtilit

y. “(

Wor

ld

Ban

k 19

72a,

p. 3

17).

Econ

omic

gro

wth

and

pov

erty

re

duct

ion:

"Hum

an d

evel

opm

ent-

educ

atio

n an

d tra

inin

g, b

ette

r hea

lth

and

nutri

tion,

and

ferti

lity

redu

ctio

n- is

sh

own

to b

e im

porta

nt n

ot o

nly

in

alle

viat

ing

pove

rty d

irect

ly, b

ut a

lso

in

incr

easi

ng in

com

es o

f the

poo

r, an

d G

NP

gro

wth

as

wel

l" (W

orld

Ban

k 19

80b,

p. i

ii).

Econ

omic

gro

wth

, pov

erty

re

duct

ion,

and

hum

anita

rian:

"F

oste

ring

impr

ovem

ents

in h

ealth

se

ctor

fina

nce

is a

mon

g th

e m

ost

valu

able

con

tribu

tion

the

Wor

ld B

ank

can

mak

e to

bet

ter h

ealth

car

e in

low

in

com

e co

untri

es" (

Wor

ld B

ank

1986

a, p

. 51)

. "If

dev

elop

ing

coun

tries

gov

ernm

ents

and

key

do

nors

acc

ept t

he c

halle

nges

and

em

brac

e th

e ke

y he

alth

pol

icy

refo

rms

. . .

impr

ovem

ents

in h

uman

w

elfa

re in

the

com

ing

year

s w

ill be

en

orm

ous.

A la

rge

shar

e of

the

curre

nt b

urde

n of

dis

ease

. . .

will

be

prev

ente

d. A

nd p

eopl

e ar

ound

the

wor

ld, e

spec

ially

the

mor

e th

an 1

bi

llion

peop

le n

ow li

ving

in p

over

ty,

will

live

long

er, h

ealth

ier,

and

mor

e pr

oduc

tive

lives

(Wor

ld B

ank

1993

, p.

171)

.

Pove

rty

redu

ctio

n, h

uman

itaria

n,

econ

omic

gro

wth

: "G

ood

heal

th,

nutri

tion,

and

repr

oduc

tive

polic

ies,

an

d ef

fect

ive

heal

th s

ervi

ces

are

criti

cal l

inks

in th

e ch

ain

of e

vent

s th

at a

llow

cou

ntrie

s to

bre

ak o

ut o

f th

e vi

ciou

s ci

rcle

of p

over

ty, h

igh

ferti

lity,

poo

r hea

lth, a

nd lo

w

econ

omic

gro

wth

, rep

laci

ng th

is w

ith

a vi

rtuou

s ci

rcle

of g

reat

er

prod

uctiv

ity, l

ow fe

rtilit

y, b

ette

r hea

lth,

and

risin

g in

com

es" (

Wor

ld B

ank

1997

a, p

. v).

Rat

iona

le d

oes

not c

hang

e bu

t a

ratio

nale

to s

uppo

rt gl

obal

pro

gram

s em

erge

s.

Pove

rty

redu

ctio

n, h

uman

itaria

n,

econ

omic

gro

wth

: "H

NP

pol

icie

s pl

ay a

fund

amen

tal r

ole

in e

cono

mic

an

d hu

man

dev

elop

men

t and

pov

erty

al

levi

atio

n. .

. .

Goo

d he

alth

boo

sts

econ

omic

gro

wth

, and

eco

nom

ic

grow

th e

nabl

es fu

rther

gai

ns in

he

alth

.” G

iven

cha

nges

that

oc

curre

d si

nce

the

1997

stra

tegy

, the

B

ank

will

impr

ove

“its

own

capa

city

to

resp

ond

glob

ally

and

with

a c

ount

ry

focu

s to

the

urge

nt is

sues

pos

ted

by

thes

e ch

ange

s an

d (p

ersi

stin

g w

orld

wid

e H

NP

) cha

lleng

es" (

Wor

ld

Ban

k 20

07a,

p. 2

0).

Strategies

Wor

k w

ith g

over

nmen

ts to

im

plem

ent p

roje

cts

to

prov

ide

a m

ore

equi

tabl

e di

strib

utio

n of

pop

ulat

ion

and

fam

ily p

lann

ing

serv

ices

, and

gat

her

info

rmat

ion

to e

stab

lish

the

usef

ulne

ss o

f the

pro

ject

ap

proa

ch.

Wor

k w

ith g

over

nmen

ts a

nd p

rovi

de

dire

ct le

ndin

g fo

r hea

lth p

roje

cts

to

impr

ove

acce

ss to

prim

ary

heal

th

care

to p

rovi

de a

mor

e eq

uita

ble

dist

ribut

ion

of s

ervi

ces

(incl

udin

g po

pula

tion

and

fam

ily p

lann

ing

serv

ices

). M

eet t

he n

eed

for b

asic

he

alth

ser

vice

s, e

spec

ially

in ru

ral

area

s, b

y de

velo

ping

bas

ic h

ealth

in

frast

ruct

ure,

trai

ning

com

mun

ity

heal

th w

orke

rs a

nd p

arap

rofe

ssio

nal

staf

f, st

reng

then

ing

the

logi

stic

s an

d su

pply

of e

ssen

tial d

rugs

, pro

vidi

ng

mat

erna

l and

chi

ld h

ealth

car

e, a

nd

impr

ovin

g fa

mily

pla

nnin

g an

d di

seas

e co

ntro

l.

Sup

port

gove

rnm

ents

to im

plem

ent

heal

th s

ecto

r ref

orm

s th

at e

stab

lish

the

prop

er ro

le fo

r gov

ernm

ents

, qu

asi-m

arke

ts a

nd th

e pr

ivat

e se

ctor

in

hea

lth.

Fost

er im

prov

emen

ts in

he

alth

sec

tor f

inan

cing

by

prom

otin

g:

(i) u

ser f

ees

at g

over

nmen

t hea

lth

faci

litie

s; (i

i) in

sura

nce

or ri

sk

cove

rage

to m

obiliz

e re

sour

ces

whi

le

prot

ectin

g ho

useh

olds

from

hea

lth

shoc

ks; (

iii) m

ore

effe

ctiv

e ut

iliza

tion

of n

ongo

vern

men

tal r

esou

rces

; (iv

) de

cent

raliz

ed p

lann

ing,

bud

getin

g an

d pu

rcha

sing

(Wor

ld B

ank

1986

a).

Pro

vide

pol

icy

advi

ce a

nd fi

nanc

ial

supp

ort t

hat i

s gu

ided

by

coun

try-

spec

ific

appr

oach

es b

y: (i

) sh

arpe

ning

stra

tegi

c di

rect

ions

; (ii)

ac

hiev

ing

grea

ter i

mpa

ct; (

iii)

empo

wer

ing

HN

P s

taff;

and

(iv)

bu

ildin

g pa

rtner

ship

s (W

orld

Ban

k 19

97a)

.

Sam

e st

rate

gy b

ut w

ith in

crea

sed

focu

s on

sin

gle

dise

ase

prio

ritie

s an

d en

gage

men

t in

glob

al p

rogr

ams.

In

orde

r to

bette

r alig

n th

e B

ank'

s co

untry

ass

ista

nce

stra

tegi

es w

ith th

e M

DG

s: (i

) int

egra

te g

oals

in

sect

orw

ide

and

prog

ram

mat

ic

inst

rum

ents

; (ii)

reor

ient

and

incr

ease

B

ank

loan

s an

d gr

ants

to a

chie

ve th

e M

DG

s; a

nd (i

ii) u

se M

DG

s to

mon

itor

and

eval

uate

cap

acity

(Wag

staf

f and

C

laes

on 2

004)

.

Sup

port

coun

try e

fforts

to a

chie

ve

resu

lts b

y: (i

) ren

ewin

g B

ank

focu

s on

H

NP

resu

lts; (

ii) in

crea

sing

Ban

k co

ntrib

utio

n to

clie

nt-c

ount

ry e

fforts

to

stre

ngth

en a

nd re

aliz

e w

ell-o

rgan

ized

an

d su

stai

nabl

e he

alth

sys

tem

s fo

r H

NP

resu

lts; (

iii) e

nsur

e sy

nerg

y be

twee

n he

alth

sys

tem

stre

ngth

enin

g an

d pr

iorit

y-di

seas

e in

terv

entio

ns,

parti

cula

rly in

LIC

s; (i

v) s

treng

then

B

ank

capa

city

to a

dvis

e cl

ient

co

untri

es o

n an

inte

rsec

tora

l ap

proa

ch ;

(v) i

ncre

ase

sele

ctiv

ity,

impr

ove

stra

tegi

c en

gage

men

t, an

d re

ach

agre

emen

t with

glo

bal p

artn

ers

on c

olla

bora

tive

divi

sion

of l

abor

for

the

bene

fit o

f clie

nt c

ount

ries

(Wor

ld

Ban

k 20

07a)

.

43 Annex B: Summaries of Key HNP Documents and

Strategy Papers

ANNEX B: SUMMARIES OF KEY HNP DOCUMENTS AND STRATEGY PAPERS, 1997-2007

1. World Development Report 1993: Investing in Health justifies the need for increased investment and political commitment to health by establishing a link between improved health, productivity, economic growth and development (World Bank 1993). The Report calculates the Global Burden of Disease (GBD) using the disability life- adjusted year (DALY) to quantify the loss of healthy life from disease and disability. These assessments are used to evaluate cost-effectiveness of specific interventions and set priorities for health spending. The Report proposes a three-pronged approach to government policies in developing and formerly socialist countries for improving health: (i) pursue economic growth policies that benefit the poor and enable households to make decisions to improve health; (ii) redirect government spending on health to cost-effective programs and a minimal package of essential clinical services that will particularly benefit the poor; and (iii) promote greater diversity and competition in the finance and delivery of health services. Noting that aid for health declined in the 1980s, the Report argues that the international community must do more to improve donor coordination to support broad health system reform, shift donor money towards public health programs and essential clinical care, and support health research. 2. The 1997 Health, Nutrition, and Population Sector Strategy Paper identifies the World Bank’s objectives as: (i) improving the HNP outcomes of the poor; (ii) enhancing the performance of health systems, especially their capacity to provide equitable access to services; and (iii) securing sustainable health care financing (World Bank 1997a). The strategy establishes four action areas to accomplish these objectives. The first action area is facilitating improved strategic decision-making to develop country-specific strategies with short and medium term activities designed to accomplish longer-term HNP outcomes. Country Assistance Strategies (CAS) will be used to mobilize multisectoral involvement to formulate strategies that address decentralization, partnerships, and public involvement in sustainable financing. The country-level reform strategies will be informed by sector studies and research. The second action area is achieving greater impact through improving client services and responsiveness through expanding the knowledge base, improving project processes, and enhancing the role of monitoring and evaluation at both the project and sector levels. In order to accomplish these objectives, the Strategy’s third action area is to bring Bank staff closer to clients. The last action area is to build selective partnerships based on the Bank’s comparative advantages. The 1997 Strategy demonstrates the Bank’s position that institutional and systemic changes are fundamental for improving health outcomes for the poor, improving health system performance, and achieving sustainable financing.

3. Confronting AIDS: Public Priorities in a Global Epidemic (1997), a Policy Research Report issued by Development Economics and the World Bank’s Chief Economist, presents evidence of the economic impact of AIDS, social and economic determinants, and the effectiveness of interventions in developing countries (World Bank

Annex B: Summaries of Key HNP Documents and

Strategy Papers

44

1997c). The report demonstrates the rationale for government commitment to controlling AIDS from epidemiological, public health, and public economic perspectives. It presents priorities for countries at different stages in the epidemic and argues that country strategies must be immediate, concerted and focused. All countries must consider their resources as well as the stage of the epidemic to determine cost-effect strategies to prioritize provision of public goods and promote safe behavior for high-risk populations. The report also calls on countries to improve access to cost-effective health care for AIDS patients, and to develop activities to promote behavior change and prevent discrimination. Donors must base their support on evidence of country-specific effectiveness for interventions, and finance key international public goods, including research on HIV incidence and best practices, along with development of affordable vaccines and appropriate medical technologies. The report suggests that activities and policies be integrated with poverty reduction programs, and that the country-context and resources determine priorities and the roles of government, NGOs, the private sector, and external donors. 4. The objective of A Health Sector Strategy for the Europe and Central Asia Region (1999) is to respond to changes in the health care systems of transition countries by providing a guide to support regionally appropriate, intersectoral health system reforms (World Bank 1999a). The key priorities identified are: (i) promoting wellness and reducing the prevalence of avoidable illness; (ii) creating affordable and sustainable delivery systems; and (iii) maintaining functioning health systems during the reform process. The strategy argues that governments should work with multiple stakeholders to build consensus around a vision for the desired health care system. The implementation of the systemic reform must be undertaken in carefully sequenced and coordinated subsectoral reforms that are guided by the long term vision. To facilitate the process of selecting a phased primary program of overall reform, the ECA region will compile a structured menu of options for subsectoral reforms, as well as define a research agenda on relevant health-related questions affecting transition countries. The strategy suggests that professional groups and institutions be entrusted to lead certain quality-related subsectoral reforms in the sake of maximizing the rate of the reform. In order to further support this strategy, the Bank proposes several internal reforms including: redefinition of activities to support the best policy advice, streamlining of business processes, and ensuring sufficient staff and resources to meet its commitments. 5. The World Bank’s population strategy, Population and the World Bank: Adapting to Change (1999) is shaped largely by its commitment to the 1994 ICPD and by the Bank’s emphasis on health sector reform in the 1990s (World Bank 1999b). It responds to significant changes in population growth, age and spatial distribution, and the emergence of HIV/AIDS since the Bank began its lending for population in the 1970s and recognizes that country context, and decision-making at the community and family level are key determinants of population outcomes. The strategy’s principal objective is to increase the Bank’s effectiveness to build population policies and programs that contribute to poverty reduction at the household and country levels. It commits to assisting countries to pursue these goals by: linking population to poverty reduction and human development, advocating for cost-effective policies that give adequate

Annex B: Summaries of Key HNP Documents and

Strategy Papers

45

consideration to country context, building on analysis and dialogue, providing sustained support, and strengthening skills and partnerships at country and global levels. The strategy establishes mechanisms, such as the Bank-wide Population and Reproductive Health Thematic Group, to ensure that population and reproductive health components are incorporated into broader development strategies. Furthermore, it stresses that population and reproductive health outcomes must be tracked to ensure the quality of program and operational effectiveness. 6. The World Bank Strategy for Health, Nutrition and Population in the East Asia and Pacific Region (2000) closely adheres to the sectoral goals of 1997 HNP Sector Strategy (World Bank 2000a). The overall objective of the strategy is broad: to improve the Bank’s effectiveness in HNP in the region. The strategy urges selectivity and flexibility on behalf of the Bank to develop new approaches, as necessary, based on lessons learned and experience in the region. The strategy prioritizes: improving outcomes for the poor; enhancing the performance of health care systems; and securing sustainable financing. Specifically, it argues that efficient, equitable and sustainable intersectoral approaches must be developed to target the poor’s key health problems as increased public health service use is promoted among poor and vulnerable populations. Furthermore, it argues that increased health spending and reallocation to public health programs must be accompanied by a strengthening of the capacities of the Ministries of Health in regulation, control and education of consumers, and monitoring and evaluation. The strategy supports country efforts to decentralize, work with the private sector to provide services, and expand sustainable social insurance programs. However, the recommendations remain broad and emphasize that specific strategies must be developed at the country level to respond to varying health priorities and policy climates. Improving portfolio quality and client services, supporting work in the sector with research and analysis, and strengthening partnerships are identified as the key ways for the World Bank to contribute to progress in these priority areas. 7. Intensifying Action against HIV/AIDS in Africa: Responding to a Development Crisis (2000) is an important strategy document for the Africa region (World Bank 2000c). The failure of governments to act in spite of longstanding evidence is described as a “crisis,” affecting all development efforts due to the severity of the epidemic in the region. The strategy prioritizes: increased advocacy to strengthen political commitments to fight HIV/AIDS; mobilization of resources; and a strengthened knowledge base. It advocates increased resources and technical support to assist African partners and the World Bank to mainstream HIV/AIDS into all sectors (creating a regional team, ACTafrica) to facilitate a multisectoral approach and maximize benefits from relationships and influence with national governments. The strategy urges greater support for prevention targeted at general and specific audiences, along with activities to improve care and treatment. In countries with lower HIV prevalence, behavior change initiatives targeted at high-risk populations must be the first area of focus, followed by broader approaches to reach other at-risk populations. In high HIV prevalence countries, the strategy advocates strengthened interventions targeted to high-risk populations and then extended to all vulnerable groups, as well as quick movement to provide care for those affected by HIV/AIDS to mitigate the effects of the epidemic. A key component of

Annex B: Summaries of Key HNP Documents and

Strategy Papers

46

the strategy is to improve the quality of data available to: (i) provide evidence of the devastating effects of the epidemic and the urgency to respond; (ii) determine the effectiveness of activities; and (iii) assist governments to understand the severity of the epidemic in their country/region and then design the most appropriate prevention, care and treatment programs based on the data. 8. World Development Report 2004: Making Services Work for Poor People calls attention to the frequent failure of basic services, particularly health, education, water, and sanitation, to reach the poor and their potential to improve outcomes (World Bank 2003a). Services fail poor people in four critical ways: (i) only a small portion of national budgets are spent on services for the poor; (2) if spending is allocated to the poor, often it does not reach them; (3) if spending does reach the poor, weak incentives for providers often lead to poor quality service; and (4) due to poor service quality or limitations to accessing them, demand is often is weak. In order to address these barriers to service delivery, the report advocates that the poor are put at the center of service provision. It argues that services for the poor can be improved by enabling the poor to monitor service delivery and quality, improving pro-poor advocacy and representation in policymaking, and providing incentives for providers to serve the poor. While institutional change is fundamental to strengthen relationships of accountability, the report emphasizes that institutional changes are often long-term processes that must be tailored to the local context. The WDR extends its message to the donor community, emphasizing that in order to improve service reform and accountability at the country-level, that aid effectiveness and development outcomes must be prioritized. 9. Improving Health, Nutrition, and Population Outcomes in Sub-Saharan Africa: The Role of the World Bank (2004) notes that positive trends in health indicators have slowed or reversed in Sub-Saharan Africa (World Bank 2004a). The strategy argues that the World Bank must use its comparative advantage to work with governments and partners to strengthen the capacity of countries to improve health outcomes. Nutrition and population must remain central issues in development in Sub-Saharan Africa and accordingly, the report presents a regional guide to shape strategy formulation at the country or sub-regional level. Its priorities are aligned with the Bank’s comparative advantages: integrating macroeconomic and health policy; promoting multisectoral polices that contribute to health outcomes; strengthening health systems; and developing appropriate and innovative approaches to achieving sustainable health finance. As the Bank moves away from project support in the HNP sector and towards sector-wide approaches (SWAps) and budget support, improved M&E is fundamental to track health outcomes and ensure the effectiveness of these approaches. Moreover, it argues that at the country and regional levels, decision-making must be based on an expanded knowledge base including results from M&E, best practices from regional and global experiences, and analytic work.

10. Rolling Back Malaria: The World Bank Global Strategy and Booster Program (2005) outlines the five-year Booster Program for Malaria Control and rationale for initiating the strategy (World Bank 2005a). The Program’s immediate objectives are to increase coverage of malaria-specific interventions, improve outcomes, contribute to

Annex B: Summaries of Key HNP Documents and

Strategy Papers

47

developing health systems, and build capacity in several sectors. With a focus on targeting poor and vulnerable groups, the World Bank will attempt to meet its corporate commitment primarily with efforts to support countries to: develop and implement cost-effective programs that target poor and vulnerable groups; mitigate the negative consequences of malaria; and reduce morbidity, productivity losses, and mortality. It also aims to address the challenges of regional and global public goods. Described as a “new business model”, it prioritizes flexibility, giving countries choices in financing mechanisms and modes of implementation. For example, the Program allows for cofinancing with other sources, country-by-country partnerships with the GFATM, grants or performance-based buy-downs. In terms of implementation, it also does not adhere closely to any mode, and suggests possibilities including: enhancing PRSCs and SWAps to support malaria control; country or subregional level malaria control projects; and combined HIV, TB and malaria control projects. The report, however, does advocate strongly that malaria control is included in PRSCs and health SWAps to address the issue in the medium- to long-term, while simultaneously supporting intensive programs to ensure rapid increases in coverage. There is an emphasis on measurable results and “closing the gap between learning and doing.” At the country level, it is argued that the results emphasis will ensure that strategies remain results-driven and strengthen country capacity in monitoring and evaluation. The Bank will establish clear programs and budgets, and track its commitment to malaria control in order to assess its effectiveness. The business model creates a Bank-wide Malaria Task Force, composed of individuals from corporate units, networks, operational vice presidential units and the IFC, to increase the scale and impact of Bank support at country level, and improve the institutional knowledge base on the economics of malaria, channeling this into work on poverty reduction strategies. A high-level Steering Committee formed by the vice presidents of several regions and units along with the Senior Vice President and Chief Economist, will be established to provide institutional oversight and guidance. 11. The World Bank’s Global HIV/AIDS Plan of Action (2005) outlines a three-year working plan to strengthen the response to the HIV/AIDS epidemic at the country, regional and global levels through lending, grants, analysis, technical support and policy dialogue (World Bank 2005b). This Plan of Action contributes to the Bank and international community’s overall objective of reversing the spread of HIV/AIDS. It establishes five action areas: strengthening national HIV/AIDS strategies; continuing to fund national and regional programs to strengthen health systems; accelerating implementation by improving coordination; strengthening country monitoring and evaluation and evidence-informed responses; and knowledge generation and shared impact evaluation. Although its top priority is to prevent new infections, it argues that an effective response to HIV/AIDS also must include treatment and care. The Bank will work with client countries and development partners including civil society and people living with AIDS in its next phase of work on the epidemic. The plan identifies several constraints that commonly limit the effectiveness of resources devoted to fighting HIV/AIDS. These include: poor planning; lack of surveillance and monitoring and evaluation information; implementation constraints; health systems without adequate capacity to manage additional resources and responsibilities; programs that are limited in scope; and political, social and economic climates that do not deal well with controversial

Annex B: Summaries of Key HNP Documents and

Strategy Papers

48

services or marginalized groups. Due to a surge in resources dedicated to fighting the epidemic, along with increased knowledge of how to tackle it and increased awareness, HIV/AIDS is no longer classified as a “crisis” but instead as a broad, long-term development issue that must be addressed with harmonized and coordinated action to promote common approaches. 12. Reproductive Health: The Missing Millennium Development Goal (2006) argues that despite a surge in the levels of attention and funding dedicated to reproductive health in the years following the 1994 International Conference on Population and Development (ICPD), that it is no longer a priority on the international community’s agenda (White and others 2006). As the title of the report indicates, the goal to provide universal access to reproductive health information and services was dropped from the agenda when the MDGs were adopted in 2000. Opponents of the goal argued that it promoted abortion and undermined family values, and thus in order avoid further controversy and ensure consensus, it was eliminated. Consequentially, this decision has jeopardized funding and support for reproductive health. Citing evidence that services are failing the poor, particularly women, the report employs an adapted version of the “pathways” framework to assess factors and several levels which influence reproductive health. It argues that too often individual and family decisions and actions, the demand side of medical care, are overlooked despite their instrumental role in achieving health outcomes. The report maintains the validity of the rights-based approach, but argues that because it has not been successful overall, that a more practical approach could contribute more effectively to the achieving the underlying objectives. It asserts that reproductive health advocates need to understand how to face the challenges and opportunities that have arisen due to changes in the international health landscape including, the emergence of disease-specific global initiatives (particularly HIV/AIDS), health sector reforms and new financial aid modalities. It suggests an approach that focuses on expected outcomes and the extent to which investments in reproductive health services save lives, reduce suffering and help address socially and culturally challenging programs. Building the evidence base, which has been weak, is a critical component of the approach which recognizes the power of advocacy to affect change and improve health outcomes, particularly for poor women. 13. Health Financing Revisited: A Practitioner’s Guide (2006) reviews the policy options and tools available for health finance in low-income and middle-income countries. Due to demographic and epidemiological transitions, health care financing is particularly urgent because these changes will alter quantity and type of health services needed, and put more pressure on the health care systems (Gottret and Schieber 2006). The guide details the features, strengths and weaknesses of different mechanisms for revenue collection, risk pooling, resource allocation and purchasing. Its objective is to provide an overview of health finance tools and policies to assist policy makers and stakeholders design, implement, and evaluate effective health finance reforms. Key priorities in health financing for both LICs and MICs include: (i) mobilizing increased and sustainable government health spending; (ii) improving governance and regulation to strengthen the capacity of health systems and ensure that investments are equitable and efficient; and (iii) coordinating donors to make more flexible and longer-term commitments that are aligned with the development goals of a country. The publication

Annex B: Summaries of Key HNP Documents and

Strategy Papers

49

advocates that LICs and MICs consider the options available for health financing and formulate appropriate policies based on their specific country-context, case studies, and lessons learned from high-income countries. Moreover, it advocates that decisions concerning specific products and services be evaluated along the lines of effectiveness and cost-effectiveness. Fundamental to improving and ultimately achieving sustaining health financing, is strengthening government capacity to raise revenue along with its accountability and absorptive capacity for donor funding. Last, because sustainable financing depends on political stability, the international community must work with countries to formulate sound macroeconomic policy, develop tools to improve public sector management (such as PRSPs, PRSCs, MTEFs), and develop clear rules regarding compliance with international contracts. 14. Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action (2006) makes the case that malnutrition is the world’s most serious health problem and largest contributor to child mortality (World Bank 2006). It argues that due to the threat to health and development posed by malnutrition, countries must take the lead to reposition nutrition on their agendas. The international community needs to provide both incentives to establish nutrition as a priority and resources to scale-up successful interventions. The report prioritizes: developing approaches that reach the poor and most vulnerable at strategic stages in their development; scaling up proven and cost-effective programs; reorienting ineffective programs; improving nutrition through deliberate activities in other sectors; supporting action research and learning by doing; and mainstreaming nutrition into development strategies (CASs, SWAps, MAPs, PRSPs). To support effective work in these priority areas, the development community must: coordinate its efforts to strengthen commitments to nutrition, focus on agreed-on set of priority countries for investment and another set for researching best practices, and provide support for nutrition initiatives with large-scale programs as opposed to smaller-scale projects. The report argues that funding should come through normal financing channels instead of a special nutrition fund. It also provides a framework for making policy choices in nutrition and a methodology for determining how to prioritize countries for action in nutrition. 15. Population Issues in the 21st Century: The Role of the World Bank (2007 differentiates between the two main areas under the population umbrella: (i) reproductive, maternal and sexual health, and the services that address them; and (ii) factors that determine population and age structure, including births, deaths, and migration (World Bank 2007b). The report focuses on the second area, stating that it was written as a follow-up to an early draft of the 2007 HNP strategy to emphasize areas not covered comprehensively in the background strategy note submitted. It provides an overview of the demographic context globally, trends by region, and issues in high, medium and low-fertility countries, giving emphasis to Sub-Saharan Africa. Also, it highlights the multisectoral dimensions of fertility. After establishing the need to address population issues, the report argues that the Bank’s action in this area is rational given the relationships between population and economic growth and poverty reduction. It also argues that this is in-line with the Bank’s focus on improving outcomes for the poor and vulnerable, as these populations experience the highest fertility rates and lowest

Annex B: Summaries of Key HNP Documents and

Strategy Papers

50

contraception use rates, and would gain from targeted efforts. The report then broadens its scope to look at the global policy context for population, including the challenges and opportunities generated by the MDGs, ICPD, and recent trends in total population assistance. According to the report, there has been a shift in funds towards STD/HIV/AIDS expenditures and away from family planning, other reproductive health assistance, and basic research. After reviewing the Bank’s support for population and reproductive health assistance, the report concludes: (i) lending has increased over the past decade with lending for high fertility countries remaining relatively constant; (ii) that approximately half of high fertility countries had population and reproductive Analytical and Advisory Activities (AAA); and (iii) efforts to mainstream these areas into Country Assistance Strategies need to be intensified; and (iv) most PRSPs addressed population growth to some extent, but this did not mean that population policies were necessarily enacted. The final section of the report lays out priorities for strategies in low, middle and high-fertility countries given the Bank’s areas of comparative advantage: multisectoral and health systems approaches, its capacity for large-scale implementation; its core economic, fiscal, and cross-sectoral analysis capacity across sectors; substantial country focus and presence; and its capacity to engage private sector health actors. 16. Healthy Development: The World Bank’s Strategy for Health, Nutrition and Population Results (2007) the most recent sector strategy, identifies new challenges that have emerged since 1997, and reflects shifts in the international community and Bank’s approaches to health (World Bank 2007a). Its overall objective is to use a selective and disciplined framework to redouble efforts to support client countries to: (i) improve level and distribution of key HNP outcomes (e.g MDGs), outputs, and system performance at country and global levels in order to improve living conditions, particularly for the poor and vulnerable; (ii) prevent poverty due to illness (by improving financial protection); (iii) improve financial sustainability in the HNP sector and its contribution to sound macroeconomic and fiscal policy and to country competitiveness; (iv) improve governance, accountability, and transparency in the health sector. Whereas strengthening health systems was one of three priorities in the 1997 Strategy, the 2007 Strategy emphasizes that health system strengthening is a crucial means to achieving results in each of the other priority areas. The Bank will advocate for and support the elaboration of country-driven and owned strategies that take intersectoral approaches. Efforts will be focused in areas of comparative advantage which include providing policy and technical advice in areas related to health system strengthening and finance to client countries and global partners; promoting intersectoral approaches for country assistance; and capacity to implement large-scale programs. Due to the Bank’s many commitments to global partners, it will attempt to work more selectively with key partners in order to ensure that it is able to maintain close relationships with client countries. The Strategy emphasizes the importance of tightening the link between HNP-related lending and non-lending support with outcomes, output and health system performance. The importance of effective monitoring and evaluation linked to design and management is fundamental to the strategy. The Bank will sharpen its focus on results by supporting improved national public health surveillance and performance monitoring systems, and implementing the Global Results Framework.

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

51

AN

NE

X C

: WO

RL

D B

AN

K H

NP

TIM

EL

INE

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

1952

E

cono

mic

Sur

vey

Mis

sion

to J

amai

ca to

st

udy

the

coun

try’s

dev

elop

men

t re

quire

men

ts c

onsi

ders

the

effe

cts

of ra

pid

popu

latio

n gr

owth

. (M

arch

) (1)

Con

cern

ove

r the

impa

ct o

f pop

ulat

ion

grow

th o

n de

velo

pmen

t dis

cuss

ed a

t Sev

enth

Ann

ual

Mee

tings

in M

exic

o C

ity. C

hairm

an o

f the

Boa

rd

of G

over

nors

arg

ues

that

the

Wor

ld B

ank

is w

ell

plac

ed to

com

bine

sou

nd b

anki

ng p

rinci

ples

with

cr

eativ

e ef

forts

to a

ddre

ss p

opul

atio

n gr

owth

is

sues

. (S

epte

mbe

r) (1

)

1961

W

orld

Ban

k be

gins

lend

ing

for w

ater

sup

ply

and

sani

tatio

n pr

ojec

ts. (

2 )

1968

Rob

ert M

cNam

ara

beco

mes

Wor

ld B

ank

Pre

side

nt. (

Apr

il) (1

) M

cNam

ara

calls

for g

over

nmen

ts to

dev

elop

st

rate

gies

to c

ontro

l pop

ulat

ion

grow

th. H

e ad

mits

that

ther

e is

no

alte

rnat

ive

to th

e W

orld

Ban

k's

invo

lvem

ent i

n "th

is c

risis

." (O

ctob

er) (

1)

Eco

nom

ics

Dep

artm

ent’s

Spe

cial

Stu

dies

D

ivis

ion

reor

gani

zed

to c

reat

e a

Pop

ulat

ion

Stu

dies

Div

isio

n he

aded

by

E.K

. Haw

kins

. (3)

P

opul

atio

n Pr

ojec

ts D

epar

tmen

t est

ablis

hed

unde

r the

Offi

ce o

f the

Dire

ctor

of P

roje

cts.

(N

ovem

ber)

(4)

K. K

anag

arat

nam

is a

sked

and

acc

epts

to h

ead

Pop

ulat

ion

Proj

ects

Dep

artm

ent;

how

ever

he

is

unab

le to

sta

rt im

med

iate

ly, a

nd in

the

inte

rim

Geo

rge

C. Z

aida

n be

com

es th

e fir

st d

ivis

ion

chie

f of

the

new

dep

artm

ent.

(3)

1969

McN

amar

a ca

lls fo

r em

phas

is o

n po

pula

tion

plan

ning

, edu

catio

nal a

dvan

ces,

and

ag

ricul

tura

l gro

wth

in h

is A

nnua

l Mee

tings

ad

dres

s. H

e hi

ghlig

hts

the

need

for

deve

lopm

ent i

n nu

tritio

n, w

ater

sup

ply,

and

lit

erac

y. (S

epte

mbe

r) (1

)

1970

Firs

t Pop

ulat

ion

loan

app

rove

d fo

r $2

milli

on to

su

ppor

t Jam

aica

's fa

mily

pla

nnin

g pr

ogra

m.

(Jun

e) (1

)

19

71

In h

is A

nnua

l Mee

ting

addr

ess,

McN

amar

a em

phas

izes

the

impo

rtanc

e of

add

ress

ing

the

basi

c pr

oble

ms

affe

ctin

g th

e da

ily li

ves

of p

eopl

e in

dev

elop

ing

coun

tries

, inc

ludi

ng

nutri

tion,

em

ploy

men

t, an

d in

com

e di

strib

utio

n, a

mon

g ot

hers

. He

desc

ribes

Wor

ld B

ank/

WH

O C

oope

rativ

e P

rogr

am

esta

blis

hed

to a

ddre

ss w

ater

sup

ply,

was

te

disp

osal

, and

sto

rm d

rain

age.

(Sep

tem

ber)

(1)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

52

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

19

71

mal

nutri

tion

as a

maj

or b

arrie

r to

hum

an

deve

lopm

ent.

(Sep

tem

ber)

(1)

19

72

A B

ank-

wid

e re

orga

niza

tion

crea

tes

a se

nior

vi

ce p

resi

dent

of o

pera

tions

with

five

re

gion

al v

ice

pres

iden

ts a

nd a

vic

e pr

esid

ent

for p

roje

ct s

taff.

(Aug

ust)

(1)

As

a re

sult

of th

e re

orga

niza

tion,

Pop

ulat

ion

and

Nut

ritio

n Pr

ojec

ts (P

NP

) Dep

artm

ent a

nd s

ever

al

othe

rs w

ith to

o fe

w s

taff

for d

ecen

traliz

atio

n ar

e gr

oupe

d in

the

Cen

tral O

pera

tion

Pro

ject

s D

epar

tmen

t and

pro

vide

tech

nica

l ser

vice

s to

the

regi

ons.

(4)

Pos

sibl

e B

ank

Actio

ns o

n M

alnu

tritio

n P

robl

ems

is re

leas

ed. I

t is

influ

entia

l in

calli

ng

atte

ntio

n to

the

Ban

k's

role

in a

ddre

ssin

g m

alnu

tritio

n. (J

anua

ry) (

5*)

Sec

tora

l Pro

gram

s an

d P

olic

ies

Pap

er

incl

udes

reco

mm

enda

tions

on

popu

latio

n po

licie

s. It

poi

nts

to th

e ec

onom

ic e

ffect

s of

po

pula

tion

grow

th in

dev

elop

ing

coun

tries

, de

scrib

es th

e B

ank'

s ef

forts

to a

ssis

t mem

ber

coun

tries

to re

duce

pop

ulat

ion

grow

th ra

tes,

an

d ou

tline

s its

futu

re p

rogr

am in

pop

ulat

ion

as

sist

ance

. (M

arch

) (6*

)

Wor

ld B

ank

parti

cipa

tes

in a

n ad

viso

ry

capa

city

in W

HO

's S

peci

al P

rogr

am o

f R

esea

rch

Dev

elop

men

t and

Tra

inin

g in

H

uman

Rep

rodu

ctio

n (H

RP

). (7

)

1973

M

cNam

ara

uses

his

add

ress

at t

he A

nnua

l M

eetin

gs to

em

phas

ize

the

need

to

inco

rpor

ate

popu

latio

n pl

anni

ng in

to

deve

lopm

ent s

trate

gies

. (Se

ptem

ber)

(1)

The

Boa

rd o

f Exe

cutiv

e D

irect

ors

appr

oves

M

cNam

ara'

s pr

opos

al fo

r the

Ban

k ta

ke th

e le

ad

in m

obiliz

ing

inte

rnat

iona

l fun

ds fo

r an

onch

ocer

sias

is (r

iver

blin

dnes

s) c

ontro

l pro

gram

. (M

ay) (

1)

A n

utrit

ion

polic

y pa

per m

akes

the

case

for

inve

stm

ent i

n nu

tritio

n an

d pr

opos

es th

at th

e B

ank

"ass

ume

a m

ore

activ

e an

d di

rect

role

in

nut

ritio

n." (

8*)

Wor

ld B

ank

conv

enes

Mee

ting

of

Onc

hoce

rsia

sis

Con

trol P

rogr

am in

Par

is w

ith

WH

O, F

AO, U

ND

P. T

he p

urpo

se o

f the

m

eetin

g is

to fo

rmul

ate

a st

rate

gy to

figh

t riv

er

blin

dnes

s. (J

une)

(1)

1974

Fund

s to

cov

er th

e fir

st y

ear o

f the

O

ncho

cers

iasi

s (r

iver

blin

dnes

s) C

ontro

l Pro

gram

ar

e m

obiliz

ed. (

Mar

ch) (

1)

Pop

ulat

ion

Polic

ies

and

Econ

omic

D

evel

opm

ent a

naly

zes

the

impa

ct o

f po

pula

tion

grow

th o

n th

e fig

ht a

gain

st

pove

rty. (

Aug

ust)

(9*)

WH

O, F

AO, U

ND

P an

d th

e W

orld

Ban

k im

plem

ent t

he O

ncho

cers

iasi

s C

ontro

l P

rogr

am (O

CP

) whi

ch is

end

orse

d by

the

seve

n go

vern

men

ts o

f Wes

t Afri

can

the

coun

tries

mos

t affe

cted

by

the

dise

ase.

(M

arch

) (1)

1975

1975

Hea

lth S

ecto

r Pol

icy

Pap

er p

ublis

hed.

As

the

first

form

al H

NP

polic

y st

atem

ent,

it es

tabl

ishe

s th

at le

ndin

g w

ill b

e on

ly fo

r fam

ily

plan

ning

and

pop

ulat

ion.

(10*

)

Wor

ld B

ank

co-s

pons

ors

the

Trop

ical

R

esea

rch

Prog

ram

alo

ng w

ith W

HO

, UN

ICE

F an

d U

ND

P to

coo

rdin

ate

a gl

obal

effo

rt to

co

mba

t dis

ease

s th

at a

ffect

the

poor

and

di

sadv

anta

ged

thro

ugh

rese

arch

and

de

velo

pmen

t, an

d tra

inin

g an

d st

reng

then

ing.

(1

)

1976

Firs

t loa

n in

nut

ritio

n, $

19 m

illio

n to

Bra

zil,

is

appr

oved

. (Ju

ne) (

1)

1977

Wor

ld B

ank

help

s to

foun

d an

d be

com

es a

m

embe

r of t

he U

N S

ubco

mm

ittee

on

Nut

ritio

n (S

CN

). (1

1)

1979

The

Pop

ulat

ion,

Hea

lth a

nd N

utrit

ion

Dep

artm

ent

(PH

N) i

s es

tabl

ishe

d. T

he B

ank

appr

oves

a

polic

y to

con

side

r fun

ding

sta

nd-a

lone

hea

lth

proj

ects

and

hea

lth c

ompo

nent

s of

oth

er p

roje

cts.

(J

uly)

(2)

John

R. E

vans

app

oint

ed P

HN

Dep

artm

ent

Dire

ctor

. (12

)

Wor

ld B

ank

and

UN

DP

initi

ate

the

UN

DP-

Wor

ld B

ank

Wat

er a

nd S

anita

tion

Pro

gram

(W

SP)

to a

naly

ze c

ost-e

ffect

ive

stra

tegi

es a

nd

tech

nolo

gies

to b

ring

clea

n w

ater

to th

e po

or.

(1)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

53

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

1980

WD

R 1

980:

Pov

erty

and

Hum

an

Dev

elop

men

t hig

hlig

hts

the

impo

rtanc

e of

he

alth

sec

tor,

educ

atio

n, a

nd s

ocia

l pr

otec

tion

to a

llevi

ate

pove

rty. P

art o

f the

re

port

desc

ribes

the

role

of h

uman

de

velo

pmen

t pro

gram

s its

effe

cts

on

prod

uctiv

ity a

nd p

opul

atio

n gr

owth

. (Au

gust

) (1

3*)

1980

Hea

lth S

ecto

r Pol

icy

Pap

er c

omm

its th

e B

ank

to d

irect

lend

ing

in th

e he

alth

sec

tor.

The

stra

tegy

focu

ses

on th

e ne

ed fo

r bas

ic

heal

th s

ervi

ces,

esp

ecia

lly in

rura

l are

as, a

nd

desc

ribes

the

links

bet

wee

n th

e he

alth

sec

tor,

pove

rty a

llevi

atio

n, a

nd fa

mily

pla

nnin

g. (1

4*)

1981

Firs

t loa

n to

exp

and

basi

c he

alth

ser

vice

s m

ade

to T

unis

ia. (

15)

1983

John

N. N

orth

bec

omes

Dire

ctor

of t

he P

HN

D

epar

tmen

t. (1

2)

1984

WD

R 1

984:

Pop

ulat

ion

and

Dev

elop

men

t em

phas

izes

the

role

of g

over

nmen

ts to

re

duce

mor

talit

y an

d fe

rtilit

y. (1

6*)

Res

earc

h de

partm

ent l

aunc

hes

the

first

B

ank-

spon

sore

d Li

ving

Sta

ndar

ds

Mea

sure

men

t Sur

vey

(LS

MS

) in

Cot

e D

'Ivoi

re. L

SM

S s

urve

ys a

re m

ulti-

topi

c ho

useh

old

surv

eys

capa

ble

of li

nkin

g th

e le

vel a

nd d

istri

butio

n of

wel

fare

at t

he

hous

ehol

d le

vel t

o he

alth

car

e de

cisi

ons,

the

avai

labi

lity

and

qual

ity o

f hea

lth s

ervi

ces,

an

d H

NP

out

com

es.

(17)

Wor

ld B

ank

partn

ers

with

The

Roc

kefe

ller

Foun

datio

n, U

ND

P, U

NIC

EF, a

nd W

HO

to

esta

blis

h th

e Ta

sk F

orce

for C

hild

Sur

viva

l an

d D

evel

opm

ent,

a ca

mpa

ign

to a

chie

ve th

e go

al o

f uni

vers

al c

hild

imm

uniz

atio

n by

199

0.

(1)

1985

Fred

Sai

app

oint

ed S

enio

r Pop

ulat

ion

Adv

iser

. (1

8)

1986

Bar

ber C

onab

le a

ppoi

nted

as

the

Ban

k's

7th

Pre

side

nt. (

July

) (1)

A

"Pov

erty

Tas

k Fo

rce"

com

pose

d of

sen

ior

staf

f is

esta

blis

hed

to re

view

the

Ban

k's

wor

k an

d pr

opos

e ne

w a

ctiv

ities

. (19

)

Pov

erty

and

Hun

ger:

Issu

es a

nd O

ptio

ns fo

r Fo

od S

ecur

ity in

Dev

elop

ing

Cou

ntrie

s ar

gues

that

food

inse

curit

y is

cau

sed

mai

nly

by p

oor p

eopl

e’s

lack

of p

urch

asin

g po

wer

. It

asse

rts th

at th

e ro

le fo

r int

erna

tiona

l don

ors

is

to p

rovi

de a

ssis

tanc

e to

dev

elop

and

fin

anci

ng to

sup

port

impr

oved

pol

icie

s to

re

duce

food

inse

curit

y, a

s w

ell a

s ad

dres

sing

in

tern

atio

nal t

rade

fact

ors

that

con

tribu

te to

fo

od in

secu

rity.

(20)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

54

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

1987

Pre

side

nt C

onab

le a

nnou

nces

an

inte

rnal

re

orga

niza

tion

to b

e co

mpl

eted

by

Sep

tem

ber.

(May

) (1)

PH

N b

ecom

es a

div

isio

n of

the

Pop

ulat

ion

and

Hum

an R

esou

rces

(PH

R) D

epar

tmen

t. Te

chni

cal

depa

rtmen

ts, i

nclu

ding

PH

N u

nits

, are

cre

ated

w

ithin

eac

h re

gion

, and

cou

ntry

dep

artm

ents

are

cr

eate

d w

ithin

regi

ons,

com

bini

ng th

e fu

nctio

ns

form

erly

div

ided

bet

wee

n pr

ogra

ms

and

proj

ects

de

partm

ents

. (21

) A

nn O

. Ham

ilton

is a

ppoi

nted

PH

R D

epar

tmen

t D

irect

or. (

12)

Dea

n T.

Jam

ison

is a

ppoi

nted

Chi

ef M

anag

er o

f PH

N D

ivis

ion.

(12)

Fina

ncin

g H

ealth

Ser

vice

s in

Dev

elop

ing

Cou

ntrie

s: A

n A

gend

a fo

r Ref

orm

arg

ues

that

go

vern

men

t exp

endi

ture

s sh

ould

shi

ft to

war

ds p

rovi

ding

hea

lth s

ervi

ces

for t

he

poor

. The

pol

icy

stud

y ad

dres

ses

them

es o

f in

effic

ient

pub

lic s

pend

ing

on h

ealth

car

e an

d re

curr

ent c

ost f

inan

cing

. (M

ay) (

22*)

Wor

ld B

ank

cosp

onso

rs th

e S

afe

Mot

herh

ood

Con

fere

nce

in N

airo

bi, K

enya

. The

Ban

k pl

edge

s to

take

spe

cific

ste

ps to

add

ress

is

sues

affe

ctin

g w

omen

, and

the

Saf

e M

othe

rhoo

d In

itiat

ive

is la

unch

ed. (

Febr

uary

) (1

)

1988

Firs

t fre

e-st

andi

ng A

IDS

pro

ject

app

rove

d in

Za

ire. T

his

is a

lso

the

first

app

rove

d fre

e-st

andi

ng

Ban

k pr

ojec

t for

a s

ingl

e di

seas

e. (2

1)

Ant

hony

Mea

sham

bec

omes

PH

N C

hief

M

anag

er. (

12)

Acq

uire

d Im

mun

odef

icie

ncy

Synd

rom

e (A

IDS

): Th

e B

ank'

s A

gend

a fo

r Act

ion

is

prep

ared

by

the

Afri

ca T

echn

ical

Dep

artm

ent.

It w

as n

ot fo

rmal

ly a

dopt

ed b

y th

e B

ank

man

agem

ent a

s a

stra

tegy

but

rele

ased

as

a w

orki

ng p

aper

. (23

*)

Wor

ld B

ank

beco

mes

a fu

nder

of t

he W

HO

's

HR

P. (

24)

1989

The

IDA

Deb

t Red

uctio

n Fa

cilit

y es

tabl

ishe

d to

redu

ce th

e st

ock

of d

ebt o

wed

to

com

mer

cial

cre

dito

rs b

y ID

A-o

nly

coun

tries

. (A

ugus

t) (1

) B

ank

finan

ces

the

first

free

stan

ding

NG

O-

impl

emen

ted

proj

ect f

or g

rass

root

s de

velo

pmen

t in

Togo

. (19

) Fi

rst s

ocia

l fun

d pr

ojec

t app

rove

d. (1

)

Sub

-Sah

aran

Afri

ca: F

rom

Cris

is to

S

usta

inab

le D

evel

opm

ent c

alls

for a

dou

blin

g of

exp

endi

ture

on

hum

an re

sour

ce

deve

lopm

ent:

food

sec

urity

, prim

ary

educ

atio

n, a

nd h

ealth

car

e. (N

ovem

ber)

(25*

)

1990

The

IBR

D a

ppro

ves

the

larg

est l

oan

at th

is

poin

t in

its h

isto

ry (n

omin

al te

rms)

to M

exic

o to

sup

port

a de

bt-r

educ

tion

prog

ram

, and

th

e D

ebt-R

educ

tion

Faci

lity

for I

DA

-onl

y co

untri

es u

nder

take

s its

firs

t ope

ratio

n in

B

oliv

ia. (

19)

Ste

ve S

indi

ng b

ecom

es S

enio

r Pop

ulat

ion

Adv

iser

. (26

)

1991

Le

wis

T. P

rest

on is

app

oint

ed a

s th

e 8t

h pr

esid

ent o

f the

Wor

ld B

ank.

(Sep

tem

ber)

(2

1)

Wor

ld B

ank

join

s w

ith U

ND

P, U

NIC

EF, W

HO

, an

d R

otar

y In

tern

atio

nal t

o fo

rm th

e C

hild

ren'

s V

acci

ne In

itiat

ive

(CV

I). C

VI's

goa

l is

to

vacc

inat

e ev

ery

child

in th

e w

orld

aga

inst

vira

l an

d ba

cter

ial d

isea

ses.

(27)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

55

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

1992

A re

port

of th

e Ta

sk F

orce

on

Por

tfolio

M

anag

emen

t (th

e "W

apen

hans

Rep

ort")

is

trans

mitt

ed to

the

Exec

utiv

e D

irect

ors

and

is

a m

ajor

fact

or in

the

Ban

k's

impe

tus

to re

-do

uble

its

effo

rts to

war

d ef

fect

ive

impl

emen

tatio

n of

lend

ing

proj

ects

. (1)

Ban

k is

sues

a s

tate

men

t tha

t abo

rtion

is a

n is

sue

whi

ch c

ount

ries

them

selv

es m

ust a

ddre

ss a

nd

deni

es a

dvoc

atin

g th

e le

galiz

atio

n of

abo

rtion

in

Latin

Am

eric

a. (M

arch

) (1)

W

orld

Ban

k pa

rtici

pate

s in

Inte

rnat

iona

l C

onfe

renc

e on

Nut

ritio

n in

Rom

e. (D

ecem

ber)

(15)

1993

WD

R 1

993:

Inve

stin

g in

Hea

lth e

valu

ates

th

e ro

les

of g

over

nmen

ts a

nd m

arke

ts in

he

alth

, as

wel

l as

owne

rshi

p an

d fin

anci

ng

arra

ngem

ents

to im

prov

e he

alth

and

reac

h th

e po

or. I

t int

rodu

ces

the

DA

LY to

cal

cula

te

the

Glo

bal B

urde

n of

Dis

ease

, and

arg

ues

that

the

inte

rnat

iona

l com

mun

ity m

ust

com

mit

to a

ddre

ssin

g he

alth

issu

es. (

June

) (2

7*)

AID

S in

Asi

a, th

e fir

st R

egio

nal A

IDS

sup

port

unit

is e

stab

lishe

d in

the

Eas

t Asi

a an

d P

acifi

c R

egio

n. (2

1)

Jane

t de

Mer

ode

beco

mes

Dire

ctor

of t

he P

HN

D

ivis

ion.

(12)

Dis

ease

Con

trol P

riorit

ies

in D

evel

opin

g C

ount

ries

prov

ides

info

rmat

ion

on d

isea

se

cont

rol i

nter

vent

ions

for t

he m

ost c

omm

on

dise

ases

and

inju

ries

in d

evel

opin

g co

untri

es

to h

elp

them

def

ine

esse

ntia

l hea

lth s

ervi

ce

pack

ages

. Th

e pu

blic

atio

n ev

entu

ally

lead

s to

incr

ease

d B

ank

lend

ing

for d

isea

se c

ontro

l. (O

ctob

er) (

28*)

1994

A p

olic

y pa

per,

Wat

er R

esou

rces

M

anag

emen

t, pr

opos

es a

new

app

roac

h to

m

anag

ing

wat

er re

sour

ces.

The

app

roac

h ad

voca

tes

a co

mpr

ehen

sive

pol

icy

fram

ewor

k an

d tre

atm

ent o

f wat

er a

s an

ec

onom

ic g

ood,

alo

ng w

ith d

ecen

traliz

ed

man

agem

ent a

nd d

eliv

ery

stru

ctur

es,

grea

ter r

elia

nce

on p

ricin

g an

d fu

ller

parti

cipa

tion

by s

take

hold

ers.

(29*

)

Dav

id d

e Fe

rrant

i bec

omes

Dire

ctor

of P

HN

D

ivis

ion.

(12)

Bet

ter H

ealth

in A

frica

, dire

cted

to b

oth

Ban

k an

d ex

tern

al a

udie

nces

, arg

ues

that

bec

ause

ho

useh

olds

and

com

mun

ities

hav

e th

e ca

paci

ty to

use

kno

wle

dge

and

reso

urce

s to

re

spon

d to

hea

lth p

robl

ems,

pol

icy

mak

ers

shou

ld m

ake

effo

rts to

cre

ate

an e

nabl

ing

envi

ronm

ents

that

stim

ulat

e "g

ood"

dec

isio

n m

akin

g. It

als

o po

ints

out

that

hea

lth re

form

s ar

e ne

cess

ary,

that

cos

t-effe

ctiv

e pa

ckag

es

of s

ervi

ces

can

mee

t nee

ds, a

nd th

at

chan

ges

in d

omes

tic a

nd in

tern

atio

nal

finan

cing

for h

ealth

are

nec

essa

ry.

The

publ

icat

ion

was

nev

er a

ppro

ved

as a

n of

ficia

l st

rate

gy, b

ut th

e W

orld

Ban

k su

ppor

ted

an

inde

pend

ent '

Bet

ter H

ealth

in A

frica

' Exp

ert

Pan

el, t

hat w

orke

d to

dis

sem

inat

e ke

y m

essa

ges

to A

frica

n po

licy

mak

ers.

(30*

)

Ban

k pa

rtici

pate

s in

Inte

rnat

iona

l Con

fere

nce

on P

opul

atio

n an

d D

evel

opm

ent (

ICPD

) in

Cai

ro a

nd c

omm

its to

its

plan

of a

ctio

n. (3

1)

1995

Jam

es W

olfe

nsoh

n is

app

oint

ed a

s th

e ni

nth

Wor

ld B

ank

pres

iden

t. (J

une)

(1)

The

Bro

ad S

ecto

r App

roac

h to

Inve

stm

ent

Lend

ing:

Sec

tor I

nves

tmen

t Pro

gram

s de

fines

sec

tor i

nves

tmen

t pro

gram

s (S

IP),

anal

yzes

exp

erie

nce

with

the

new

lend

ing

inst

rum

ent a

nd a

dvoc

ates

for m

ore

lear

ning

an

d su

ppor

t of S

IPs,

par

ticul

arly

in A

frica

. (3

2)

The

Hum

an D

evel

opm

ent D

epar

tmen

t is

esta

blis

hed

and

Dav

id d

e Fe

rran

ti se

rves

as

Dep

artm

ent D

irect

or. R

icha

rd F

each

em (H

ealth

), Jo

rge

Bar

rient

os (I

mpl

emen

tatio

n), A

lan

Ber

g (N

utrit

ion)

and

Tho

mas

Mer

rick

(Pop

ulat

ion)

are

ap

poin

ted

as m

anag

ers/

advi

sers

. (Ju

ly) (

4,12

)

The

Ban

k ho

sts

a co

nfer

ence

to la

unch

the

Afri

can

Pro

gram

for O

ncho

cers

iasi

s C

ontro

l, a

follo

w-u

p to

a s

ucce

ssfu

l pro

ject

laun

ched

in

the

1970

s. S

pons

ored

by

gove

rnm

ents

, N

GO

s, b

ilate

ral d

onor

s an

d in

tern

atio

nal

inst

itutio

ns, i

t im

plem

ents

com

mun

ity-b

ased

dr

ug-tr

eatm

ent p

rogr

ams

in 1

6 Af

rican

co

untri

es. (

Dec

embe

r) (1

)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

56

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

1995

Lear

ning

and

Lea

ders

hip

Cen

ter-H

uman

D

evel

opm

ent N

etw

ork

train

ing

wee

k in

itiat

ed to

pr

ovid

e st

aff w

ith in

tens

ive

train

ing

focu

sed

on

topi

cal i

ssue

s in

the

HN

P s

ecto

r. (1

5)

The

Ban

k pa

rtici

pate

s in

the

Four

th W

orld

C

onfe

renc

e on

Wom

en in

Bei

jing

(FW

CW

) an

d ag

rees

to: r

educ

e th

e ge

nder

gap

in

educ

atio

n an

d en

sure

that

wom

en h

ave

equi

tabl

e ac

cess

and

con

trol o

ver e

cono

mic

re

sour

ces.

(31)

19

96

Wor

ld B

ank

Par

ticip

atio

n S

ourc

eboo

k la

unch

ed. W

olfe

nsoh

n an

noun

ces

that

the

Ban

k w

ill in

volv

e N

GO

s, th

e pr

ivat

e se

ctor

, co

mm

unity

gro

ups,

coo

pera

tives

, wom

en’s

or

gani

zatio

ns, a

nd th

e po

or a

nd

disa

dvan

tage

d in

dec

isio

n-m

akin

g pr

oces

ses.

(Feb

ruar

y) (3

3)

In h

is A

nnua

l Mee

tings

add

ress

, Wol

fens

ohn

defin

es th

e ke

y el

emen

ts o

f the

Stra

tegi

c C

ompa

ct to

rene

w th

e B

ank

Gro

up a

nd

impr

ove

deve

lopm

ent e

ffect

iven

ess:

im

prov

ing

reso

urce

mob

ilizat

ion;

taki

ng

mor

e in

tegr

ated

app

roac

hes;

bui

ldin

g pa

rtner

ship

s an

d sh

arin

g kn

owle

dge;

and

re

stru

ctur

ing

the

Ban

k to

be

clos

er to

clie

nts

thro

ugh

resp

onsi

ve a

nd h

igh-

qual

ity

prod

ucts

. (O

ctob

er) (

33)

The

Ban

k an

noun

ces

that

thre

e ne

w

netw

orks

will

be

crea

ted:

Env

ironm

enta

lly

and

Soc

ially

Sus

tain

able

Dev

elop

men

t (E

SS

D),

Fina

nce,

Priv

ate

Sec

tor a

nd

Infra

stru

ctur

e (F

PSI),

and

Pov

erty

Red

uctio

n an

d Ec

onom

ic M

anag

emen

t (P

RE

M).

(Dec

embe

r) (1

) P

over

ty R

educ

tion

and

the

Wor

ld B

ank:

P

rogr

ess

and

Cha

lleng

es in

the

1990

s is

re

leas

ed a

nd v

ows

to re

doub

le B

ank'

s ef

forts

to e

nsur

e su

cces

s in

its

man

date

to

help

cou

ntrie

s re

duce

pov

erty

. The

Ban

k sa

ys th

at it

will

judg

e its

elf a

nd s

taff

by th

eir

cont

ribut

ions

to a

chie

ving

this

goa

l. (J

une)

(1

) Th

e B

ank

and

IMF

laun

ch th

e H

IPC

In

itiat

ive,

cre

atin

g a

fram

ewor

k fo

r cre

dito

rs

to p

rovi

de d

ebt r

elie

f to

the

wor

ld's

mos

t po

or a

nd in

debt

ed c

ount

ries.

The

HIP

C

Trus

t Fun

d an

d H

IPC

Impl

emen

tatio

n U

nit

are

esta

blis

hed.

(N

ovem

ber)

(1)

Wor

ld B

ank

spon

sors

toba

cco-

rela

ted

and

non-

com

mun

icab

le d

isea

se c

onfe

renc

e in

W

ashi

ngto

n, D

C. (

June

) (1)

Th

e Fl

agsh

ip P

rogr

am o

n H

ealth

Sec

tor R

efor

m

and

Sus

tain

able

Fin

anci

ng is

initi

ated

by

the

Eco

nom

ic D

evel

opm

ent I

nstit

ute

(ED

I, no

w W

orld

B

ank

Inst

itute

) to

prov

ide

know

ledg

e an

d tra

inin

g on

opt

ions

for h

ealth

sec

tor d

evel

opm

ent,

incl

udin

g le

sson

s le

arne

d an

d be

st p

ract

ices

from

co

untry

exp

erie

nce.

Cou

rse

is o

ffere

d at

regi

onal

an

d co

untry

leve

ls. (

1)

Spe

cial

UN

Initi

ativ

e fo

r Afri

ca la

unch

ed; B

ank

partn

ers

with

UN

to p

rom

ote

an e

xpan

ded

prog

ram

of a

ssis

tanc

e to

Sub

-Sah

aran

Afri

ca

and

impr

ove

coop

erat

ion

betw

een

the

Ban

k an

d th

e U

N. B

ank

com

mits

to ta

ke s

peci

al

resp

onsi

bilit

y fo

r mob

ilizi

ng re

sour

ces

for

basi

c he

alth

and

edu

catio

n re

form

s. (M

arch

) (1

) W

olfe

nsoh

n an

noun

ces

Ban

k's

supp

ort f

or th

e G

-7's

dec

lara

tion

and

obje

ctiv

e of

pro

vidi

ng a

n ex

it st

rate

gy fo

r hea

vily

inde

bted

cou

ntrie

s.

Ban

k pl

edge

s $5

00 m

illio

n to

a tr

ust f

und

for

debt

relie

f as

its th

e in

itial

con

tribu

tion.

(Jun

e)

(33)

W

orld

Ban

k co

-spo

nsor

s Th

e Jo

int U

N

Prog

ram

on

HIV

/AID

S (U

NAI

DS)

with

UN

DP,

U

NE

SC

O, U

NFP

A, U

NIC

EF,

and

WH

O. (

21)

Wor

ld B

ank

beco

mes

a d

onor

to th

e ne

wly

fo

rmed

Inte

rnat

iona

l AID

S V

acci

ne In

itiat

ive

(IAVI

). It

is e

stab

lishe

d to

ens

ure

the

deve

lopm

ent o

f an

HIV

vac

cine

for u

se a

roun

d th

e w

orld

. (35

)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

57

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

19

96

The

Ban

k an

noun

ces

that

thre

e ne

w

netw

orks

will

be

crea

ted:

Env

ironm

enta

lly

and

Soc

ially

Sus

tain

able

Dev

elop

men

t (E

SS

D),

Fina

nce,

Priv

ate

Sec

tor a

nd

Infra

stru

ctur

e (F

PSI),

and

Pov

erty

Red

uctio

n an

d Ec

onom

ic M

anag

emen

t (P

RE

M).

(Dec

embe

r) (1

) Q

ualit

y A

ssur

ance

Gro

up (Q

AG

) est

ablis

hed

with

the

expr

esse

d pu

rpos

e of

impr

ovin

g th

e qu

ality

of t

he B

ank'

s op

erat

iona

l wor

k w

ithin

th

e br

oad

cont

ext o

f alle

viat

ing

pove

rty, a

nd

achi

evin

g de

velo

pmen

t im

pact

s. (3

4)

1997

Wor

ld D

evel

opm

ent I

ndic

ator

s 19

97, t

he fi

rst

editi

on, i

s pu

blis

hed.

Wol

fens

ohn

desc

ribes

th

at th

e pu

blic

atio

n is

an

exam

ple

of th

e W

orld

Ban

k's

role

in d

isse

min

atin

g kn

owle

dge

to fa

cilit

ate

deci

sion

-mak

ing

in

deve

lopm

ent.

(Apr

il) (3

3)

The

Stra

tegi

c C

ompa

ct p

erio

d, a

thre

e ye

ar

orga

niza

tion

rene

wal

pro

cess

is la

unch

ed.

(Apr

il) (1

) B

ank

reor

gani

zatio

n le

ads

to th

e cr

eatio

n of

B

ank-

wid

e "a

ncho

r" u

nits

to p

rovi

de q

ualit

y su

ppor

t to

the

Reg

ions

. The

reor

gani

zatio

n w

as d

esig

ned

to p

rom

ote

bala

nce

betw

een

"cou

ntry

focu

s" a

nd "s

ecto

ral e

xcel

lenc

e."

(21)

The

Hum

an D

evel

opm

ent N

etw

ork

(HD

N) i

s fo

rmed

, alo

ng w

ith th

e H

NP

Sec

tor B

oard

, whe

n B

ank

reor

gani

zatio

n gr

oups

sec

tor s

taff

into

re

gion

al s

ecto

r uni

ts o

r dep

artm

ents

. Sec

tor s

taff

wor

ks w

ith c

ount

y de

partm

ents

in a

mat

rix

rela

tions

hip.

Thi

s al

low

s R

egio

nal m

anag

ers

wor

king

in th

e H

NP

Sec

tor t

o co

me

toge

ther

. (21

) D

avid

de

Ferra

nti s

erve

s as

Vic

e P

resi

dent

and

H

ead

of H

DN

. Ric

hard

G.A

. Fea

chem

is n

amed

H

NP

Dire

ctor

and

ser

ves

as C

hair

of th

e S

ecto

r B

oard

. (12

) W

orld

Ban

k or

gani

zes

and

host

s an

Inte

rnat

iona

l C

onfe

renc

e on

Inno

vatio

ns in

Hea

lth F

inan

cing

. (3

6)

The

1997

Hea

lth, N

utrit

ion,

and

Pop

ulat

ion

Sec

tor S

trate

gy P

aper

em

phas

izes

the

impo

rtanc

e of

inst

itutio

nal a

nd s

yste

mic

ch

ange

s to

impr

ove

heal

th o

utco

mes

for t

he

poor

, im

prov

e he

alth

sys

tem

per

form

ance

, an

d ac

hiev

e su

stai

nabl

e fin

anci

ng in

the

heal

th s

ecto

r. (S

epte

mbe

r) (1

5*)

Con

front

ing

AID

S: P

ublic

Prio

ritie

s in

a G

loba

l E

pide

mic

mak

es th

e ca

se fo

r gov

ernm

ent

inte

rven

tion

to c

ontro

lling

AID

S in

dev

elop

ing

coun

tries

from

epi

dem

iolo

gica

l, pu

blic

hea

lth,

and

publ

ic e

cono

mic

s pe

rspe

ctiv

es. T

he

repo

rt ad

voca

tes

that

don

ors

base

thei

r su

ppor

t on

evid

ence

of c

ount

ry-s

peci

fic

effe

ctiv

enes

s fo

r int

erve

ntio

ns, a

nd fi

nanc

e ke

y in

tern

atio

nal p

ublic

goo

ds.

(Nov

embe

r)

(37*

)

Wor

ld B

ank

colla

bora

tes

with

UN

Eco

nom

ic

Com

mis

sion

for A

frica

and

UN

ICEF

to

orga

nize

the

Foru

m o

n C

ost S

harin

g in

the

Soc

ial S

ecto

rs o

f Sub

-Sah

aran

Afri

ca. 1

5 pr

inci

ples

for c

ost s

harin

g in

hea

lth a

nd

educ

atio

n ar

e ag

reed

upo

n at

the

Foru

m. (

38)

The

Wor

ld B

ank

and

The

Dan

ish

Min

istry

of

Fore

ign

Affa

irs c

o-ho

st a

mee

ting

for d

onor

ag

enci

es in

Cop

enha

gen

to d

iscu

ss s

ecto

r-w

ide

appr

oach

es. A

t the

mee

ting

the

term

SW

Ap

is c

oine

d, a

SW

Ap

guid

e is

co

mm

issi

oned

, and

an

Inte

r-A

genc

y G

roup

on

SWA

p is

form

ed. (

32)

1998

Pre

side

nt W

olfe

nsoh

n's

addr

ess

at th

e A

nnua

l Mee

tings

war

ns th

at fi

nanc

ial

refo

rms

are

not s

uffic

ient

, tha

t hum

an n

eeds

an

d so

cial

just

ice

mus

t als

o be

sou

ght.

(1)

Ass

essi

ng A

id: W

hat w

orks

, wha

t doe

sn't

and

why

con

clud

es th

at th

ere

is a

role

for

fore

ign

aid

and

that

pro

perly

man

aged

aid

ca

n co

ntrib

ute

tow

ard

impr

ovin

g pe

ople

's

lives

. It a

rgue

s th

at in

stitu

tiona

l dev

elop

men

t an

d po

licy

refo

rms

alon

g w

ith s

trong

thre

e-

way

par

tner

ship

am

ong

reci

pien

t cou

ntrie

s,

aid

agen

cies

, and

don

or c

ount

ries

can

impr

ove

the

impa

ct o

f for

eign

ass

ista

nce.

(3

9*)

The

Wor

ld B

ank

laun

ches

AID

S V

acci

ne T

ask

Forc

e to

spe

ed u

p de

ploy

men

t of e

ffect

ive

and

affo

rdab

le A

IDS

vacc

ine.

It s

uppo

rts h

igh-

leve

l di

alog

ue w

ith p

olic

ymak

ers

and

indu

stry

, bot

h “p

ush”

’ and

“pul

l” st

rate

gies

to g

ener

ate

inve

stm

ents

in R

&D, a

nd s

pons

ors

stud

ies

of

pote

ntia

l dem

and

for a

vac

cine

in d

evel

opin

g co

untri

es.

(Apr

il) (1

) Th

e W

orld

Ban

k In

stitu

te d

evel

ops

a co

urse

and

le

arni

ng p

rogr

am ti

tled

"Ada

ptin

g to

Cha

nge"

as

a re

spon

se to

the

ICP

D. (

40)

Chr

isto

pher

Lov

elac

e ap

poin

ted

Dire

ctor

of t

he

HN

P S

ecto

r. (1

2)

The

Wor

ld B

ank

partn

ers

with

WH

O a

nd

Sm

ith K

line

Bee

cham

to in

itiat

e a

Pro

gram

to

Elim

inat

e E

leph

antia

sis

by d

istri

butin

g dr

ugs

free

of c

harg

e to

gov

ernm

ents

and

co

llabo

ratin

g or

gani

zatio

ns.

(Jan

uary

) (1)

Th

e W

orld

Ban

k, W

HO

, UN

DP

and

UN

ICEF

la

unch

Rol

l Bac

k M

alar

ia to

pro

vide

a

coor

dina

ted

glob

al a

ppro

ach

to h

alve

mal

aria

by

201

0. (4

1)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

58

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

19

99

Wol

fens

ohn

calls

for d

evel

opm

ent p

artn

ers

to a

dopt

a C

ompr

ehen

sive

Dev

elop

men

t Fr

amew

ork,

whi

ch a

ims

to im

prov

e th

e ef

fect

iven

ess

of d

evel

opm

ent a

ctiv

ities

and

m

ove

beyo

nd in

divi

dual

pro

ject

s, p

rom

otin

g na

tiona

l lea

ders

hip

and

cons

ensu

s an

d re

quiri

ng a

com

mitm

ent t

o ex

pand

ed

partn

ersh

ip, t

rans

pare

ncy,

and

ac

coun

tabi

lity.

(Jan

uary

) (33

) B

oliv

ia b

ecom

es th

e pi

lot c

ount

ry fo

r the

C

DF

with

two

loan

s fo

r hea

lth a

nd

inst

itutio

nal r

efor

m. (

June

) (1)

In

pre

para

tion

for W

DR

200

0/20

01, t

he B

ank

laun

ches

the

Voi

ces

of th

e P

oor s

tudy

to

gath

er in

form

atio

n fro

m 6

0,00

0 pa

rtici

pant

s in

60

coun

tries

. The

stu

dy fo

cuse

d on

pe

rcep

tions

of a

qua

lity

of li

fe; p

ress

ing

prob

lem

s an

d pr

iorit

ies;

the

qual

ity o

f in

tera

ctio

ns w

ith k

ey p

ublic

, mar

ket a

nd c

ivil

soci

ety

inst

itutio

ns in

thei

r liv

es; a

nd

chan

ges

in g

ende

r and

soc

ial r

elat

ions

. (S

epte

mbe

r) (4

2*)

Wol

fens

ohn

unan

imou

sly

appo

inte

d fo

r se

cond

term

as

Wor

ld B

ank

pres

iden

t. (S

epte

mbe

r) (3

3)

Wol

fens

ohn

expl

ains

the

link

betw

een

corr

uptio

n an

d po

verty

, out

linin

g th

e W

orld

B

ank'

s re

spon

se a

t Int

erna

tiona

l Ant

i-C

orru

ptio

n C

onfe

renc

e in

Dur

ban.

He

stat

es

that

the

Ban

k w

ill p

ositi

on c

orru

ptio

n as

a

cent

ral i

ssue

to d

evel

opm

ent,

appl

y ex

tern

al

pres

sure

s fo

r cha

nge

at th

e co

untry

leve

l w

hile

enc

oura

ging

inte

rnal

pre

ssur

es fo

r ch

ange

, and

cre

ate

partn

ersh

ips

to a

ddre

ss

corr

uptio

n is

sues

. (O

ctob

er) (

33)

The

Wor

ld B

ank

and

IMF

anno

unce

that

co

nces

sion

ary

lend

ing

to 8

1 el

igib

le p

oor

coun

tries

will

be

base

d on

pov

erty

redu

ctio

n st

rate

gies

, ini

tiatin

g th

e P

RS

P pr

oces

s. (4

3)

Enh

ance

d H

IPC

laun

ched

. HIP

C in

itiat

ive

is

mod

ified

to p

rovi

de d

eepe

r and

bro

ader

re

lief,

fast

er re

lief,

and

to c

reat

e a

mor

e di

rect

link

bet

wee

n de

bt re

lief a

nd p

over

ty

redu

ctio

n th

roug

h Po

verty

Red

uctio

n S

trate

gy P

aper

s. (1

)

The

AID

S C

ampa

ign

Team

for A

frica

(AC

Tafri

ca)

unit

is c

reat

ed to

hel

p m

ains

tream

HIV

/AID

S

activ

ities

in a

ll se

ctor

s. (2

1)

Edu

ardo

A. D

orya

n is

app

oint

ed H

DN

Vic

e P

resi

dent

. (12

)

Pop

ulat

ion

and

the

Wor

ld B

ank:

Ada

ptin

g to

C

hang

e is

sha

ped

larg

ely

by it

s co

mm

itmen

t to

the

1994

ICP

D a

nd b

y an

em

phas

is o

n he

alth

sec

tor r

efor

m in

the

1990

s. I

ts

obje

ctiv

e is

to a

ddre

ss p

opul

atio

n is

sues

with

a

peop

le-c

ente

red

and

mul

tisec

tora

l ap

proa

ch th

at im

prov

es re

prod

uctiv

e he

alth

th

roug

h ac

cess

to in

form

atio

n an

d se

rvic

es,

and

reco

gniz

es th

e im

porta

nce

of c

onte

xtua

l fa

ctor

s su

ch a

s ge

nder

equ

ity a

nd h

uman

rig

hts.

(Jan

uary

) (31

*)

The

Ban

k's

new

stra

tegy

to fi

ght H

IV/A

IDS

in

Afri

ca in

par

tner

ship

with

Afri

can

gove

rnm

ent

and

Join

t UN

Pro

gram

on

HIV

/AID

S (U

NA

IDS

) app

rove

d by

Reg

iona

l Lea

ders

hip

Team

. (M

ay) (

21)

A H

ealth

Sec

tor S

trate

gy fo

r the

Eur

ope

and

Cen

tral A

sia

Reg

ion

resp

onds

to c

hang

es in

th

e he

alth

car

e sy

stem

s, p

artic

ular

ly in

tra

nsiti

on c

ount

ries,

by

prov

idin

g a

guid

e to

su

ppor

t reg

iona

lly a

ppro

pria

te, i

nter

sect

oral

he

alth

sys

tem

refo

rms.

Key

prio

ritie

s ar

e id

entif

ied

as: (

i) pr

omot

ing

wel

lnes

s an

d re

duci

ng th

e pr

eval

ence

of a

void

able

illn

ess;

(ii

) cre

atin

g af

ford

able

and

sus

tain

able

de

liver

y sy

stem

s; a

nd (i

ii) m

aint

aini

ng

func

tioni

ng h

ealth

sys

tem

s du

ring

the

refo

rm

proc

ess.

(Sep

tem

ber)

(45*

)

The

Wor

ld B

ank

partn

ers

to e

stab

lish

The

G

loba

l Alli

ance

for V

acci

nes

and

Imm

uniz

atio

n (G

AVI),

a p

ublic

-priv

ate

partn

ersh

ip, t

o en

sure

fina

ncin

g to

sav

e ch

ildre

n's

lives

and

peo

ple'

s he

alth

thro

ugh

wid

espr

ead

vacc

inat

ions

. (46

)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

59

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

19

99

The

OE

D re

leas

es a

n ev

alua

tion

of th

e H

NP

S

ecto

r tha

t sug

gest

s th

at th

e B

ank

impr

ove

know

ledg

e m

anag

emen

t, de

velo

p m

ore

flexi

ble

inst

rum

ents

, and

sup

port

incr

ease

d ec

onom

ic a

nd s

ecto

r wor

k to

hel

p co

untri

es

to id

entif

y ch

alle

nges

and

impr

ove

the

effic

ient

ly, e

ffect

iven

ess

and

equi

ty o

f hea

lth

refo

rms.

It a

gues

than

pro

ject

s ha

d be

en to

o co

mpl

ex, h

ad n

egle

cted

inst

itutio

nal a

naly

sis

and

that

mon

itorin

g an

d ev

alua

tion

was

al

mos

t non

-exi

sten

t. It

urge

d th

at th

e Se

ctor

"d

o be

tter,

not m

ore,

" tha

t is

be m

ore

sele

ctiv

e to

do

a fe

w th

ings

bet

ter

rath

er

than

too

muc

h w

ith p

oor r

esul

ts. (

44)

2000

Wor

ld B

ank

anno

unce

s a

plan

to w

ork

with

C

hurc

h gr

oups

in A

frica

to fi

ght p

over

ty a

nd

AID

S. (

Mar

ch) (

1)

Thou

sand

s of

dem

onst

rato

rs p

rote

st T

he

Dev

elop

men

t Com

mitt

ee’s

Spr

ing

mee

tings

in

Was

hing

ton,

whi

ch w

ere

cond

ucte

d in

sp

ite o

f the

pro

test

s. T

he D

evel

opm

ent

Com

mitt

ee re

new

ed it

s pl

edge

to s

peed

up

debt

relie

f and

to s

uppo

rt th

e fig

ht a

gain

st

AID

S. (

Mar

ch) (

1)

Wol

fens

ohn

addr

esse

s th

e U

N S

ecur

ity C

ounc

il an

d ca

lls fo

r inc

reas

ed re

sour

ce a

lloca

tion

to fi

ght

a "W

ar o

n AI

DS

", no

ting

the

epid

emic

's

deva

stat

ing

effe

cts

on th

e de

velo

ping

wor

ld,

espe

cial

ly A

frica

. (J

anua

ry) (

33)

The

first

Mul

ti-C

ount

ry A

IDS

Pro

gram

(MA

P) i

s ap

prov

ed b

y th

e B

oard

and

pro

vide

s a

$500

m

illio

n en

velo

pe fo

r fin

anci

ng H

IV/A

IDS

pro

ject

s in

Afri

ca. (

Sep

tem

ber)

(21)

The

over

all o

bjec

tive

of th

e W

orld

Ban

k S

trate

gy fo

r Hea

lth, N

utrit

ion,

and

Pop

ulat

ion

in E

ast A

sia

and

the

Pac

ific

Reg

ion

is to

im

prov

e th

e B

ank’

s ef

fect

iven

ess

in h

ealth

, nu

tritio

n an

d po

pula

tion

in th

e re

gion

. Th

e st

rate

gy u

rges

sel

ectiv

ity a

nd fl

exib

ility

to

deve

lop

new

app

roac

hes,

as

nece

ssar

y,

base

d on

less

ons

lear

ned

and

expe

rienc

e in

th

e re

gion

. It p

riorit

izes

: im

prov

ing

outc

omes

fo

r the

poo

r, en

hanc

ing

the

perfo

rman

ce o

f he

alth

car

e sy

stem

s, a

nd s

ecur

ing

sust

aina

ble

finan

cing

. (Ju

ne) (

47*)

W

orld

Ban

k an

d W

HO

issu

e a

publ

icat

ion,

To

bacc

o C

ontro

l in

Dev

elop

ing

Cou

ntrie

s. It

ar

gues

that

a re

duct

ion

in to

bacc

o us

e is

es

sent

ial t

o im

prov

e gl

obal

hea

lth. (

Aug

ust)

(48*

) In

tens

ifyin

g A

ctio

n A

gain

st A

IDS

in A

frica

em

phas

izes

the

impo

rtanc

e of

incr

ease

d ad

voca

cy to

stre

ngth

en p

oliti

cal c

omm

itmen

t to

figh

ting

HIV

/AID

S, m

obiliz

atio

n of

re

sour

ces,

and

stre

ngth

enin

g th

e kn

owle

dge

base

. It

advo

cate

s al

loca

tion

of in

crea

sed

reso

urce

s an

d te

chni

cal s

uppo

rt to

ass

ist

Afri

can

partn

ers

and

the

Wor

ld B

ank

to

mai

nstre

am H

IV/A

IDS

into

all

sect

ors.

(A

ugus

t) (4

9*)

Wor

ld B

ank

rele

ases

44

coun

try re

ports

on

Soc

io-E

cono

mic

Diff

eren

ces

in H

ealth

, N

utrit

ion

and

Pop

ulat

ion.

The

repo

rts s

tress

th

at th

e po

ores

t sec

tors

of t

he p

opul

atio

n m

ust r

ecei

ve a

dequ

ate

heal

thca

re.

(Nov

embe

r) (5

0*)

At t

he W

orld

Eco

nom

ic F

orum

, Wol

fens

ohn

urge

s w

orld

lead

ers

to s

uppo

rt G

AVI

and

its

cam

paig

n fo

r chi

ldre

n. (J

anua

ry) (

33)

At t

he S

econ

d W

orld

Wat

er F

orum

, W

olfe

nsoh

n pl

edge

s th

e B

ank'

s su

ppor

t to

ensu

re th

at e

very

one

has

wat

er s

ervi

ces

for

heal

th, f

ood,

ene

rgy,

and

the

envi

ronm

ent.

The

appr

oach

he

outli

nes

emph

asiz

es

parti

cipa

tory

inst

itutio

ns a

s w

ell a

s te

chno

logi

cal a

nd fi

nanc

ial i

nnov

atio

n. (M

arch

) (1

) A

t the

XIII

th In

tern

atio

nal A

IDS

Con

fere

nce,

th

e W

orld

Ban

k pl

edge

s $5

00m

illion

. The

M

ulti-

coun

t AID

S P

rogr

am, d

evel

oped

with

U

NA

IDS

, hel

ps c

ount

ries

to im

plem

ent

natio

nal H

IV/A

IDS

pro

gram

s. (J

uly)

(1)

The

Ban

k-N

ethe

rland

s W

ater

Par

tner

ship

P

rogr

am (B

NW

PP) i

s es

tabl

ishe

d to

impr

ove

wat

er s

ecur

ity b

y pr

omot

ing

inno

vativ

e ap

proa

ches

to In

tegr

ated

Wat

er R

esou

rces

M

anag

emen

t (IW

RM

), an

d th

ereb

y co

ntrib

ute

to p

over

ty re

duct

ion.

(51)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

60

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

2001

WD

R 2

000/

2001

: Atta

ckin

g P

over

ty

emph

asiz

es th

at in

secu

rity,

in in

com

e or

he

alth

ser

vice

s, is

one

of m

any

depr

ivat

ions

su

ffere

d by

poo

r. (5

2*)

The

Wor

ld B

ank

anno

unce

s th

at it

will

join

th

e U

N a

s a

full

partn

er to

impl

emen

t the

M

illenn

ium

Dev

elop

men

t Goa

ls a

nd to

put

th

ese

goal

s at

the

cent

er o

f the

dev

elop

men

t ag

enda

. (S

epte

mbe

r) (1

) W

B m

akes

a D

ecla

ratio

n of

Com

mitm

ent a

t S

peci

al S

essi

on o

f the

UN

Gen

eral

A

ssem

bly

reaf

firm

ing

pled

ges

mad

e by

w

orld

lead

ers

to h

alt a

nd re

vers

e th

e sp

read

of

HIV

/AID

S by

201

5. (J

une)

(33)

Th

e W

ater

Sup

ply

and

San

itatio

n P

rogr

am

(WS

P) C

ounc

il is

cre

ated

to o

vers

ee

prog

ram

act

iviti

es a

nd g

uide

stra

tegi

c de

velo

pmen

t in

wat

er a

nd s

anita

tion.

(53)

B

oard

of E

xecu

tive

Dire

ctor

s ap

prov

es a

ge

nder

and

dev

elop

men

t mai

nstre

amin

g st

rate

gy. (

54)

Firs

t pov

erty

redu

ctio

n su

ppor

t cre

dit

(PR

SC

) app

rove

d. (1

)

Ban

k an

noun

ces

it w

ill b

uild

upo

n cu

rrent

pr

ogra

ms

and

follo

w th

e C

arib

bean

Reg

iona

l S

trate

gic

Pla

n of

Act

ion

for H

IV/A

IDS,

dev

otin

g up

to $

150

mill

ion

to th

e fig

ht a

gain

st H

IV/A

IDS

in

the

Car

ibbe

an. (

Apr

il) (2

1)

Jose

ph R

itzen

app

oint

ed H

DN

Vic

e Pr

esid

ent.

(Jun

e) (1

) Le

ader

ship

Pro

gram

on

AID

S la

unch

ed b

y W

BI

to b

uild

cap

acity

for a

ccel

erat

ed im

plem

enta

tion

of H

IV/A

IDS

prog

ram

s. (2

1)

Sub

-reg

iona

l HIV

/AID

S s

trate

gy fo

r C

arib

bean

. HIV

/AID

S in

the

Car

ibbe

an:

Issu

es a

nd O

ptio

ns re

leas

ed. (

Janu

ary)

(55*

)

The

Ban

k an

d pa

rtner

s ga

ther

in W

ashi

ngto

n,

DC

to fu

rther

com

mit

to o

pera

tiona

lize

the

Am

ster

dam

Dec

lara

tion.

The

Glo

bal P

lan

to

Sto

p TB

cal

ls fo

r the

exp

ansi

on o

f acc

ess

to

DO

TS a

nd in

crea

sed

finan

cial

bac

king

for t

he

prog

ram

from

gov

ernm

ents

thro

ugho

ut th

e w

orld

. (O

ctob

er) (

56)

The

Ban

k's

Wat

er a

nd S

anita

tion

Pro

gram

fo

rms

the

Priv

ate-

Publ

ic P

artn

ersh

ip fo

r Han

d w

ashi

ng w

ith th

e Lo

ndon

Sch

ool o

f Hyg

iene

an

d Tr

opic

al M

edic

ine,

the

Acad

emy

for

Edu

catio

nal D

evel

opm

ent,

USA

ID, U

NIC

EF,

the

Ban

k-N

ethe

rland

s W

ater

Par

tner

ship

and

th

e pr

ivat

e se

ctor

. (57

) Th

e B

ank

beco

mes

a tr

uste

e of

the

Glo

bal

Fund

to F

ight

HIV

/AID

S, T

B, a

nd M

alar

ia

(GFA

TM),

a fin

anci

ng m

echa

nism

est

ablis

hed

to fo

ster

par

tner

ship

s be

twee

n go

vern

men

ts,

civi

l soc

iety

, the

priv

ate

sect

or, a

nd a

ffect

ed

com

mun

ities

to in

crea

se re

sour

ces

and

dire

ct

finan

cing

tow

ards

effo

rts to

figh

t HIV

/AID

S,

TB, a

nd m

alar

ia. (

58)

In c

oope

ratio

n w

ith th

e G

ates

Fou

ndat

ion

and

Dut

ch a

nd S

wed

ish

Gov

ernm

ents

, The

Wor

ld

Ban

k H

ealth

and

Pov

erty

The

mat

ic G

roup

in

itiat

es th

e R

each

ing

the

Poor

Pro

gram

(R

PP

). R

PP

is a

n ef

fort

to fi

nd b

ette

r way

s to

en

sure

that

the

bene

fits

of H

NP

pro

gram

s flo

w

to d

isad

vant

aged

pop

ulat

ion

grou

ps th

roug

h re

sear

ch, p

olic

y gu

idan

ce, a

nd a

dvoc

acy.

(1)

The

Ban

k jo

ins

the

Roc

kefe

ller F

ound

atio

n,

Sid

a/S

AR

EC

, and

Wel

lcom

e Tr

ust t

o la

unch

th

e IN

DE

PTH

Net

wor

k, a

n in

tern

atio

nal

plat

form

of s

entin

el d

emog

raph

ic s

ites

that

pr

ovid

es h

ealth

and

dem

ogra

phic

dat

a, a

nd

rese

arch

to e

nabl

e de

velo

ping

cou

ntrie

s to

set

ev

iden

ce-b

ased

hea

lth p

riorit

ies

and

polic

ies.

(5

9)

The

Ban

k an

d U

SAI

D c

o-ho

st th

e A

nnua

l M

eetin

gs o

f the

Glo

bal P

artn

ersh

ip to

E

limin

ate

Riv

erbl

indn

ess

in W

ashi

ngto

n. T

he

partn

ers

pled

ged

to e

limin

ate

river

blin

dnes

s in

A

frica

by

2010

. (1)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

61

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

20

02

Wol

fens

ohn

pres

ents

a s

even

poi

nt P

ost-

Mon

terre

y A

ctio

n P

lan

to th

e D

evel

opm

ent

Com

mitt

ee o

n ho

w to

boo

st d

evel

opm

ent a

id

and

effe

ctiv

enes

s, a

nd tr

ansl

ate

Mon

terr

ey

com

mitm

ents

into

resu

lts. (

Apr

il) (3

3)

From

this

poi

nt, C

ount

ry A

ssis

tanc

e S

trate

gies

(CAS

), th

e m

ain

vehi

cle

for

mak

ing

stra

tegi

c ch

oice

s ab

out p

rogr

am

desi

gn a

nd re

sour

ce a

lloca

tions

for

indi

vidu

al c

ount

ries,

wer

e ba

sed

on P

RS

Ps

in L

ICs.

(Ju

ly) (

60)

IDA

ann

ounc

es th

at 1

8-21

per

cent

of I

DA

w

ould

be

in g

rant

s an

d av

aila

ble

for s

peci

fic

activ

ities

and

for t

he d

ebt-v

ulne

rabl

e po

ores

t co

untri

es. (

July

) (1)

$500

mill

ion

is a

ppro

ved

for t

he s

econ

d st

age

of

its M

ulti-

Cou

ntry

HIV

/AID

S P

rogr

am fo

r Afri

ca

(MA

P).

(Feb

ruar

y) (1

) W

BI's

cou

rse

"Ada

ptin

g to

Cha

nge"

bec

omes

"A

chie

ving

the

MD

Gs:

Rep

rodu

ctiv

e H

ealth

, P

over

ty R

educ

tion,

and

Hea

lth S

ecto

r Ref

orm

." (4

0)

The

HN

P S

ecto

r Boa

rd p

rese

nts

an H

NP

st

rate

gy u

pdat

e to

the

Boa

rd .

The

Pow

erpo

int p

rese

ntat

ion

revi

ews

trend

s in

pr

ojec

t len

ding

and

obj

ectiv

es, A

AA,

QA

G

ratin

gs, I

FC le

ndin

g fo

r HN

P, a

nd s

taffi

ng.

The

upda

te re

conf

irms

the

sect

or’s

co

mm

itmen

t to

the

obje

ctiv

es in

the

1997

st

rate

gy. I

t als

o em

phas

izes

that

gre

ater

co

untry

sel

ectiv

ity a

nd d

iver

sity

in le

ndin

g in

stru

men

ts w

ill b

e pu

rsue

d al

ong

with

effo

rts

to: s

harp

en th

e fo

cus

on q

ualit

y an

d ef

fect

iven

ess,

wor

k m

ore

clos

ely

with

clie

nts

and

com

mun

ities

, and

im

prov

e tra

inin

g fo

r st

aff a

nd th

eir a

lloca

tion

to e

nsur

e th

e ap

prop

riate

ski

lls m

ix. (

Mar

ch) (

61)

The

Glo

bal/H

IV A

IDS

pro

gram

is c

reat

ed

alon

g w

ith th

e G

loba

l Mon

itorin

g an

d E

valu

atio

n Te

am (G

AM

ET)

. GA

ME

T is

ho

used

at t

he W

orld

Ban

k an

d su

ppor

ts

effo

rts w

ith U

NA

IDS

to b

uild

cou

ntry

-leve

l m

onito

ring

and

eval

uatio

n ca

paci

ties

as w

ell

as c

oord

inat

e te

chni

cal s

uppo

rt. (J

une)

(21)

Fi

rst p

hase

of B

ank-

Net

herla

nds

Wat

er

Par

tner

ship

- Wat

er S

uppl

y an

d S

anita

tion

initi

ated

. (51

) G

loba

l Allia

nce

for I

mpr

oved

Nut

ritio

n (G

AIN

) cr

eate

d at

a s

peci

al U

N s

essi

on fo

r chi

ldre

n.

The

Wor

ld B

ank

is a

key

par

tner

, mai

nly

man

agin

g Tr

ust F

unds

and

pro

gram

im

plem

enta

tion.

(62

)

2003

Wor

ld B

ank

Ann

ual R

epor

t des

crib

es th

e B

ank'

s co

mm

itmen

t tow

ard

mee

ting

the

MD

Gs

and

emph

asiz

es it

s co

mm

itmen

t to

four

prio

rity

sect

ors

incl

udin

g: H

IV/A

IDS

, w

ater

and

san

itatio

n, h

ealth

, and

edu

catio

n fo

r all.

(Sep

tem

ber)

(1)

Jean

-Lou

is S

arbi

b as

sum

es H

DN

Vic

e P

resi

denc

y. (J

uly)

(12)

B

oard

app

rove

s fir

st p

ilots

of b

uy-d

own

mec

hani

sm in

sev

eral

pol

io e

radi

catio

n pr

ojec

ts

in P

akis

tan

and

Nig

eria

. Pro

ject

s w

ere

finan

ced

by G

ates

Fou

ndat

ion,

UN

F, R

otar

y In

tern

atio

nal,

and

the

CD

C. (

63)

Reg

iona

l AID

S s

trate

gy fo

r EC

A p

ublis

hed:

A

verti

ng A

IDS

Cris

es in

Eas

tern

Eur

ope

and

Cen

tral A

sia

(Sep

tem

ber)

(64*

)

The

Ban

k an

d PA

HO

inau

gura

te th

e "H

ealth

P

artn

ersh

ip fo

r Kno

wle

dge

Sha

ring

and

Lear

ning

in th

e A

mer

icas

." Th

e in

itiat

ive

prom

otes

the

use

of te

chno

logy

to s

hare

ex

perti

se in

ord

er to

mee

t the

MD

Gs

acro

ss

the

regi

on. (

Oct

ober

) (1)

2004

Wat

er R

esou

rces

Sec

tor S

trate

gy: S

trate

gic

Dire

ctio

ns fo

r Wor

ld B

ank

Eng

agem

ent i

s pu

blis

hed.

The

stra

tegy

hig

hlig

hts

the

cent

ralit

y of

wat

er re

sour

ce m

anag

emen

t an

d de

velo

pmen

t to

sust

aina

ble

grow

th a

nd

pove

rty re

duct

ion.

It a

rgue

s th

at th

e W

orld

B

ank

is p

erce

ived

to h

ave

a co

mpa

rativ

e ad

vant

age

in th

e ar

ea. I

t em

phas

izes

the

need

to ta

ilor C

ount

ry W

ater

Ass

ista

nce

Stra

tegi

es to

be

cons

iste

nt w

ith c

ount

ry

cont

ext,

CA

Ss a

nd P

RS

Ps.

(Jan

uary

) (65

) R

each

ing

the

Poo

r Pro

gram

-spo

nsor

ed

glob

al c

onfe

renc

e fo

r res

earc

hers

to

diss

emin

ate

evid

ence

of h

ow w

ell h

ealth

and

ot

her s

ocia

l pro

gram

s re

ach

the

poor

and

to

prod

uce

polic

y gu

idel

ines

bas

ed u

pon

the

evid

ence

. (Fe

brua

ry) (

66)

The

Ban

k sp

onso

rs a

n ev

ent f

or 3

5 Af

rican

am

bass

ador

s, H

arm

oniz

ing

App

roac

hes

to

Hea

lth in

Afri

ca, t

o in

tens

ify e

fforts

to

impr

ove

wom

en's

hea

lth in

Afri

ca a

nd p

lan

follo

w-u

p ac

tiviti

es. (

Apr

il) (1

)

Reg

iona

l HIV

/AID

S st

rate

gy fo

r EA

P pu

blis

hed:

Add

ress

ing

HIV

/AID

S in

Eas

t Asi

a an

d th

e P

acifi

c. (

Janu

ary)

(69*

) Im

prov

ing

Hea

lth, N

utrit

ion,

and

Pop

ulat

ion

Out

com

es in

Sub

-Sah

aran

Afri

ca- T

he R

ole

of th

e W

orld

Ban

k no

tes

that

pos

itive

tren

ds

in h

ealth

indi

cato

rs h

ave

slow

ed o

r rev

erse

d in

Sub

-Sah

aran

Afri

ca.

It ar

gues

that

the

Ban

k m

ust u

se it

s co

mpa

rativ

e ad

vant

age

to

wor

k w

ith g

over

nmen

ts a

nd p

artn

ers

to

stre

ngth

en th

e ca

paci

ty o

f cou

ntrie

s to

im

prov

e he

alth

out

com

es. N

utrit

ion

and

popu

latio

n m

ust r

emai

n ce

ntra

l iss

ues

in

deve

lopm

ent i

n S

ub-S

ahar

an A

frica

and

ac

cord

ingl

y, th

e re

port

pres

ents

a re

gion

al

guid

e to

sha

pe s

trate

gy fo

rmul

atio

n at

the

coun

try o

r sub

-reg

iona

l lev

el. (

Dec

embe

r)

(70*

)

WH

O a

nd th

e B

ank

co-s

pons

or th

e 1s

t Hig

h-Le

vel F

orum

on

the

Hea

lth M

DG

s. H

eads

of

deve

lopm

ent a

genc

ies,

bila

tera

l age

ncie

s,

glob

al h

ealth

initi

ativ

es, a

nd h

ealth

and

fin

ance

min

iste

rs a

gree

on

4 ac

tion

area

s: 1

) re

sour

ces

for h

ealth

and

pov

erty

redu

ctio

n pa

pers

; 2) a

id e

ffect

iven

ess

and

harm

oniz

atio

n; 3

) hum

an re

sour

ces;

4)

mon

itorin

g pe

rform

ance

. (Ja

nuar

y) (1

)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

62

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

20

04

The

OE

D re

leas

es a

n ev

alua

tion

of th

e B

ank'

s ap

proa

ch to

glo

bal p

rogr

ams,

A

ddre

ssin

g th

e C

halle

nges

of G

loba

lizat

ion.

Th

e ev

alua

tion

reco

mm

ends

that

the

Ban

k se

para

te o

vers

ight

of g

loba

l pro

gram

s fro

m

man

agem

ent,

impr

ove

stan

dard

s of

go

vern

ance

and

man

agem

ent o

f ind

ivid

ual

prog

ram

s, re

eval

uate

sel

ectio

n an

d ex

it cr

iteria

, stre

ngth

en li

nks

betw

een

glob

al

prog

ram

s an

d co

untry

stra

tegi

es, a

nd

stre

ngth

en e

valu

atio

ns a

nd re

view

of g

loba

l pr

ogra

ms

with

in th

e B

ank.

(67*

) W

DR

200

4: M

akin

g S

ervi

ces

Wor

k fo

r Poo

r P

eopl

e id

entif

ies

good

gov

erna

nce

and

acco

unta

bilit

y m

echa

nism

s as

key

de

term

inan

ts o

f hea

lth s

yste

m p

erfo

rman

ce.

(68*

)

2005

Pau

l Wol

fow

itz is

una

nim

ousl

y ap

prov

ed b

y th

e B

oard

of E

xecu

tive

Dire

ctor

s as

the

Wor

ld B

ank'

s 10

th P

resi

dent

. (M

arch

) (1)

In

his

spe

ech

at th

e A

nnua

l Mee

tings

, W

olfo

witz

em

phas

izes

the

impo

rtanc

e of

le

ader

ship

and

acc

ount

abilit

y, c

ivil

soci

ety

and

wom

en, a

nd th

e ru

le o

f law

as

wel

l as

focu

sing

on

resu

lts.

Whe

n sp

eaki

ng o

n th

e im

porta

nce

of h

ealth

on

the

deve

lopm

ent

agen

da, h

e em

phas

izes

the

Wor

ld B

ank'

s co

mm

itmen

t to

fight

mal

aria

with

the

sam

e in

tens

ity a

s H

IV/A

IDS

. (Se

ptem

ber)

(71)

A

n IE

G e

valu

atio

n of

the

Ban

k's

HIV

/AID

S

Ass

ista

nce,

Com

mitt

ing

to R

esul

ts:

Impr

ovin

g th

e Ef

fect

iven

ess

of H

IV/A

IDS

A

ssis

tanc

e, is

rele

ased

. It f

inds

that

the

Ban

k’s

supp

ort h

as ra

ised

com

mitm

ent a

nd

acce

ss to

ser

vice

s bu

t the

effe

ct o

n th

e sp

read

of H

IV a

nd s

urvi

val i

s un

clea

r. It

reco

mm

ends

that

the

Ban

k: h

elp

gove

rnm

ents

to b

e st

rate

gic

and

sele

ctiv

e,

and

prio

ritiz

e hi

gh-im

pact

act

iviti

es a

nd th

e

high

est r

isk

beha

vior

s; s

treng

then

nat

iona

l in

stitu

tions

to m

anag

e an

d im

plem

ent l

ong-

run

resp

onse

s; a

nd im

prov

e m

onito

ring

and

eval

uatio

n to

stre

ngth

en th

e lo

cal e

vide

nce

base

for d

ecis

ion

mak

ing.

(21*

)

Whe

n th

e Ad

vise

r for

Pop

ulat

ion

and

Rep

rodu

ctiv

e, M

ater

nal a

nd C

hild

Hea

lth

(Eliz

abet

h Lu

le) i

s ap

poin

ted

as m

anag

er a

s of

A

CTA

frica

, the

Adv

iser

pos

ition

is e

limin

ated

. (J

anua

ry) (

72)

Rol

ling

Bac

k M

alar

ia: T

he W

orld

Ban

k G

loba

l S

trate

gy a

nd B

oost

er P

rogr

am p

rovi

des

the

basi

s an

d ra

tiona

le fo

r ini

tiatin

g th

e 5-

year

B

oost

er P

rogr

am fo

r Mal

aria

Con

trol.

Its

obje

ctiv

es a

re to

incr

ease

cov

erag

e, im

prov

e ou

tcom

es, a

nd b

uild

cap

acity

. Des

crib

ed a

s a

“new

bus

ines

s m

odel

”, it

prio

ritiz

es fl

exib

le,

coun

try-d

riven

, and

resu

lts-fo

cuse

d ap

proa

ches

. (J

anua

ry) (

41*)

Wor

ld B

ank

partn

ers

to la

unch

the

Hea

lth

Met

rics

Net

wor

k la

unch

ed, a

glo

bal

partn

ersh

ip to

impr

ove

the

qual

ity, a

vaila

bilit

y an

d di

ssem

inat

ion

of d

ata

for d

ecis

ion-

mak

ing

in h

ealth

. (Ju

ne) (

73)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

63

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

2006

Task

For

ce o

n A

vian

Flu

for A

frica

es

tabl

ishe

d to

man

age

the

info

rmat

ion,

co

mm

unic

atio

n, a

nd c

oord

inat

ion

aspe

cts

of

the

resp

onse

to a

vian

influ

enza

. It s

uppo

rts

coun

try te

ams

to p

repa

re in

divi

dual

cou

ntry

op

erat

ions

, hel

ps c

oord

inat

e th

e re

gion

’s

resp

onse

with

the

glob

al a

nd B

ank-

wid

e fu

ndin

g pr

ogra

ms,

with

don

ors,

and

mob

ilize

ad

ditio

nal f

undi

ng a

s ne

cess

ary.

(74)

Cris

tian

Bae

za a

ppoi

nted

as

Actin

g H

NP

Dire

ctor

(F

ebru

ary)

(75)

Rep

ositi

onin

g N

utrit

ion

as C

entra

l to

Dev

elop

men

t: A

Stra

tegy

for L

arge

-Sca

le

Act

ion

aim

s to

pos

ition

nut

ritio

n as

a p

riorit

y on

the

deve

lopm

ent a

gend

a at

bot

h th

e co

untry

and

inte

rnat

iona

l lev

els

to b

olst

er

incr

ease

d co

mm

itmen

ts a

nd in

vest

men

t to

fight

mal

nutri

tion.

It p

riorit

izes

: app

roac

hes

that

reac

h th

e po

or a

nd m

ost v

ulne

rabl

e at

st

rate

gic

stag

es in

thei

r dev

elop

men

t; sc

alin

g-up

pro

ven

and

cost

-effe

ctiv

e pr

ogra

ms;

re

orie

ntin

g in

effe

ctiv

e pr

ogra

ms;

impr

ovin

g nu

tritio

n th

roug

h de

liber

ate

activ

ities

in o

ther

se

ctor

s; s

uppo

rting

act

ion

rese

arch

and

le

arni

ng b

y do

ing;

and

mai

nstre

amin

g nu

tritio

n in

to d

evel

opm

ent s

trate

gies

. (J

anua

ry) (

76*)

H

ealth

Fin

anci

ng R

evis

ited:

A P

ract

ition

er's

G

uide

revi

ews

the

polic

y op

tions

and

tool

s av

aila

ble

for h

ealth

fina

nce

in lo

w a

nd m

iddl

e in

com

e co

untri

es. K

ey p

riorit

ies

incl

ude:

(i)

mob

ilizi

ng in

crea

sed

and

sust

aina

ble

gove

rnm

ent h

ealth

spe

ndin

g; (i

i) im

prov

ing

gove

rnan

ce a

nd re

gula

tion

to s

treng

then

the

capa

city

of h

ealth

sys

tem

s an

d en

sure

that

in

vest

men

ts a

re e

quita

ble

and

effic

ient

; and

(ii

i) co

ordi

natin

g do

nors

to m

ake

mor

e fle

xibl

e an

d lo

nger

-term

com

mitm

ents

that

are

al

igne

d w

ith th

e de

velo

pmen

t goa

ls o

f a

coun

try. (

May

) (77

*)

Wor

ld B

ank

co-s

pons

ors

the

Inte

rnat

iona

l P

ledg

ing

Con

fere

nce

on A

vian

and

Hum

an

Influ

enza

in B

eijin

g to

ass

ess

finan

cing

nee

ds

at c

ount

ry, r

egio

nal a

nd g

loba

l lev

els.

(J

anua

ry) (

74)

Wor

ld B

ank

join

ed th

e IM

F an

d th

e Af

rican

D

evel

opm

ent B

ank

in im

plem

entin

g th

e M

ultil

ater

al D

ebt R

elie

f Ini

tiativ

e (M

DR

I),

forg

ivin

g 10

0 pe

rcen

t of e

ligib

le o

utst

andi

ng

debt

ow

ed to

thes

e th

ree

inst

itutio

ns b

y al

l co

untri

es re

achi

ng th

e co

mpl

etio

n po

int o

f the

H

IPC

Initi

ativ

e. T

he M

DR

I will

effe

ctiv

ely

doub

le th

e vo

lum

e of

deb

t rel

ief a

lread

y ex

pect

ed fr

om th

e en

hanc

ed H

IPC

Initi

ativ

e.

(78)

20

07

Pau

l Wol

fow

itz re

sign

s as

Wor

ld B

ank

Pre

side

nt. (

June

) (7

9)

Rob

ert Z

oellic

k be

com

es 1

1th

Wor

ld B

ank

Pre

side

nt. (

July

) (80

)

Joy

Phu

map

hi b

ecom

es V

ice

Pre

side

nt o

f the

H

uman

Dev

elop

men

t Net

wor

k. (F

ebru

ary)

(81)

Ju

lian

Schw

eitz

er b

ecom

es H

NP

Sec

tor D

irect

or.

(Oct

ober

) (82

)

The

obje

ctiv

e of

the

2007

Wor

ld B

ank

Stra

tegy

for H

ealth

, Nut

ritio

n an

d P

opul

atio

n R

esul

ts is

to u

se a

sel

ectiv

e an

d di

scip

lined

fra

mew

ork

to re

doub

le e

fforts

to s

uppo

rt cl

ient

cou

ntrie

s to

: im

prov

e H

NP

out

com

es,

espe

cial

ly fo

r the

poo

r; pr

otec

t hou

seho

lds

from

illn

ess;

ens

ure

sust

aina

ble

finan

cing

; an

d im

prov

e se

ctor

gov

erna

nce

and

redu

ce

corr

uptio

n. (A

pril)

(63*

) P

opul

atio

n Is

sues

in th

e 21

st C

entu

ry: T

he

Rol

e of

the

Wor

ld B

ank

focu

ses

on le

vels

and

tre

nds

in b

irths

, dea

ths,

mig

ratio

n an

d po

pula

tion

grow

th a

nd re

late

d ch

alle

nges

. A

fter a

naly

zing

glo

bal a

nd re

gion

al tr

ends

, as

wel

l as

thos

e fo

r len

ding

for p

opul

atio

n, th

e re

port

outli

nes

the

Ban

k’s

area

s of

co

mpa

rativ

e ad

vant

age.

It c

oncl

udes

that

the

Ban

k m

ust f

ocus

ana

lytic

al w

ork

on

popu

latio

n is

sues

, and

col

labo

rate

with

the

Wor

ld B

ank

sign

s ag

reem

ent t

o jo

in th

e In

tern

atio

nal H

ealth

Par

tner

ship

. The

P

artn

ersh

ip a

ims

to im

prov

e th

e w

ork

of d

onor

an

d de

velo

ping

cou

ntrie

s an

d in

tern

atio

nal

agen

cies

to c

reat

e an

d im

plem

ent p

lans

and

se

rvic

es th

at im

prov

e he

alth

out

com

es fo

r the

po

or.

(Sep

tem

ber)

(84)

A

nnex

C:

Wor

ld B

ank

HN

P Ti

mel

ine

64

YEAR

B

ANK

-WID

E EV

ENTS

H

NP

SEC

TOR

EVE

NTS

H

NP

PUB

LIC

ATI

ON

S a

nd

ST

RA

TEG

IES

H

NP

PAR

TNER

SHIP

S an

d C

OM

MIT

MEN

TS

20

07

priv

ate

sect

or a

nd g

loba

l par

tner

s to

dev

elop

an

d m

ains

tream

mul

tisec

tora

l pop

ulat

ion

polic

ies

appr

opria

te fo

r low

, mid

dle

and

high

fe

rtilit

y co

untri

es. (

Apr

il) (8

3*)

65 Annex C: World Bank HNP Timeline

ANNEX C SOURCES

* indicates the publication itself, otherwise, facts are reported in the cited reference.

1 World Bank Group Archives 2005. 2 World Bank Website. “Water Supply and Sanitation Projects the Bank’s Experience: 1967-1989.” (http://go.worldbank.org/8LRMSA1520) 3 King 2007. 4 World Bank Group Archives, “Sector Department Chart.” 5 World Bank 1972b. 6 World Bank 1972a. 7 Golladay and Liese 1980. 8 World Bank 1973. 9 World Bank 1974. 10 World Bank 1975. 11 United Nations System Website. “Standing Committee on Nutrition.” (http://www.unsystem.org/SCN/Publications/html/mandate.html). 12 World Bank Group Archives, World Bank Group Staff Directories. 13 World Bank 1980b. 14 World Bank 1980a. 15 World Bank 1997a. 16 World Bank 1984. 17 Grosh and Muñoz 1996. 18 Harvard School of Public Health Web site. (http://www.hsph.harvard.edu/review/fellow.shtml). 19 Kapur and others 1997. 20 World Bank 1986. 21 OED 2005. 22 World Bank 1986a. 23 World Bank 1988. 24 Nassim 1991. 25 World Bank 1989. 26 People and Planet. Net Web site. (http://www.peopleandplanet.net/doc.php?id=1740). 27 World Bank 1993. 28 Jamison and others 1993. 29 World Bank. 1994. “Water resources management.” World Bank Policy Paper. Washington, DC: World Bank. 30 World Bank 1994b. 31 World Bank 1999b. 32 Vaillancourt (Forthcoming) 33 World Bank Group Archives. “James D. Wolfensohn Timeline of Major Developments.” 34 World Bank Web site. “Quality Assurance Group.”

(http://web.worldbank.org/WBSITE/EXTERNAL/PROJECTS/QAG/0,,contentMDK:20067126~menuPK:114865~pagePK:109617~piPK:109636~theSitePK:109609,00.html).

35 IAVI Web Site (http://www.iavi.org/viewpage.cfm?aid=24). 36 Schieber 1997. 37 World Bank 1997c. 38 UNECA, UNICEF and World Bank. 1998. "Addis Ababa Consensus on principles of cost sharing in education and health." New York:

UNICEF. 39 Dollar and Pritchett 1998. 40 White and others. 2006. 41 World Bank 2005a. 42 Narayan and Petesch 2002. 43 Wagstaff and Claeson 2004. 44 OED 1999a. 45 World Bank 1999a. 46 Walt and Buse 2006. 47 World Bank 2000a. 48 Jha and Chaloupka 2000. 49 World Bank 2000c. 50 Gwatkin and others 2000. 51 Bank-Netherlands Water Partnership Program Web site (http://www-esd.worldbank.org/bnwpp/). 52 World Bank 2000b. 53 WSP Web Site (http://www.wsp.org). 54 World Bank Web site. “Gender and Development.”

(http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTGENDER/0,,menuPK:336874~pagePK:149018~piPK:149093~theSitePK:336868,00.html).

55 World Bank 2001b. 56 Stop TB Partnership Web site (http://www.stoptb.org/stop_tb_initiative/).

Annex C: World Bank HNP Timeline

66

57 Global Public-Private Partnership for Handwashing with Soap Web site (http://www.globalhandwashing.org/). 58 Kaiser Family Foundation Web site (www.kff.org/hivaids/timeline). 59 INDEPTH Web site (http://www.indepth-network.org/core_documents/vision.htm). 60 World Bank Web Site. “Strategies.”

(http://intranet.worldbank.org/WBSITE/INTRANET/SECTORS/HEALTHNUTRITIONANDPOPULATION/INTHIVAIDS/0,,contentMDK:20120702~menuPK:375837~pagePK:210082~piPK:210098~theSitePK:375799,00.html).

61 HNP Sector Board. (draft February 7, 2002). “Health, Nutrition and Population Sector Strategy Briefing.” 62 GAIN Web site (http://www.gainhealth.org/gain/ch/en-en/index.cfm?page=/gain/home/about_gain/history). 63 World Bank 2007a. 64 World Bank 2003b. 65 World Bank 2004c. 66 World Bank Web site.

(http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTPAH/0,,contentMDK:20744334~pagePK:210058~piPK:210062~theSitePK:400476,00.html?).

67 OED 2004. 68 World Bank 2003a. 69 World Bank 2004a. 70 World Bank 2004b. 71 World Bank Web site. News and Broadcast. “Annual Meetings 2005 Opening Press Conference with Paul Wolfowitz.”

(http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:20656903~pagePK:64257043~piPK:437376~theSitePK:4607,00.html). 72 World Bank Web site. “News and Broadcasts>”

http://web.worldbank.org/WBSITE/EXTERNAL/NEWS/0,,contentMDK:20138122~pagePK:64257043~piPK:437376~theSitePK:4607,00.html 73 WHO Web site. “What is HMN?” (http://www.who.int/healthmetrics/about/whatishmn/en/index.html). 74 World Bank Web site. "Avian and Pandemic Influenza."

(http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATION/EXTTOPAVIFLU/0,,menuPK:1793605~pagePK:64168427~piPK:64168435~theSitePK:1793593,00.html).

75 World Bank Web site. “Acting Asssignments in HNP.” (http://intranet.worldbank.org/WBSITE/INTRANET/SECTORS/HEALTHNUTRITIONANDPOPULATION/0,,contentMDK:20131131~pagePK:210082~piPK:210098~theSitePK:281628,00.html)

76 World Bank 2006. 77 Gottret and Schieber 2006. 78 World Bank Web site. “Debt issues.”

(http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTDEBTDEPT/0,,menuPK:64166739~pagePK:64166681~piPK:64166725~theSitePK:469043,00.html).

79 World Bank Web site. “Statements of Executive Director and President Wolfowitz.” (http://intranet.worldbank.org/WBSITE/INTRANET/UNITS/INTPRESIDENT2007/INTPASTPRESIDENTS/INTPRESIDENTSTAFCONN/0,,contentMDK:21339650~menuPK:64324835~pagePK:64259040~piPK:64258864~theSitePK:1014519,00.html).

80 World Bank Web site. “President’s Staff Connection.” http://intranet.worldbank.org/WBSITE/INTRANET/UNITS/INTPRESIDENT2007/0,,contentMDK:21477815~menuPK:64821535~pagePK:64821348~piPK:64821341~theSitePK:3915045,00.html

81 World Bank Web site. January 30, 2007. “Interview with Joy Phumaphi, New HD Vice President.” (http://intranet.worldbank.org/WBSITE/INTRANET/UNITS/INTHDNETWORK/0,,contentMDK:21199087~menuPK:514396~pagePK:64156298~piPK:64152276~theSitePK:514373,00.html).

82 World Bank Web site. “Julian Schweitzer, Sector Director, HNP, Human Development Network.” http://intranet.worldbank.org/WBSITE/INTRANET/KIOSK/0,,contentMDK:21473063~menuPK:34897~pagePK:37626~piPK:37631~theSitePK:3664,00.html

83 World Bank 2007b. 84 DFID Web Site. “International Health Partnership launched today.” (http://www.dfid.gov.uk/news/files/ihp/default.asp).

67

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

AN

NEX

D: G

LOBA

L H

NP

EVEN

TS T

IMEL

INE

YE

AR

INTE

RN

ATI

ON

AL

OR

GAN

IZA

TIO

NS

B

ILA

TER

AL

AGEN

CIE

S an

d

DEV

ELO

PMEN

T B

ANK

S FO

UN

DA

TIO

NS/

NG

Os

PUB

LIC

-PR

IVA

TE

PAR

TNER

SHIP

S D

EVEL

OPI

NG

CO

UN

TRIE

S EX

TER

NA

L EV

ENTS

1951

WH

O h

as b

een

in e

xist

ence

fo

r thr

ee y

ears

. (1)

B

rock

Chi

shol

m (C

anad

a)

serv

es a

s W

HO

Dire

ctor

-G

ener

al. (

2)

A

gra

nt fr

om th

e P

lann

ed

Par

enth

ood

Fede

ratio

n of

A

mer

ica

(PP

FA) s

uppo

rts w

ork

to d

evel

op th

e or

al

cont

race

ptiv

e pi

ll. (3

)

Mal

aria

era

dica

ted

in th

e U

S. (

4)

1952

The

Inte

rnat

iona

l Pla

nned

P

aren

thoo

d Fe

dera

tion

(IPP

F)

is fo

rmed

by

natio

nal f

amily

pl

anni

ng a

ssoc

iatio

ns fr

om

eigh

t cou

ntrie

s. (3

) Fo

rd F

ound

atio

n be

com

es

activ

e in

pop

ulat

ion

prog

ram

s.

(5)

John

D. R

ocke

felle

r con

vene

s a

grou

p of

sci

entis

ts to

dis

cuss

de

mog

raph

ic c

once

rns.

Thi

s le

ads

to th

e cr

eatio

n of

the

Pop

ulat

ion

Cou

ncil.

(6)

Th

e fir

st n

atio

nal p

opul

atio

n po

licy

is e

stab

lishe

d by

Indi

a.

(7)

Wor

ld p

opul

atio

n pa

sses

2.

6 bi

llion

. (8)

1953

M

arco

lino

Gom

es C

anda

u (B

razi

l) be

com

es W

HO

D

irect

or-G

ener

al. (

2)

1954

UN

org

aniz

es T

he F

irst

Wor

ld P

opul

atio

n C

onfe

renc

e to

exc

hang

e sc

ient

ific

info

rmat

ion

on

popu

latio

n va

riabl

es, t

heir

dete

rmin

ants

and

thei

r co

nseq

uenc

es. T

he

conf

eren

ce, h

eld

in R

ome,

re

solv

ed to

gen

erat

e in

form

atio

n on

the

dem

ogra

phic

situ

atio

n of

the

deve

lopi

ng c

ount

ries

and

to

prom

ote

the

crea

tion

of

regi

onal

trai

ning

cen

ters

w

hich

wou

ld h

elp

to a

ddre

ss

popu

latio

n is

sues

and

to

prep

are

spec

ialis

ts in

de

mog

raph

ic a

naly

sis.

(A

ugus

t- S

epte

mbe

r). (

9)

Th

e P

opul

atio

n C

ounc

il be

gins

fin

anci

al s

uppo

rt to

the

Pop

ulat

ion

Ref

eren

ce B

urea

u.

(6)

Ford

Fou

ndat

ion

gran

ts

$600

,000

to th

e P

opul

atio

n C

ounc

il. (6

)

Pol

io v

acci

ne c

reat

ed. (

3)

Cig

aret

te s

mok

ing

repo

rted

to c

ause

can

cer.

(3)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

68

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1955

W

HO

sub

mits

a p

ropo

sal f

or

the

erad

icat

ion

of m

alar

ia

wor

ldw

ide

at th

e W

orld

H

ealth

Ass

embl

y. (4

)

Indi

a es

tabl

ishe

s th

e w

orld

's

first

nat

iona

l fam

ily p

lann

ing

prog

ram

and

requ

ests

as

sist

ance

from

the

Pop

ulat

ion

Cou

ncil.

(6)

1958

UN

has

est

ablis

hed

regi

onal

ce

nter

s fo

r dem

ogra

phic

tra

inin

g an

d re

sear

ch in

B

omba

y, In

dia,

and

in

San

tiago

, Chi

le, w

ith s

uppo

rt fro

m th

e P

opul

atio

n C

ounc

il.

(6)

1959

Pak

ista

n es

tabl

ishe

s fa

mily

pl

anni

ng s

ervi

ces

with

as

sist

ance

from

the

Pop

ulat

ion

Cou

ncil.

(6)

1960

By

1960

, IP

PF

cond

ucts

fie

ldw

ork

in A

frica

and

Lat

in

Am

eric

a. (3

)

The

oral

con

trace

ptio

n pi

ll go

es o

n sa

le in

the

U.S

. (3)

W

orld

pop

ulat

ion

pass

es 3

bi

llion

. (8)

1961

The

Food

and

Agr

icul

tura

l O

rgan

isat

ion

(FA

O) a

nd th

e U

N G

ener

al A

ssem

bly

appr

ove

para

llel r

esol

utio

ns

that

est

ablis

h th

e W

orld

Fo

od P

rogr

amm

e (W

FP) o

n a

thre

e-ye

ar e

xper

imen

tal

basi

s. (1

0)

Afte

r pas

sing

the

Fore

ign

Assi

stan

ce A

ct, t

he U

S C

ongr

ess

auth

oriz

es re

sear

ch

on fa

mily

pla

nnin

g is

sues

, in

clud

ing

the

prov

isio

n of

fa

mily

pla

nnin

g in

form

atio

n to

co

uple

s w

ho re

ques

t it.

(11)

Pop

ulat

ion

Cou

ncil

prov

ides

su

ppor

t to

initi

ate

the

Taic

hung

fa

mily

pla

nnin

g ex

perim

ent i

n Ta

iwan

. (6)

1962

Pop

ulat

ion

Cou

ncil

hold

s fir

st

inte

rnat

iona

l con

fere

nce

on

intra

uter

ine

devi

ces

(IUD

s) a

nd

faci

litat

es g

rant

ing

of ro

yalty

-fre

e lic

ense

s fo

r man

ufac

ture

of

the

Lipp

es L

oop

IUD

for u

se

in p

ublic

pro

gram

s w

orld

wid

e.

(6)

S

outh

Kor

ea re

ques

ts

assi

stan

ce fr

om th

e P

opul

atio

n C

ounc

il. (6

)

1963

UN

est

ablis

hes

a re

gion

al

cent

er fo

r dem

ogra

phic

tra

inin

g an

d re

sear

ch in

C

airo

, Egy

pt w

ith s

uppo

rt fro

m th

e P

opul

atio

n C

ente

r. (6

)

The

Gov

ernm

ents

of T

unis

ia

and

Turk

ey re

ques

t adv

ice

from

Pop

ulat

ion

Cou

ncil

on

esta

blis

hing

fam

ily p

lann

ing

prog

ram

s. (6

)

Tria

ls b

eing

car

ried

out o

n in

traut

erin

e de

vice

s (IU

Ds)

, or

al c

ontra

cept

ives

, and

D

epo-

Pro

vera

, an

inje

ctab

le

cont

race

ptiv

e. (3

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

69

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1964

IP

PF

gain

s co

nsul

tativ

e st

atus

fro

m th

e U

nite

d N

atio

ns

Eco

nom

ic a

nd S

ocia

l Cou

ncil

(Une

sco)

. (3)

1965

A re

port

of th

e U

nite

d N

atio

ns A

dvis

ory

Mis

sion

to

Indi

a, th

e m

ost i

nten

sive

fa

mily

pla

nnin

g st

udy

ever

un

derta

ken

by th

e U

N,

prov

ides

evi

denc

e th

at th

e U

N is

pre

pare

d to

pro

vide

as

sist

ance

in th

e fie

ld. (

3)

The

Sec

ond

Wor

ld

Pop

ulat

ion

Con

fere

nce

is

held

in B

elgr

ade

and

orga

nize

d by

the

Inte

rnat

iona

l Uni

on fo

r the

S

cien

tific

Stu

dy o

f P

opul

atio

n (IU

SS

P) a

nd th

e U

N. T

he c

onfe

renc

e fo

cuse

s on

the

anal

ysis

of f

ertil

ity a

s pa

rt of

a p

olic

y fo

r de

velo

pmen

t pla

nnin

g.

(Aug

ust-

Sep

tem

ber)

(9)

US

AID

beg

ins

finan

cing

fam

ily

plan

ning

pro

gram

s. T

he U

nite

d S

tate

s go

vern

men

t ado

pts

a pl

an to

redu

ce b

irth

rate

s in

de

velo

ping

cou

ntrie

s th

roug

h its

War

on

Hun

ger a

nd

inve

stm

ents

in fa

mily

pla

nnin

g pr

ogra

ms.

(11)

The

Pop

ulat

ion

Cou

ncil

and

Ford

Fou

ndat

ion

co-s

pons

or

the

Firs

t Int

erna

tiona

l C

onfe

renc

e on

Fam

ily

Pla

nnin

g P

rogr

ams

in G

enev

a.

(6)

Th

e P

opul

atio

n C

ounc

il la

unch

es th

e In

tern

atio

nal

Pos

tpar

tum

Pro

ject

, inv

olvi

ng

138

inst

itutio

ns in

21

coun

tries

. (6

)

1966

SID

A is

a le

adin

g ag

ency

in

prom

otin

g po

pula

tion

and

fam

ily p

lann

ing

prog

ram

s. I

t w

as o

ne o

f few

cou

ntrie

s to

pr

ovid

e of

ficia

l ass

ista

nce

for

fam

ily p

lann

ing

and

was

in

stru

men

tal i

n pe

rsua

ding

the

UN

to b

ecom

e m

ore

invo

lved

in

fam

ily p

lann

ing.

(3)

US

AID

fund

s th

e Po

pula

tion

Cou

ncil's

Dem

ogra

phic

D

ivis

ion

(late

r Pol

icy

Res

earc

h D

ivis

ion)

to in

itiat

e a

maj

or

effo

rt to

mea

sure

and

eva

luat

e fa

mily

pla

nnin

g pr

ogra

ms.

(6)

The

Indi

an g

over

nmen

t in

trodu

ces

targ

ets

for n

umbe

rs

of c

ontra

cept

ive

acce

ptor

s.

Hea

lth w

orke

rs in

prim

ary

heal

th c

ente

rs a

re a

ssig

ned

targ

ets

for s

teril

izat

ion

and

othe

r met

hods

in o

rder

to m

eet

dem

ogra

phic

targ

ets.

(12)

Th

e R

oman

ian

gove

rnm

ent

bans

all

form

s of

mod

ern

cont

race

ptio

n an

d ab

ortio

n. (3

)

Chi

na's

Cul

tura

l Rev

olut

ion

begi

ns. (

3)

1967

WH

O la

unch

es a

n in

tens

ified

pla

n to

era

dica

te

smal

lpox

(13)

IPP

F ho

lds

the

first

eve

r in

tern

atio

nal c

onfe

renc

e in

La

tin A

mer

ica

(Chi

le) w

here

po

pula

tion

and

fam

ily p

lann

ing

wer

e ex

plos

ive

topi

cs. (

3)

Firs

t suc

cess

ful h

uman

he

art t

rans

plan

t. (3

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

70

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1967

Man

off I

nter

natio

nal (

now

M

anof

f Gro

up) i

s es

tabl

ishe

d to

use

mas

s m

edia

to c

reat

e pu

blic

aw

aren

ess

of u

rgen

t he

alth

pro

blem

s an

d to

co

mm

unic

ate

info

rmat

ion

abou

t pra

ctic

al p

rogr

ams

that

m

et th

ose

chal

leng

es. I

t beg

ins

its w

ork

in In

dia.

(14)

UK

Par

liam

ent p

asse

s th

e A

borti

on B

ill, le

galiz

ing

abor

tion

on m

enta

l or

phys

ical

hea

lth g

roun

ds. (

3)

1968

Inte

rnat

iona

l Con

fere

nce

of

Hum

an R

ight

s in

Teh

ran

pass

es re

solu

tion

reco

gniz

ing

fam

ily p

lann

ing

as a

hum

an ri

ght.

(3)

USA

ID m

akes

its

first

pur

chas

e of

con

trace

ptiv

es fo

r di

strib

utio

n in

dev

elop

ing

coun

tries

. (11

)

The

Pap

al E

ncyc

lical

H

uman

ae V

itae

cond

emns

al

l met

hods

of a

rtific

ial

cont

race

ptio

n. (3

) W

orld

pop

ulat

ion

pass

es

3.5

billi

on. (

8)

1969

Uni

ted

Nat

ions

Fun

d fo

r P

opul

atio

n Ac

tiviti

es

(UN

FPA

) beg

ins

oper

atio

ns

adm

inis

tere

d by

UN

DP.

(15)

1970

Wor

ld B

ank

appr

oves

its

first

po

pula

tion

loan

for $

2 m

illion

to

sup

port

Jam

aica

’s fa

mily

pl

anni

ng p

rogr

am.

(16)

By

1970

, the

Pop

ulat

ion

Cou

ncil

had

spon

sore

d kn

owle

dge,

atti

tude

s, a

nd

prac

tices

(KAP

) stu

dies

in

Arg

entin

a, B

razi

l, C

hile

, Cos

ta

Ric

a, E

l Sal

vado

r, G

hana

, H

aiti,

Jam

aica

, Ind

ia,

Indo

nesi

a, L

eban

on, M

exic

o,

Pak

ista

n, P

eru,

Sou

th K

orea

, S

ri La

nka,

Tai

wan

, Tha

iland

, Tu

nisi

a, T

urke

y, U

rugu

ay, a

nd

Ven

ezue

la. (

6)

Pop

ulat

ion

Serv

ices

In

tern

atio

nal (

PSI

) fou

nded

to

dem

onst

rate

that

soc

ial

mar

ketin

g of

con

trace

ptiv

es in

th

e pr

ivat

e se

ctor

cou

ld

succ

eed

unde

r diff

erin

g ci

rcum

stan

ces

and

on d

iffer

ent

cont

inen

ts. (

17)

1971

WH

O a

nd U

NIC

EF

form

Jo

int C

omm

ittee

on

Alte

rnat

ive

App

roac

hes

to

Mee

ting

Bas

ic H

ealth

Nee

ds

of P

opul

atio

ns in

Dev

elop

ing

Cou

ntrie

s. (1

8)

US

AID

's O

ffice

of P

opul

atio

n be

gins

sup

porti

ng re

prod

uctiv

e he

alth

trai

ning

and

in

tern

atio

nal s

urve

ys. (

11)

IPP

F's

Mid

dle

Eas

t and

Nor

th

Afri

ca R

egio

n co

nven

es fi

rst

inte

rnat

iona

l Mus

lim

conf

eren

ce o

n fa

mily

pla

nnin

g.

80 s

chol

ars

and

spec

ialis

ts

from

23

coun

tries

end

orse

Sur

geon

s de

velo

p th

e fib

er-

optic

end

osco

pe fo

r loo

king

in

side

the

hum

an b

ody.

(3)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

71

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1971

Inte

rnat

iona

l Con

fere

nce

on

Nut

ritio

n, N

atio

nal

Dev

elop

men

t and

Pla

nnin

g he

ld a

t MIT

, whi

ch g

ives

im

petu

s to

food

and

nut

ritio

n pl

anni

ng. (

19)

fam

ily p

lann

ing.

(3)

Med

ecin

s Sa

ns F

ront

iers

(M

SF)

foun

ded.

(20)

1972

UN

FPA

is p

lace

d un

der t

he

UN

Gen

eral

Ass

embl

y's

dire

ct a

utho

rity

and

rais

ed to

th

e sa

me

stat

us a

s U

ND

P an

d U

NIC

EF.

(15)

US

AID

laun

ches

the

Wor

ld

Ferti

lity

Sur

vey

(WFS

) to

gath

er c

ompa

rativ

e da

ta a

t the

gl

obal

leve

l. (2

1)

IPP

F la

unch

es C

omm

unity

-B

ased

Dis

tribu

tion

of

Con

trace

ptiv

es P

rogr

amm

e to

in

crea

se th

e av

aila

bilit

y an

d lo

wer

the

cost

s of

co

ntra

cept

ives

. (3)

In

tern

atio

nal N

utrit

ion

Pla

nnin

g P

rogr

am c

reat

ed a

t MIT

fu

nded

by

the

Roc

kefe

ller

Foun

datio

n an

d U

SAID

. (19

)

Pop

ulat

ion

Cou

ncil

laun

ches

m

ater

nal a

nd c

hild

hea

lth c

are

and

fam

ily p

lann

ing

prog

ram

s in

rura

l are

as o

f Ind

ones

ia,

Nig

eria

, the

Phi

lippi

nes,

and

Tu

rkey

with

sup

port

from

W

orld

Ban

k an

d U

NFP

A. (

6)

1973

H

alfd

an T

. Mah

ler

(Den

mar

k) b

ecom

es W

HO

D

irect

or-G

ener

al. (

2)

US

AID

pro

hibi

ts p

rom

otin

g or

fu

ndin

g ab

ortio

n un

der T

he

Hel

ms

amen

dmen

t to

the

1961

Fo

reig

n As

sist

ance

Act

. (11

)

Fam

ine

strik

es E

thio

pia.

(1

6)

U.S

. Sup

rem

e C

ourt

lega

lizes

abo

rtion

. (3)

1974

WH

O c

reat

es th

e Ex

pand

ed

Pro

gram

on

Imm

uniz

atio

n (E

PI)

to im

prov

e va

ccin

e de

liver

y by

pro

vidi

ng s

uppo

rt an

d gu

idan

ce. (

22)

WH

O, F

AO, U

ND

P an

d th

e W

orld

Ban

k im

plem

ent t

he

Onc

hoce

rsia

sis

Con

trol

Pro

gram

(OC

P) w

hich

is

endo

rsed

by

the

seve

n go

vern

men

ts o

f the

Wes

t A

frica

n co

untri

es m

ost

affe

cted

by

the

dise

ase.

(M

arch

) (16

) W

FP c

o-or

dina

tes

the

first

-ev

er m

ulti-

natio

nal a

irlift

of

food

aid

, dra

win

g on

the

reso

urce

s of

12

natio

nal a

ir

forc

es, t

o W

est A

frica

in

resp

onse

to a

dro

ught

. (10

)

US

AID

fund

s th

e Po

pula

tion

Cou

ncil's

firs

t ope

ratio

ns

rese

arch

pro

ject

, fie

ld-b

ased

re

sear

ch s

tudi

es to

ex

perim

enta

lly te

st a

nd

eval

uate

inno

vativ

e w

ays

to

deliv

er fa

mily

pla

nnin

g an

d re

prod

uctiv

e he

alth

ser

vice

s in

de

velo

ping

cou

ntrie

s. (6

)

IPP

F la

unch

es T

he L

aw a

nd

Pla

nned

Par

enth

ood

Pro

ject

to

wor

k w

ith F

amily

Pla

nnin

g A

ssoc

iatio

ns to

refo

rm

outm

oded

and

rest

rictiv

e la

ws,

re

gula

tions

and

pol

icie

s th

at

act a

s ba

rrie

rs a

nd b

ottle

neck

s to

the

prov

isio

n of

fam

ily

plan

ning

ser

vice

s. (3

)

Wor

ld p

opul

atio

n pa

sses

4

billi

on. (

8)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

72

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1974

The

UN

org

aniz

es T

he T

hird

W

orld

Pop

ulat

ion

Con

fere

nce

in B

ucha

rest

, R

oman

ia, w

hich

is a

ttend

ed

by re

pres

enta

tives

from

135

co

untri

es. I

t foc

uses

on

the

rela

tions

hip

betw

een

popu

latio

n is

sues

and

de

velo

pmen

t. Th

e m

ain

outc

ome

of th

e co

nfer

ence

is

the

Wor

ld P

opul

atio

n P

lan

of

Act

ion,

whi

ch s

tate

s th

at

soci

al, e

cono

mic

and

cul

tura

l de

velo

pmen

t of c

ount

ries

are

its e

ssen

tial a

im, t

hat

popu

latio

n va

riabl

es a

nd

deve

lopm

ent a

re

inte

rdep

ende

nt, a

nd th

at

popu

latio

n po

licie

s an

d ob

ject

ives

are

an

inte

gral

pa

rt of

soc

io-e

cono

mic

de

velo

pmen

t pol

icie

s.

(Aug

ust)

(9)

1975

Wor

ld B

ank,

WH

O, U

NIC

EF,

and

UN

DP

co-s

pons

or th

e Tr

opic

al R

esea

rch

Pro

gram

to

coo

rdin

ate

a gl

obal

effo

rt to

com

bat d

isea

ses

that

af

fect

the

poor

and

di

sadv

anta

ged

thro

ugh

rese

arch

and

dev

elop

men

t, an

d tra

inin

g an

d st

reng

then

ing.

(23)

Afri

can

Dev

elop

men

t Ban

k be

gins

inte

rven

tions

in th

e he

alth

sec

tor.

(24)

Ford

Fou

ndat

ion,

Roc

kefe

ller

Foun

datio

n an

d th

e In

tern

atio

nal D

evel

opm

ent

Res

earc

h C

entre

of C

anad

a la

unch

the

Inte

rnat

iona

l Foo

d P

olic

y R

esea

rch

Inst

itute

(IF

PR

I). (2

5)

IPP

F an

d U

nesc

o es

tabl

ish

the

Inte

rnat

iona

l Aud

io-V

isua

l R

esou

rce

Serv

ice

to p

rom

ote

the

use

of c

omm

unic

atio

n m

edia

with

in fa

mily

pla

nnin

g pr

ogra

ms.

(3)

1976

UN

ICE

F E

xecu

tive

Boa

rd

com

mits

to a

bas

ic s

ervi

ces

appr

oach

and

wor

ks w

ith

WH

O o

n al

tern

ativ

e ap

proa

ches

to h

ealth

car

e.

(26)

W

orld

Ban

k m

akes

its

first

lo

an in

nut

ritio

n fo

r $19

m

illion

to B

razi

l. (1

9)

The

US

Foo

d an

d D

rug

Adm

inis

tratio

n ap

prov

es th

e P

opul

atio

n C

ounc

il's C

oppe

r T2

00 IU

D, t

he fi

rst-e

ver N

ew

Dru

g A

pplic

atio

n sp

onso

red

by

a no

npro

fit re

sear

ch

orga

niza

tion.

(6)

IPP

F la

unch

es P

lann

ed

Par

enth

ood

- Wom

en's

D

evel

opm

ent,

a m

ajor

pro

gram

to

inte

grat

e fa

mily

pla

nnin

g ed

ucat

ion

and

serv

ices

with

ot

her p

roje

cts

to im

prov

e th

e st

atus

of w

omen

. (3)

Ebo

la b

reak

s ou

t in

Zaire

(3

18 h

uman

). Th

is w

as th

e fir

st re

cogn

ition

of t

he

dise

ase.

Ano

ther

out

brea

k oc

curs

in S

udan

(284

hu

man

cas

es).

(27)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

73

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1977

The

Sub

-Com

mitt

ee o

n N

utrit

ion

is e

stab

lishe

d as

re

com

men

ded

by th

e U

N’s

A

dmin

istra

tive

Com

mitt

ee o

n C

oord

inat

ion

(AC

C),

com

pris

ed o

f the

hea

ds o

f th

e U

N A

genc

ies.

Its

man

date

is to

pro

mot

e co

oper

atio

n am

ong

UN

ag

enci

es a

nd o

ther

par

tner

s to

elim

inat

e m

alnu

tritio

n.

(28)

US

AID

sup

ports

cre

atio

n of

C

ontra

cept

ive

Pre

vale

nce

Sur

veys

, a s

urve

y pr

ogra

m

mor

e fo

cuse

d th

at th

e W

FS,

desi

gned

to q

uick

ly p

rovi

de

basi

c in

dica

tors

on

fam

ily

plan

ning

and

ferti

lity.

(21)

The

Roc

kefe

ller F

ound

atio

n cr

eate

s an

inte

rnat

iona

l ne

twor

k of

bio

med

ical

rese

arch

gr

oups

to s

tudy

the

“gre

at

negl

ecte

d di

seas

es” o

f the

de

velo

ping

wor

ld, i

nclu

ding

sl

eepi

ng s

ickn

ess,

lepr

osy,

m

alar

ia, s

chis

toso

mia

sis,

ho

okw

orm

, riv

er b

lindn

ess,

and

ch

ildho

od d

iarrh

ea. (

29)

Test

ing

of th

e Tr

ials

of

Impr

oved

Pra

ctic

es (T

IPS)

ap

proa

ch d

evel

oped

by

the

Man

off G

roup

is te

sted

in a

W

orld

Ban

k N

utrit

ion

Com

mun

icat

ion

Beh

avio

r C

hang

e (N

CB

C) p

roje

ct in

In

done

sia.

(14)

1978

At t

he In

tern

atio

nal

Con

fere

nce

on P

rimar

y H

ealth

Car

e (P

HC

) in

Alm

a-A

ta, t

he c

once

pt o

f Prim

ary

Hea

lth C

are

as a

stra

tegy

to

reac

h th

e go

al o

f Hea

lth fo

r A

ll in

200

0 is

def

ined

and

gr

ante

d in

tern

atio

nal

reco

gniti

on. (

30)

The

Asi

an D

evel

opm

ent B

ank

begi

ns le

ndin

g an

d pr

ovid

ing

tech

nica

l ass

ista

nce

in th

e he

alth

sec

tor.

(31)

The

first

out

brea

k of

tu

berc

ulos

is re

sist

ance

to

form

erly

effe

ctiv

e dr

ugs

is

repo

rted

in M

issi

ssip

pi. (

32)

1980

UN

FPA

bec

omes

full

mem

ber o

f the

A

dmin

istra

tive

Com

mitt

ee o

n C

oord

inat

ion

(AC

C),

whi

ch

brin

gs to

geth

er th

e ex

ecut

ive

head

s of

all

UN

or

gani

zatio

ns to

coo

rdin

ate

the

wor

k of

the

UN

sys

tem

. (1

5)

The

Roc

kefe

ller F

ound

atio

n la

unch

es th

e In

tern

atio

nal

Clin

ical

Epi

dem

iolo

gy N

etw

ork

(INC

LEN

) to

esta

blis

h ce

nter

s at

40

med

ical

sch

ools

in 1

8 de

velo

ping

cou

ntrie

s, to

trai

n ph

ysic

ians

to c

ondu

ct re

sear

ch

on s

erio

us h

ealth

pro

blem

s in

th

eir c

ount

ries.

The

obj

ectiv

e of

INC

LEN

is to

dev

elop

mor

e co

st-e

ffect

ive

heal

th p

olic

ies.

(2

9)

PS

I beg

ins

to m

arke

t ora

l re

hydr

atio

n sa

lts. (

17)

The

Pop

ulat

ion

Cou

ncil

laun

ches

infa

nt fe

edin

g pr

actic

es s

tudi

es in

Col

ombi

a,

Indo

nesi

a, K

enya

, and

Th

aila

nd. (

6)

Chi

na a

nnou

nces

its

"One

C

hild

Fam

ily" p

olic

y. (3

)

WH

O a

nnou

nces

er

adic

atio

n of

sm

allp

ox. (

16)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

74

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1981

1981

-199

0 is

dec

lare

d as

th

e In

tern

atio

nal D

rinki

ng

and

Wat

er S

uppl

y an

d S

anita

tion

Dec

ade.

Dur

ing

this

dec

ade,

an

addi

tiona

l 1.

2 bi

llion

peop

le g

aine

d ac

cess

to s

afe

wat

er a

nd

appr

oxim

atel

y 77

0 m

illion

ga

ined

acc

ess

to a

dequ

ate

sani

tatio

n. (2

6)

Pop

ulat

ion

Cou

ncil

begi

ns

oper

atio

ns re

sear

ch in

Asi

a.

(6)

IPPF

, UN

FPA

and

the

Pop

ulat

ion

Cou

ncil

hold

the

"Fam

ily P

lann

ing

in th

e 80

s"

conf

eren

ce in

Jak

arta

, In

done

sia.

It is

the

first

wor

ld

conf

eren

ce o

n th

e su

bjec

t to

be jo

intly

spo

nsor

ed b

y th

e th

ree

maj

or o

rgan

izat

ions

. (3)

Wor

ld p

opul

atio

n pa

sses

4.

5 bi

llion

. (8)

Fi

rst r

epor

ted

case

of g

ay-

rela

ted

imm

unod

efic

ienc

y di

seas

e (G

RID

) in

Fran

ce.

(16)

S

cien

tists

iden

tify

Acq

uire

d Im

mun

e D

efic

ienc

y S

yndr

ome

(AID

S).

(16)

1982

UN

ICEF

laun

ches

its

Chi

ld

Sur

viva

l and

Dev

elop

men

t R

evol

utio

n (C

SDR

), in

trodu

cing

GO

BI,

the

acro

nym

for i

ts fo

ur b

asic

pr

ogra

m c

ompo

nent

s:

grow

th m

onito

ring,

ora

l de

hydr

atio

n, b

reas

t-fee

ding

an

d im

mun

izat

ion.

(26)

IPP

F pu

blis

hes

a co

untry

-by

coun

try a

naly

sis

of g

over

nmen

t po

licie

s on

ferti

lity

and

fam

ily

plan

ning

whi

ch s

how

s th

at 8

6 co

untri

es a

ctiv

ely

supp

ort t

he

prov

isio

n of

fam

ily p

lann

ing

info

rmat

ion

and

serv

ices

. (3)

Latin

Am

eric

an d

ebt c

risis

be

gins

whe

n M

exic

o de

faul

ts o

n in

tern

atio

nal

debt

. (1)

1984

The

Inte

rnat

iona

l C

onfe

renc

e on

Pop

ulat

ion

expa

nds

the

Wor

ld

Pop

ulat

ion

Plan

of A

ctio

n.

The

hum

an ri

ghts

of

indi

vidu

als

and

fam

ilies

, co

nditi

ons

of h

ealth

and

w

ell-b

eing

, em

ploy

men

t and

ed

ucat

ion

are

amon

g ke

y is

sues

hig

hlig

hted

in th

e D

ecla

ratio

n si

gned

at t

he

Con

fere

nce.

Oth

er

sign

ifica

nt is

sues

are

the

inte

nsifi

catio

n of

in

tern

atio

nal c

oope

ratio

n an

d th

e pu

rsui

t of g

reat

er

effic

ienc

y in

ado

ptin

g po

licy

deci

sion

s re

latin

g to

po

pula

tion.

(9)

The

"Mex

ico

City

pol

icy"

is

anno

unce

d by

US

Pre

side

nt

Rea

gan.

It p

rohi

bits

non

- U.S

., no

ngov

ernm

enta

l or

gani

zatio

ns re

ceiv

ing

US

AID

fa

mily

pla

nnin

g as

sist

ance

fu

ndin

g (e

ither

dire

ctly

or

thro

ugh

sub-

awar

ds) f

rom

us

ing

thei

r ow

n or

oth

er n

on-

US

AID

fund

s to

pro

vide

or

prom

ote

abor

tion

as a

fam

ily

plan

ning

met

hod

(incl

udin

g su

ppor

t to

IPP

F). (

11)

US

AID

-spo

nsor

ed W

FS h

as

cond

ucte

d su

rvey

s of

ferti

lity,

fa

mily

pla

nnin

g, a

nd in

fant

and

ch

ild m

orta

lity

in m

ore

than

60

coun

tries

. US

AID

laun

ches

the

Dem

ogra

phic

and

Hea

lth

Sur

vey

(DH

S) p

roje

ct. I

t co

mbi

nes

the

qual

ities

of t

he

WFS

and

the

CP

S a

nd a

dds

impo

rtant

que

stio

ns o

n m

ater

nal a

nd c

hild

hea

lth a

nd

nutri

tion.

(21)

The

Ford

Fou

ndat

ion

requ

ests

a

revi

ew o

f its

wor

k in

po

pula

tion.

Thr

ee s

trate

gic

area

s fo

r the

futu

re a

re

outli

ned:

(1) e

ncou

ragi

ng

smal

ler f

amilie

s by

con

trolli

ng

infa

nt m

orta

lity

and

prov

idin

g op

portu

nitie

s fo

r wom

en; (

2)

enha

ncin

g th

e ef

fect

iven

ess

of

fam

ily-p

lann

ing

prog

ram

s; a

nd

(3) e

ncou

ragi

ng le

ader

s to

su

ppor

t effo

rts to

redu

ce

popu

latio

n gr

owth

. (5)

S

ave

the

Chi

ldre

n be

gins

co

mpr

ehen

sive

chi

ld s

urvi

val

prog

ram

s in

Ban

glad

esh,

E

cuad

or, I

ndon

esia

, Zim

babw

e an

d B

oliv

ia. (

33)

The

Pop

ulat

ion

Cou

ncil's

C

oppe

r T 3

80A

, now

kno

wn

as

Par

aGar

d, is

app

rove

d by

the

US

Foo

d an

d D

rug

Adm

inis

tratio

n (6

) O

XFA

M la

unch

es th

e H

ungr

y fo

r Cha

nge

cam

paig

n. (3

4)

The

Roc

kefe

ller F

ound

atio

n,

UN

DP,

UN

ICEF

, WH

O a

nd

Wor

ld B

ank

esta

blis

h th

e Ta

sk

Forc

e fo

r Chi

ld S

urvi

val a

nd

Dev

elop

men

t, a

cam

paig

n to

ac

hiev

e th

e go

al o

f uni

vers

al

child

imm

uniz

atio

n by

199

0.

(27)

Fam

ine

beco

mes

acu

te in

E

thio

pia

lead

ing

to

wor

ldw

ide

fund

rais

ing

effo

rts. (

1)

Am

eric

an a

nd F

renc

h m

edic

al re

sear

ch te

ams

inde

pend

ently

dis

cove

r HIV

, th

e vi

rus

belie

ved

to c

ause

A

IDS

. (16

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

75

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1985

At a

cer

emon

y to

co

mm

emor

ate

the

UN

's

forti

eth

anni

vers

ary,

nat

ions

re

com

mit

to a

chie

ving

ta

rget

s fo

r Uni

vers

al C

hild

Im

mun

izat

ion

(UC

I) by

199

0.

(Nov

embe

r) (2

7)

WH

O a

nnou

nces

that

AID

S ha

s re

ache

d ep

idem

ic

prop

ortio

ns. (

3)

PA

HO

laun

ches

an

initi

ativ

e to

era

dica

te p

olio

in th

e A

mer

icas

by

1990

. (35

)

The

Roc

kefe

ller F

ound

atio

n un

derta

kes

a gr

ants

pro

gram

to

hel

p A

frica

n, A

sian

, and

La

tin A

mer

ican

sci

entis

ts

colla

bora

te o

n bi

omed

ical

re

sear

ch re

latin

g to

the

use

of

cont

race

ptiv

es. (

29)

Rot

ary

Inte

rnat

iona

l es

tabl

ishe

s P

olio

Plu

s P

rogr

am.

(35)

IPP

F an

d U

NIC

EF

reac

h an

ag

reem

ent t

o co

llabo

rate

and

de

velo

p ac

tiviti

es li

nkin

g fa

mily

pl

anni

ng a

nd c

hild

sur

viva

l. (3

)

1986

The

Car

ter C

ente

r beg

ins

to

prov

ide

tech

nica

l and

fina

ncia

l as

sist

ance

to n

atio

nal G

uine

a w

orm

era

dica

tion

prog

ram

s.

(36)

IP

PF

esta

blis

hes

an A

IDS

Pre

vent

ion

Uni

t and

dev

elop

s gu

idel

ines

for F

amily

Pla

nnin

g A

ssoc

iatio

ns to

pro

mot

e in

form

atio

n, e

duca

tion,

and

co

ndom

use

. (3)

1987

Sev

eral

impo

rtant

eve

nts

posi

tione

d A

IDS

as a

hig

h-pr

iorit

y on

the

inte

rnat

iona

l ag

enda

. Th

is in

clud

es: t

he

esta

blis

hmen

t of t

he W

HO

-G

loba

l Pro

gram

AID

S;

deba

te o

n A

IDS

at th

e U

N

Gen

eral

Ass

embl

y; a

nd th

e W

orld

Hea

lth A

ssem

bly'

s ap

prov

al o

f a "G

loba

l S

trate

gy fo

r the

Pre

vent

ion

and

Con

trol o

f AID

S."

(37)

Th

e B

amak

o In

itiat

ive

is

prom

oted

by

UN

ICE

F an

d W

HO

and

ado

pted

by

Afri

can

heal

th m

inis

ters

to

Incr

ease

the

avai

labi

lity

of

The

Afri

can

Dev

elop

men

t B

ank'

s fir

st h

ealth

sec

tor p

olic

y gu

idel

ines

pre

pare

d. It

pr

iorit

izes

: hea

lth s

ervi

ce

man

agem

ent a

nd p

lann

ing,

he

alth

man

pow

er p

lann

ing,

co

ntro

l of c

omm

unic

able

di

seas

es, p

rocu

rem

ent a

nd

dist

ribut

ion

of e

ssen

tial d

rugs

, he

alth

car

e de

liver

y, a

nd

popu

latio

n an

d nu

tritio

n. It

em

phas

izes

the

impo

rtanc

e of

pr

ovid

ing

train

ing

and

tech

nica

l as

sist

ance

to a

dmin

istra

tors

to

impr

ove

plan

ning

and

m

anag

emen

t cap

abili

ties

of

heal

th p

rogr

ams.

(24)

Rot

ary

Inte

rnat

iona

l lau

nche

s a

cam

paig

n to

rais

e U

S $

120

mill

ion

to fi

ght p

olio

whi

ch

prov

ides

the

nece

ssar

y im

petu

s to

beg

in th

e po

lio

erad

icat

ion

initi

ativ

e. (3

3)

DK

T In

tern

atio

nal,

a so

cial

m

arke

ting

orga

niza

tion,

is

inco

rpor

ated

. (40

)

IPP

F, th

e Po

pula

tion

Cou

ncil,

U

NIC

EF),

WH

O, U

NFP

A sp

onso

r an

inte

rnat

iona

l co

nfer

ence

on

Bette

r Hea

lth

for W

omen

and

Chi

ldre

n th

roug

h Fa

mily

Pla

nnin

g (6

)

W

orld

pop

ulat

ion

pass

es 5

bi

llion

. (8)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

76

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1987

reso

urce

s fo

r ess

entia

l dr

ugs.

The

initi

ativ

e pr

opos

es d

ecen

traliz

atio

n,

natio

nal d

rug

polic

ies

and

prov

isio

n of

ess

entia

l dru

gs.

It al

so a

dvoc

ates

a

com

bina

tion

of fi

nanc

ing

depe

ndin

g on

the

coun

try

cont

ext,

and

stre

sses

the

need

for c

omm

unity

and

in

divi

dual

par

ticip

atio

n in

he

alth

pla

nnin

g. (3

8)

The

Saf

e M

othe

rhoo

d In

ter-

Age

ncy

Gro

up s

pons

ors

the

first

inte

rnat

iona

l Saf

e M

othe

rhoo

d C

onfe

renc

e in

N

airo

bi, K

enya

to d

raw

at

tent

ion

to th

e di

men

sion

s an

d co

nseq

uenc

es o

f poo

r m

ater

nal h

ealth

in

deve

lopi

ng c

ount

ries

and

to

mob

ilize

act

ion

to a

ddre

ss

high

rate

s of

mat

erna

l dea

th

and

illne

ss. (

39)

1988

The

Wor

ld H

ealth

Ass

embl

y pa

sses

a re

solu

tion

to

erad

icat

e po

lio b

y th

e ye

ar

2000

. (35

) Th

e G

loba

l Pol

io E

radi

catio

n In

itiat

ive

is la

unch

ed b

y th

e W

HO

, Rot

ary

Inte

rnat

iona

l, U

.S. C

ente

rs fo

r Dis

ease

C

ontro

l and

Pre

vent

ion,

and

U

NIC

EF. (

35)

Hiir

oshi

Nak

ajim

a (J

apan

) be

com

es W

HO

Dire

ctor

-G

ener

al. (

2)

IPP

F se

ts ta

rget

that

450

m

illion

cou

ples

will

be a

ble

to

use

fam

ily p

lann

ing

by th

e ye

ar

2000

. (3)

P

SI p

ione

ers

cond

om s

ocia

l m

arke

ting

for H

IV p

reve

ntio

n in

Za

ire (n

ow th

e D

emoc

ratic

R

epub

lic o

f Con

go),

alon

g w

ith

a co

mpl

emen

tary

mas

s m

edia

ca

mpa

ign

that

pro

mot

ed

abst

inen

ce, f

idel

ity a

nd c

orre

ct

and

cons

iste

nt c

ondo

m u

se.

(17)

Fr

eedo

m fr

om H

unge

r la

unch

es it

s fir

st C

redi

t with

E

duca

tion

prog

ram

in W

est

Afri

ca. I

t com

bine

s m

icro

cred

it lo

ans

to v

ery

poor

wom

en w

ith

vita

l hea

lth a

nd b

usin

ess

educ

atio

n. (4

1)

The

Roc

kefe

ller F

ound

atio

n in

augu

rate

s a

tropi

cal d

isea

se

rese

arch

pro

gram

in

The

Fren

ch M

inis

ter o

f H

ealth

ord

ers

the

new

ab

ortio

n pi

ll, R

U-4

86, b

ack

on th

e m

arke

t whe

n m

anuf

actu

rers

thre

aten

to

with

draw

it. H

e ca

lls it

"the

m

oral

pro

perty

of w

omen

". (3

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

77

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1988

coop

erat

ion

with

the

Wor

ld

Hea

lth O

rgan

izat

ion.

(29)

C

arte

r Cen

ter f

orm

s Th

e In

tern

atio

nal T

ask

Forc

e fo

r D

isea

se E

radi

catio

n to

ev

alua

te d

isea

se c

ontro

l and

pr

even

tion

and

the

pote

ntia

l for

er

adic

atin

g in

fect

ious

di

seas

es. (

36)

1989

U

N G

ener

al A

ssem

bly

adop

ts th

e C

onve

ntio

n on

th

e R

ight

s of

the

Chi

ld. (

26)

The

Ber

lin W

all f

alls

and

sy

mbo

lizes

the

end

of th

e C

old

War

. (N

ovem

ber)

(19)

P

olio

out

brea

ks in

Chi

na.

(35)

1990

UN

ICE

F pr

esen

ts a

n in

itiat

ive

to im

prov

e th

e St

ate

of th

e W

orld

's C

hild

ren

at

the

Wor

ld S

umm

it fo

r C

hild

ren.

At t

he S

umm

it, th

e in

ters

ecto

ral n

atur

e of

ef

fect

ive

nutri

tion

stra

tegi

es

was

hig

hlig

hted

and

A

Dec

lara

tion

on th

e S

urvi

val,

Pro

tect

ion

and

Dev

elop

men

t of

Chi

ldre

n an

d P

lan

of

Act

ion

esta

blis

h sp

ecifi

c qu

antit

ativ

e nu

tritio

n go

als

to

be a

chie

ved

by 2

000.

(26)

U

ND

P's

first

Hum

an

Dev

elop

men

t Rep

ort

decl

ares

"hum

an b

eing

s to

be

bot

h th

e m

eans

and

end

s of

dev

elop

men

t." (2

6)

Sav

e th

e C

hild

ren

esta

blis

hes

its W

omen

/Chi

ld Im

pact

(WC

I) as

the

uniti

ng p

rogr

am

fram

ewor

k fo

r its

inte

rnat

iona

l pr

ogra

ms.

WC

I em

phas

izes

th

at e

mpo

wer

ing

wom

en is

key

to

impr

ovin

g th

e w

ell-b

eing

of

child

ren

(33)

D

KT

Inte

rnat

iona

l bec

omes

ac

tive

in s

ocia

l mar

ketin

g pr

ojec

ts in

Eth

iopi

a an

d th

e P

hilip

pine

s. (4

0)

Orn

idyl

, a n

ew d

rug

treat

men

t for

Afri

can

slee

ping

sic

knes

s, is

ap

prov

ed b

y W

HO

. (16

) 80

% c

hild

hood

im

mun

izat

ion

wor

ldw

ide

is

reac

hed.

(35)

G

erm

any

is re

unite

d. (1

9)

1991

Inte

rnat

iona

l Mee

ting

of

Par

tner

s fo

r Saf

e M

othe

rhoo

d in

Was

hing

ton,

D

C. (

42)

Roc

kefe

ller F

ound

atio

n,

UN

DP,

UN

ICEF

, WH

O, a

nd

the

Wor

ld B

ank

form

the

The

Sov

iet U

nion

offi

cial

ly

ceas

es to

exi

st. (

Dec

embe

r) (1

9)

The

last

indi

geno

us c

ase

of

polo

occ

urs

in th

e A

mer

icas

in

Nor

ther

n P

eru.

(35)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

78

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1991

Chi

ldre

n’s

Vac

cine

Initi

ativ

e (C

VI)

to p

rote

ct th

e w

orld

’s

child

ren

agai

nst v

iral a

nd

bact

eria

l dis

ease

s. C

VI’s

go

al is

to v

acci

nate

eve

ry

child

in th

e w

orld

aga

inst

th

ese

com

mon

, pre

vent

able

ch

ildho

od il

lnes

ses.

(29)

1992

At t

he In

tern

atio

nal

Con

fere

nce

on N

utrit

ion

in

Rom

e Th

e W

orld

D

ecla

ratio

n on

Nut

ritio

n an

d P

lan

of A

ctio

n fo

r Nut

ritio

n,

whi

ch s

erve

s as

a g

uide

to

the

tech

nica

l iss

ues

of

nutri

tion

polic

y an

d pr

ogra

mm

ed d

evel

opm

ent,

is a

nnou

nced

. (D

ecem

ber)

(42)

The

Roc

kefe

ller F

ound

atio

n's

Pop

ulat

ion

Scie

nces

pro

gram

in

itiat

es a

10-

year

pro

gram

that

ai

ms

to m

ake

qual

ity fa

mily

pl

anni

ng a

nd re

prod

uctiv

e he

alth

ava

ilabl

e to

eve

ry

coup

le in

the

wor

ld w

ho w

ants

it.

(29)

M

icro

nutri

ent I

nitia

tive

esta

blis

hed

at th

e In

tern

atio

nal

Dev

elop

men

t Res

earc

h C

entre

to

initi

ate

and

sust

ain

conc

erte

d in

tern

atio

nal e

fforts

to

elim

inat

e m

icro

nutri

ent

mal

nutri

tion.

(43)

P

opul

atio

n C

ounc

il la

unch

es

the

Exp

andi

ng C

ontra

cept

ive

Cho

ice

prog

ram

(6)

The

fem

ale

cond

om

beco

mes

ava

ilabl

e. (3

)

1993

US

Pre

side

nt C

linto

n re

scin

ds

the

Mex

ico

City

pol

icy.

US

AID

an

d its

coo

pera

ting

agen

cies

sp

earh

ead

Max

imiz

ing

Acce

ss

and

Qua

lity

(MA

Q),

an in

itiat

ive

to im

prov

e re

prod

uctiv

e he

alth

se

rvic

e de

liver

y an

d be

tter

serv

e cl

ient

s. (1

1)

Sav

e th

e C

hild

ren

laun

ches

a

10-y

ear p

lan

to li

nk

com

mun

ity-b

ased

app

roac

hes

with

nat

iona

l and

glo

bal

prog

ram

s fo

r chi

ldre

n in

nee

d.

(33)

IP

PF

deve

lops

a p

oste

r, Th

e R

ight

s of

Clie

nts,

to b

e di

spla

yed

in c

linic

s an

d in

form

cl

ient

s of

thei

r rig

hts

to

info

rmat

ion,

acc

ess,

cho

ice,

sa

fety

, priv

acy,

con

fiden

tialit

y,

dign

ity, c

omfo

rt, c

ontin

uity

and

op

inio

n. (3

)

Wor

ld p

opul

atio

n pa

sses

5.

5 bi

llion

. (8)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

79

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1994

Inte

rnat

iona

l Con

fere

nce

on

Pop

ulat

ion

and

Dev

elop

men

t (IC

PD

) in

Cai

ro. I

ts p

rogr

am

of a

ctio

n w

hich

end

orse

s re

prod

uctiv

e he

alth

as

a hu

man

righ

t, ad

voca

tes

prov

isio

n of

a p

acka

ge o

f se

rvic

es to

mee

t re

prod

uctiv

e he

alth

nee

ds,

and

draw

s a

conn

ectio

n be

twee

n re

prod

uctiv

e he

alth

, rig

hts

and

othe

r de

velo

pmen

t iss

ues.

(42

) U

NFP

A na

med

lead

UN

or

gani

zatio

n to

follo

w-u

p an

d im

plem

ent t

he IC

PD's

P

rogr

am o

f Act

ion.

(44)

W

FP's

gov

erni

ng b

ody

adop

ts a

Mis

sion

Sta

tem

ent

whi

ch d

ecla

res

its u

ltim

ate

obje

ctiv

e as

elim

inat

ing

the

need

for f

ood

aid.

It

reco

gniz

es th

at fo

od a

id is

on

ly o

ne w

ay to

pro

mot

e fo

od s

ecur

ity a

nd th

at it

sh

ould

be

used

to s

uppo

rt ec

onom

ic a

nd s

ocia

l de

velo

pmen

t. It

prio

ritiz

es

targ

eted

inte

rven

tions

for t

he

poor

est a

nd e

stab

lishe

s th

at

WFP

will

con

cent

rate

in it

s ar

eas

of c

ompa

rativ

e ad

vant

age

on th

e as

pect

s of

de

velo

pmen

t to

whi

ch fo

od

aid

inte

rven

tions

are

the

mos

t use

ful.

(Dec

embe

r) (1

0)

US

AID

rele

ases

"Stra

tegi

es fo

r S

usta

inab

le D

evel

opm

ent"

that

fo

rmul

ates

the

Age

ncy'

s co

mpr

ehen

sive

app

roac

h to

fig

htin

g H

IV/A

IDS.

The

five

pr

iorit

y ar

eas

are:

(1)

envi

ronm

enta

l pro

tect

ion;

(2)

dem

ocra

cy b

uild

ing;

(3)

stab

ilizi

ng p

opul

atio

n gr

owth

an

d pr

otec

ting

hum

an h

ealth

; (4

) pro

mot

e br

oad-

base

d ec

onom

ic g

row

th; a

nd (5

) pr

ovid

e hu

man

itaria

n as

sist

ance

and

aid

pos

t-co

nflic

t tra

nsiti

ons.

(Mar

ch)

(45)

D

AN

IDA

dec

lare

s po

pula

tion

as o

ne o

f thr

ee p

riorit

y th

emat

ic a

reas

in it

s st

rate

gy

for d

evel

opm

ent p

olic

y to

war

ds

2000

. (46

) Th

e A

sian

Dev

elop

men

t Ban

k re

leas

es a

pop

ulat

ion

stra

tegy

to

incr

ease

ass

ista

nce

to li

mit

popu

latio

n gr

owth

and

hel

p co

untri

es to

dea

l with

the

basi

c ne

eds

of g

row

ing

popu

latio

ns.

The

stra

tegy

invo

lves

thre

e m

ain

actio

n ar

eas:

(1)

impr

ovin

g op

portu

nitie

s fo

r and

th

e st

atus

of w

omen

; (2)

pr

otec

ting

repr

oduc

tive

right

s an

d he

alth

; and

(3) e

nsur

ing

equi

tabl

e ac

cess

to fa

mily

pl

anni

ng. (

31)

Bill

and

Mel

inda

Gat

es

cons

olid

ate

thei

r giv

ing

to

addr

ess

two

mai

n in

itiat

ives

: G

loba

l Hea

lth a

nd c

omm

unity

ne

eds

in th

e P

acifi

c N

orth

wes

t. (4

7)

Chi

na la

unch

es it

s fir

st

Nat

iona

l Im

mun

izat

ion

Day

s,

imm

uniz

ing

80 m

illion

chi

ldre

n.

(35)

Mex

ican

fina

ncia

l cris

is

send

s sh

ockw

aves

th

roug

hout

Lat

in A

mer

ica.

(1

7)

Am

eric

as a

re c

ertif

ied

polio

-fre

e. (3

5)

1995

Four

th W

orld

Con

fere

nce

on

Wom

en (F

WC

W) i

n B

eijin

g fo

cuse

s on

eco

nom

ic a

nd

soci

al is

sues

affe

ctin

g w

omen

's p

artic

ipat

ion

in c

ivil

soci

ety,

em

phas

izin

g lin

ks

betw

een

the

stat

us o

f w

omen

and

thei

r pop

ulat

ion

and

repr

oduc

tive

heal

th

outc

omes

. (44

)

IPP

F la

unch

es T

he C

harte

r on

Sex

ual a

nd R

epro

duct

ive

Rig

hts,

its

Bill

of R

ight

s, w

hich

id

entif

ies

12 k

ey a

reas

bas

ed

on re

cogn

ized

inte

rnat

iona

l hu

man

righ

ts la

w w

ith

addi

tiona

l rig

hts

that

IPP

F be

lieve

s ar

e im

plie

d by

them

. (3

)

The

Afri

can

Pro

gram

for

Onc

hoce

rsia

sis

Con

trol

(AP

OC

), a

join

t int

erna

tiona

l pa

rtner

ship

pro

gram

of

gove

rnm

ents

, non

-go

vern

men

tal o

rgan

izat

ions

, bi

late

ral d

onor

s an

d in

tern

atio

nal a

genc

ies,

is

laun

ched

at c

erem

onie

s in

W

ashi

ngto

n. A

POC

was

Indi

a or

gani

zes

its fi

rst

Nat

iona

l Im

mun

izat

ion

Day

s,

imm

uniz

ing

87 m

illion

chi

ldre

n.

(35)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

80

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1995

At t

he W

orld

Sum

mit

for

Soc

ial D

evel

opm

ent (

WSS

D)

in C

open

hage

n, le

ader

s re

ach

cons

ensu

s on

the

impo

rtanc

e of

pos

ition

ing

peop

le a

s ce

ntra

l in

deve

lopm

ent.

UN

DP,

U

NES

CO

, UN

FPA,

UN

ICEF

an

d W

HO

bac

k th

e 20

/20

initi

ativ

e to

gen

erat

e re

sour

ces

to e

nsur

e ac

cess

to

bas

ic s

ocia

l ser

vice

s fo

r al

l by

the

end

of th

e ce

ntur

y.

(Mar

ch) (

26)

UN

Adm

inis

trativ

e C

omm

ittee

on

Coo

rdin

atio

n es

tabl

ishe

s th

e Ta

sk F

orce

on

Bas

ic S

ocia

l Ser

vice

s fo

r A

ll (B

SSA

) to

coor

dina

te a

U

N s

yste

m re

spon

se to

the

reco

mm

enda

tions

from

re

cent

con

fere

nces

. (O

ctob

er) (

42)

With

Roc

kefe

ller F

ound

atio

n fu

ndin

g, th

e P

opul

atio

n C

ounc

il es

tabl

ishe

s th

e A

frica

n P

opul

atio

n an

d H

ealth

R

esea

rch

Cen

ter.

(6)

PS

I lau

nche

s m

ater

nal a

nd

child

hea

lth p

rodu

cts,

and

in

sect

icid

e-tre

ated

mos

quito

ne

ts fo

r mal

aria

pre

vent

ion.

(1

7)

mod

eled

on

the

orig

inal

hig

hly-

succ

essf

ul O

ncho

cers

iasi

s C

ontro

l Pro

gram

whi

ch w

as

star

ted

in 1

974.

APO

C b

egan

w

ork

in s

ixte

en A

frica

n co

untri

es, u

sing

a d

rug

treat

men

t don

ated

by

Mer

ck &

C

o. (D

ecem

ber)

(16)

Ebo

la o

utbr

eak

in

Dem

ocra

tic R

epub

lic o

f C

ongo

(315

hum

an c

ases

). (2

7)

1996

Wor

ld F

ood

Sum

mit

in R

ome

emph

asiz

es th

e ne

ed to

fo

cus

polic

ies

in fi

ve

inte

rsec

tora

l are

as in

ord

er

to a

ddre

ss m

alnu

tritio

n an

d im

plem

ent e

ffect

ive

polic

ies.

Th

e R

ome

Dec

lara

tion

on

Wor

ld F

ood

Sec

urity

is

adop

ted

whi

ch d

ecla

res

acce

ss to

food

as

a ba

sic

right

and

set

s th

e ta

rget

of

redu

cing

the

num

ber o

f the

w

orld

's u

nder

nour

ishe

d in

ha

lf by

201

5. (4

2)

Six

co-

spon

sors

(UN

DP

, U

NES

CO

, UN

FPA,

UN

ICEF

, W

orld

Ban

k an

d W

HO

) es

tabl

ish

the

Join

t UN

P

rogr

am o

n H

IV/A

IDS

(U

NAI

DS)

(37)

Afri

can

Dev

elop

men

t Ban

k re

leas

es a

revi

sed

heal

th

sect

or s

trate

gy to

bet

ter

addr

ess

chal

leng

es, i

nclu

ding

H

IV/A

IDS

, and

em

phas

ize

the

impo

rtanc

e of

inst

itutio

n st

reng

then

ing.

(24)

Th

e B

oard

of E

xecu

tive

Dire

ctor

s at

the

Inte

r-A

mer

ican

D

evel

opm

ent B

ank

appr

oves

a

stra

tegy

to s

uppo

rt he

alth

re

form

to im

prov

e th

e ef

ficie

ncy

of h

ealth

inst

itutio

ns

in L

atin

Am

eric

a an

d th

e C

arib

bean

. (50

)

The

Roc

kefe

ller F

ound

atio

n co

nven

es e

xper

ts in

HIV

/AID

S

to e

xplo

re th

e fe

asib

ility

of

brin

ging

toge

ther

indu

stry

, ph

ilant

hrop

y, d

evel

opm

ent a

nd

heal

th a

genc

ies

to c

olla

bora

te

in fi

ndin

g an

AID

S va

ccin

e th

at

wou

ld b

e af

ford

able

and

av

aila

ble

thro

ugho

ut th

e w

orld

. (2

9)

IPP

F an

d th

e B

BC

pio

neer

an

educ

atio

nal b

road

cast

ing

proj

ect,

The

Sex

wis

e ra

dio

serie

s an

d bo

oks,

pro

duce

d an

d w

ritte

n in

11

lang

uage

s,

reac

h ov

er 6

0 m

illio

n lis

tene

rs

in A

frica

, the

Ara

b w

orld

, Lat

in

Am

eric

a, S

outh

Eas

t Asi

a an

d C

hina

. (3)

The

Inte

rnat

iona

l AID

S

Vac

cine

Initi

ativ

e (IA

VI)

is

foun

ded

to e

nsur

e th

e de

velo

pmen

t HIV

vac

cine

s fo

r us

e th

roug

hout

the

wor

ld. I

t is

a gl

obal

not

-for-

prof

it, p

ublic

-pr

ivat

e pa

rtner

ship

that

re

sear

ches

and

dev

elop

s va

ccin

e ca

ndid

ates

, con

duct

s po

licy

anal

yses

, and

ser

ves

as

an a

dvoc

ate

for t

he fi

eld.

(52)

Th

e R

ocke

felle

r Fou

ndat

ion

and

the

Sw

eden

Inte

rnat

iona

l D

evel

opm

ent C

oope

ratio

n A

genc

y (S

IDA

) est

ablis

h th

e G

loba

l Hea

lth E

quity

Initi

ativ

e to

sup

port

rese

arch

, rai

se

awar

enes

s an

d bu

ild c

apac

ity

to a

ddre

ss h

ealth

ineq

ualit

ies.

(2

9)

Nel

son

Man

dela

offi

cial

ly

laun

ches

the

Kic

k P

olio

Out

of

Afri

ca c

ampa

ign.

(35)

In

resp

onse

to IC

PD C

airo

, the

In

dian

gov

ernm

ent i

ntro

duce

s a

targ

et-fr

ee a

ppro

ach

to

fam

ily p

lann

ing.

(12)

Res

ults

from

clin

ical

tria

ls

show

the

effe

ctiv

enes

s of

tri

ple-

antir

etro

vira

l the

rapy

fo

r AID

S. (1

6)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

81

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1996

Uni

ted

Nat

ions

Spe

cial

In

itiat

ive

for A

frica

is

laun

ched

by

UN

Sec

reta

ry

Gen

eral

Bou

tros

Bout

ros-

Gha

li, th

e he

ads

of s

ever

al

UN

age

ncie

s, a

nd P

resi

dent

W

olfe

nsoh

n. T

he n

ew

initi

ativ

e de

fines

an

expa

nded

pro

gram

of

assi

stan

ce to

Sub

-Sah

aran

A

frica

and

a p

artn

ersh

ip th

at

aim

s to

redu

ce th

e fra

gmen

tatio

n of

de

velo

pmen

t effo

rts a

mon

g do

nors

. (M

arch

) (48

) W

HO

and

UN

ICE

F pr

esen

t In

tegr

ated

Man

agem

ent o

f C

hild

hood

Illn

ess

(IMC

I) as

a

stra

tegy

to im

prov

e ch

ild

heal

th e

mph

asiz

ing

prev

entio

n an

d he

alth

pr

omot

ion.

(49)

The

Dan

ish

Min

istry

of F

orei

gn

Affa

irs a

nd W

orld

Ban

k co

-hos

t a

mee

ting

for d

onor

age

ncie

s in

Cop

enha

gen

to d

iscu

ss

sect

or-w

ide

appr

oach

es. A

t the

m

eetin

g th

e te

rm S

WA

p is

co

ined

, a S

WA

p gu

ide

is

com

mis

sion

ed, a

nd a

n In

ter-

Age

ncy

Gro

up o

n SW

Ap

is

form

ed. (

51)

1997

The

UN

Eco

nom

ic

Com

mis

sion

for A

frica

co

llabo

rate

s w

ith U

NIC

EF

and

the

Wor

ld B

ank

to

orga

nize

a c

onfe

renc

e on

co

st s

harin

g in

Add

is A

baba

. A

t the

For

um o

n C

ost

Sha

ring

in th

e S

ocia

l Sec

tors

of

Sub

-Sah

aran

Afri

ca, 1

5 pr

inci

ples

for c

ost s

harin

g in

he

alth

and

edu

catio

n ar

e ag

reed

upo

n at

the

conf

eren

ce. (

June

) (53

) U

NFP

A b

egin

s to

dev

elop

C

omm

on C

ount

ry

Ass

essm

ents

to p

inpo

int

criti

cal c

once

rns

and

chal

leng

es fa

cing

indi

vidu

al

coun

tries

. (15

)

DH

S is

fold

ed in

to U

SA

ID's

m

ulti-

proj

ect M

EAS

UR

E

prog

ram

as

ME

ASU

RE

DH

S+,

w

hich

inco

rpor

ates

trad

ition

al

DH

S fe

atur

es, e

xpan

ds th

e co

nten

t on

mat

erna

l and

chi

ld

heal

th a

nd a

dds

biom

arke

r te

stin

g to

num

erou

s su

rvey

s.

(21)

C

IDA'

s St

rate

gy fo

r Hea

lth s

ets

top

prio

ritie

s as

sup

porti

ng

sust

aina

ble

natio

nal h

ealth

sy

stem

s, a

nd im

prov

ing

wom

en's

hea

lth a

nd

repr

oduc

tive

heal

th. (

56)

IPP

F, re

pres

entin

g th

e In

ter

Age

ncy

Gro

up fo

r Saf

e M

othe

rhoo

d, h

osts

the

Tech

nica

l Con

sulta

tion

on S

afe

Mot

herh

ood

in S

ri La

nka.

At

the

Con

sulta

tion

a tw

o-ye

ar

cam

paig

n to

revi

taliz

e it

and

garn

er s

uppo

rt fro

m s

ecto

rs

outs

ide

the

heal

th c

omm

unity

is

laun

ched

. (3)

G

loba

l For

um o

n H

ealth

R

esea

rch

laun

ched

to d

irect

m

ore

fund

s fo

r hea

lth re

sear

ch

on is

sues

affe

ctin

g pe

ople

in

deve

lopi

ng c

ount

ries.

(58)

The

Eas

t Asi

an e

cono

mic

cr

isis

beg

ins.

(Jul

y) (3

7)

El N

ino

effe

ct p

rodu

ces

extre

me

wea

ther

con

ditio

ns.

(16)

O

ver 3

0 m

illion

peo

ple

wor

ldw

ide

are

livin

g w

ith

HIV

or A

IDS.

(3)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

82

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1998

WH

O e

stab

lishe

s th

e To

bacc

o Fr

ee In

itiat

ive

(TFI

) to

redu

ce th

e to

bacc

o-ca

used

glo

bal b

urde

n of

di

seas

e. (J

uly)

(54)

S

afe

Mot

herh

ood

Inte

r-A

genc

y G

roup

mee

ting

in

Was

hing

ton

decl

ares

a

wor

ld-w

ide

call

to a

ctio

n fo

r m

ater

nal h

ealth

. (Ap

ril) (

20)

Wor

ld B

ank,

WH

O, U

ND

P an

d U

NIC

EF

laun

ch R

oll

Bac

k M

alar

ia (R

BM

) P

artn

ersh

ip to

pro

vide

a

coor

dina

ted

glob

al a

ppro

ach

to h

alve

mal

aria

by

2010

. (5

5)

UN

FPA

and

IPP

F la

unch

the

Face

to F

ace

Cam

paig

n, a

th

ree-

year

cam

paig

n to

bui

ld

supp

ort f

or in

crea

sed

dom

estic

and

inte

rnat

iona

l fu

ndin

g fo

r ser

vice

s th

at w

ill

allo

w w

omen

aro

und

the

wor

ld to

exe

rcis

e th

eir b

asic

hu

man

righ

ts in

clud

ing,

and

in

par

ticul

ar, t

heir

repr

oduc

tive

right

s. (3

) G

ro H

arle

m B

runt

dlan

d (D

enm

ark)

bec

omes

WH

O

Dire

ctor

-Gen

eral

. (2)

The

Fren

ch D

evel

opm

ent

Age

ncy

beco

mes

invo

lved

in

the

heal

th s

ecto

r, fo

cusi

ng

prim

arily

on

HIV

/AID

S a

nd

cont

agio

us d

isea

ses.

(57)

S

ave

the

Chi

ldre

n is

nam

ed

lead

age

ncy

of P

VO/N

GO

N

etw

orks

for H

ealth

Pro

ject

, a

five

year

$51

milli

on U

SA

ID-

fund

ed in

tern

atio

nal

partn

ersh

ip s

uppo

rting

co

mpr

ehen

sive

hea

lth

prog

ram

s fo

r wom

en a

nd

child

ren.

(33)

UN

Fou

ndat

ion

crea

ted

and

anno

unce

s th

at it

s gr

ants

will

fo

cus

mai

nly

on c

hild

ren'

s he

alth

, wom

en a

nd p

opul

atio

n,

and

the

envi

ronm

ent.

(59)

Wor

ld B

ank

partn

ers

with

W

HO

and

Sm

ith K

line

Bee

cham

to in

itiat

e th

e C

oope

rativ

e P

rogr

am to

E

limin

ate

Ele

phan

tiasi

s by

di

strib

utin

g dr

ugs

free

of

char

ge to

gov

ernm

ents

and

co

llabo

ratin

g or

gani

zatio

ns.

(Jan

uary

) (20

)

Hur

rican

e M

itch

deva

stat

es

the

Car

ibbe

an C

oast

. (20

) In

Rus

sia,

the

rubl

e is

de

valu

ed a

nd in

tern

atio

nal

loan

s go

unp

aid;

it is

the

mos

t diff

icul

t eco

nom

ic y

ear

sinc

e th

e co

llaps

e of

the

Sov

iet U

nion

. (16

) A

sian

cur

renc

ies

and

stoc

k m

arke

ts c

ontin

ue to

plu

nge,

cr

eatin

g an

eco

nom

ic c

risis

fo

r the

con

tinen

t. (1

6)

1999

A s

peci

al s

essi

on o

f the

UN

G

ener

al A

ssem

bly,

the

ICP

D+5

, is

con

vene

d to

as

sess

the

prog

ress

ac

hiev

ed a

nd c

halle

nges

en

coun

tere

d in

impl

emen

ting

stra

tegi

es o

n po

pula

tion

and

deve

lopm

ent s

ince

the

Pro

gram

of A

ctio

n w

as

adop

ted

at th

e 19

94 IC

PD

. (J

une

- Jul

y) (9

)

Asi

an D

evel

opm

ent B

ank

rele

ases

a h

ealth

stra

tegy

. Its

ov

eral

l app

roac

h is

to a

ssis

t co

untri

es to

ens

ure

that

ci

tizen

s ha

ve b

road

acc

ess

to

basi

c pr

even

tive,

pro

mot

ive,

an

d cu

rativ

e se

rvic

es th

at a

re

cost

-effe

ctiv

e, e

ffica

ciou

s, a

nd

affo

rdab

le. T

he s

trate

gy

argu

ed th

at in

crea

sed

acce

ss

to b

asic

ser

vice

s w

ould

hav

e

MS

F la

unch

es c

ampa

ign

for

acce

ss to

ess

entia

l med

icin

es.

(20)

U

NF

anno

unce

s $5

1milli

on

inve

stm

ent i

n U

N p

rogr

ams

focu

sing

on

child

ren'

s he

alth

. (5

9)

Med

icin

es fo

r Mal

aria

Ven

ture

(M

MV

), a

publ

ic-p

rivat

e no

n-pr

ofit

partn

ersh

ip, i

s la

unch

ed.

It ai

ms

to b

ring

toge

ther

the

publ

ic, p

rivat

e an

d ph

ilant

hrop

ic s

ecto

rs to

fund

an

d m

anag

e th

e di

scov

ery,

de

velo

pmen

t and

regi

stra

tion

of n

ew m

edic

ines

to tr

eat a

nd

prev

ent m

alar

ia. (

Nov

embe

r)

(61)

W

TO p

rote

sts

in S

eattl

e.

(17)

W

orld

pop

ulat

ion

pass

es 6

bi

llion

. (8)

Ja

pan

appr

oves

the

oral

co

ntra

cept

ive

pill

afte

r al

mos

t 4 d

ecad

es. (

3)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

83

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

1999

The

Inte

rnat

iona

l B

ench

mar

king

Net

wor

k fo

r W

ater

and

San

itatio

n U

tiliti

es

(IBN

ET)

is in

itiat

ed b

y th

e W

orld

Ban

k (in

the

late

90s

). It

is th

e w

orld

’s la

rges

t da

taba

se fo

r wat

er a

nd

sani

tatio

n ut

ilitie

s pe

rform

ance

dat

a w

hich

al

low

s tra

ckin

g of

in

frast

ruct

ure

impr

ovem

ents

, an

d m

easu

res

the

effic

ienc

y of

ser

vice

del

iver

y fo

r wat

er

supp

ly a

nd s

anita

tion.

(6

0)

sign

ifica

nt im

pact

on

mor

bidi

ty

and

mor

talit

y in

the

shor

t to

med

ium

term

and

pro

vide

the

foun

datio

n fo

r mor

e co

mpr

ehen

sive

hea

lth s

ervi

ces

in th

e lo

ng te

rm. (

31)

Bill

and

Mel

inda

Gat

es

Foun

datio

n do

nate

s $8

.8

mill

ion

to IP

PF

for a

glo

bal

prog

ram

to im

prov

e th

e qu

ality

of

car

e in

sex

ual a

nd

repr

oduc

tive

heal

th s

ervi

ces.

(3

)

The

Pub

lic-P

rivat

e In

frast

ruct

ure

Adv

isor

y Fa

cilit

y (P

PIA

F) is

est

ablis

hed

to h

elp

deve

lopi

ng c

ount

ries

impr

ove

the

qual

ity o

f the

ir in

frast

ruct

ure,

incl

udin

g w

ater

an

d sa

nita

tion,

thro

ugh

priv

ate

sect

or in

volv

emen

t. (J

uly)

(62)

Th

e G

loba

l Alli

ance

for

Vac

cine

s an

d Im

mun

izat

ion

(GA

VI),

a p

ublic

-priv

ate

partn

ersh

ip, i

s es

tabl

ishe

d to

en

sure

fina

ncin

g to

sav

e ch

ildre

n's

lives

and

peo

ple'

s he

alth

thro

ugh

wid

espr

ead

vacc

inat

ions

. (1)

At t

he A

frica

n Su

mm

it on

Rol

l B

ack

Mal

aria

in A

buja

, Nig

eria

, A

frica

n le

ader

s fro

m 4

4 m

alar

ia-e

ndem

ic c

ount

ries

sign

th

e A

buja

Dec

lara

tion.

The

D

ecla

ratio

n is

com

mitm

ent t

o in

tens

ify e

fforts

to h

alve

the

burd

en o

f mal

aria

by

2010

. (A

pril)

(16)

2000

WH

O D

irect

or G

ener

al

esta

blis

hes

the

Com

mis

sion

on

Mac

roec

onom

ics

and

Hea

lth to

ass

ess

the

plac

e of

he

alth

in g

loba

l eco

nom

ic

deve

lopm

ent.

(Jan

uary

) (63

) Th

e in

tern

atio

nal c

omm

unity

ag

rees

upo

n ei

ght

Mille

nniu

m D

evel

opm

ent

Goa

ls, e

ach

with

a n

umbe

r of

targ

ets

and

indi

cato

rs, t

o be

ach

ieve

d by

201

5. T

hese

go

als

repr

esen

t a g

loba

l ag

reem

ent t

o ad

dres

s in

equa

lity.

The

goa

ls a

re

iden

tical

to th

e In

tern

atio

nal

Dev

elop

men

t Goa

ls, e

xcep

t th

at th

e re

prod

uctiv

e he

alth

go

al w

as n

ot in

clud

ed in

the

MD

Gs.

(Sep

tem

ber)

(1)

WH

O re

ports

blo

od s

uppl

ies

in tw

o-th

irds

of th

e w

orld

m

ay b

e ta

inte

d, th

ereb

y co

ntrib

utin

g to

the

spre

ad o

f A

IDS

, hep

atiti

s, a

nd o

ther

di

seas

es. (

16)

G-8

mee

ts in

Jap

an a

nd

pled

ges

to e

nd e

xtre

me

pove

rty a

nd th

e sp

read

of

infe

ctio

us d

isea

ses,

suc

h as

A

IDS

and

mal

aria

. Deb

t rel

ief

initi

ativ

e ga

ins

mom

entu

m

amon

g w

ealth

y na

tions

. (16

) Th

e U

K a

nd N

ethe

rland

s do

nate

an

addi

tiona

l US

$ 90

m

illion

to G

loba

l Pol

io

Era

dica

tion

Initi

ativ

e. D

FID

pr

ovid

ed U

S$

50 m

illion

for

oper

atio

nal c

osts

, sur

veilla

nce,

O

PV

and

per

sonn

el, a

nd th

e N

ethe

rland

s co

ntrib

uted

US

$ 50

mill

ion

for s

urve

illan

ce. (

37)

Bill

and

Mel

inda

Gat

es

Foun

datio

n do

nate

s $7

50

milli

on to

GA

VI f

or th

e su

ppor

t of

rese

arch

and

del

iver

y of

va

ccin

es. (

65)

UN

F aw

ards

$21

milli

on to

UN

pr

ogra

ms

that

focu

s on

im

prov

ing

the

lives

of

adol

esce

nt g

irls.

(59)

Th

e fir

st tr

ial o

f Com

mun

ity-

base

d Th

erap

eutic

Car

e (C

TC)

is c

arrie

d ou

t in

Eth

iopi

a.

Dev

elop

ed b

y V

alid

In

tern

atio

nal,

the

mod

el is

an

alte

rnat

ive

to th

e tra

ditio

nal

ther

apeu

tic c

ente

r mod

el w

hich

ha

s be

en in

effe

ctiv

e fo

r dea

ling

with

mal

nutri

tion

in la

rge-

scal

e hu

man

itaria

n cr

ises

. (66

)

The

GA

VI v

acci

natio

n ca

mpa

ign,

The

Chi

ldre

n's

Cha

lleng

e, is

offi

cial

ly

laun

ched

at t

he W

orld

E

cono

mic

For

um. (

Janu

ary)

(6

5)

The

Am

ster

dam

Dec

lara

tion

to

Sto

p TB

cal

ls fo

r acc

eler

ated

ac

tion

from

min

iste

rial

dele

gatio

ns o

f 20

coun

tries

w

ith h

ighe

st b

urde

n of

TB

. (M

arch

) (67

) G

AV

I beg

ins

its fi

rst r

ound

of

glob

al v

acci

ne d

eliv

erie

s,

send

ing

appr

oxim

atel

y 65

0,00

0 do

ses

of v

acci

nes

agai

nst d

ipht

heria

, tet

anus

, w

hoop

ing

coug

h an

d he

patit

is

B to

Moz

ambi

que.

(Apr

il) (1

7)

Jubi

lee

2000

, an

orga

niza

tion

lobb

ying

for

inte

rnat

iona

l deb

t rel

ief,

hold

s a

prot

est m

arch

in

Was

hing

ton,

DC

, tim

ed to

co

inci

de w

ith th

e W

orld

B

ank’

s S

prin

g M

eetin

gs.

(17)

M

ozam

biqu

e, B

angl

ades

h an

d In

dia

hit b

y so

me

of th

e w

orst

floo

ding

in 1

00 y

ears

. (1

7)

Ebo

la o

utbr

eak

in U

gand

a (4

25 h

uman

cas

es in

200

0-20

001)

. (27

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

84

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2000

DFI

D re

leas

es B

ette

r Hea

lth

for P

oor P

eopl

e, a

stra

tegy

pa

per t

hat e

stab

lishe

s m

eetin

g he

alth

targ

ets

as a

cen

tral

obje

ctiv

e to

be

achi

eved

th

roug

h ef

fect

ive

partn

ersh

ips

and

bila

tara

l pro

gram

s ba

sed

upon

cou

ntry

-con

text

. (64

)

2001

Com

mis

sion

on

Mac

roec

onom

ics

and

Hea

lth

pres

ents

Mac

roec

onom

ics

and

Hea

lth: I

nves

ting

in

Hea

lth fo

r Eco

nom

ic

Dev

elop

men

t to

the

Dire

ctor

-G

ener

al o

f WH

O. I

t cal

ls fo

r an

incr

ease

in d

evel

opm

ent

assi

stan

ce fo

r hea

lth a

nd fo

r th

e W

orld

Ban

k to

mov

e su

ppor

t fro

m c

redi

ts to

gr

ants

. (D

ecem

ber)

(68)

Den

mar

k la

unch

es a

Pla

n of

A

ctio

n fo

r int

erna

tiona

l as

sist

ance

to fi

ght H

IV/A

IDS.

Th

e pl

an w

as b

ased

on

“Par

tner

ship

200

0”, a

stra

tegy

w

hich

iden

tifie

d th

e fig

ht

agai

nst H

IV/A

IDS

as o

ne o

f fo

ur p

riorit

y ar

eas

for D

anis

h de

velo

pmen

t ass

ista

nce.

(69)

U

S P

resi

dent

G.W

. Bus

h re

inst

ates

the

Mex

ico

City

po

licy.

The

pol

icy

does

not

re

stric

t org

aniz

atio

ns fr

om

prov

idin

g po

st-a

borti

on c

are

or

from

trea

ting

inju

ries

or

illne

sses

cau

sed

by le

gal o

r ille

gal a

borti

ons.

(11)

Th

e W

orld

Ban

k an

d U

SA

ID

co-h

ost t

he A

nnua

l Mee

tings

of

the

Glo

bal P

artn

ersh

ip to

E

limin

ate

Riv

erbl

indn

ess

in

Was

hing

ton.

The

par

tner

s pl

edge

d to

elim

inat

e riv

erbl

indn

ess

in A

frica

by

2010

. (D

ecem

ber)

(16)

D

FID

rele

ases

its

first

form

al

HIV

/AID

S st

rate

gy, w

hich

is

desi

gned

to in

form

div

isio

nal

and

coun

try-le

vel p

lans

. (70

)

OX

FAM

laun

ches

Cut

the

Cos

t C

ampa

ign

whi

ch a

ims

to

incr

ease

the

avai

labi

lity

of

affo

rdab

le m

edic

ines

for t

he

poor

. (34

) U

NF

esta

blis

hes

a sp

ecia

l ac

coun

t for

the

Glo

bal A

IDS

an

d H

ealth

Fun

d to

acc

ept

dona

tions

from

indi

vidu

als,

co

rpor

atio

ns, a

nd o

ther

s w

ho

wan

t to

cont

ribut

e to

the

fight

ag

ains

t HIV

/AID

S. (5

9)

The

Bill

and

Mel

inda

Gat

es

Foun

datio

n pl

edge

s $2

0 m

illion

to

acc

eler

ate

the

elim

inat

ion

of

Lym

phat

ic fi

laria

sis

(LF)

, als

o kn

ow a

s E

leph

antia

sis.

The

gr

ant w

ill b

e ch

anne

led

thro

ugh

a W

orld

Ban

k Tr

ust

Fund

. (Fe

brua

ry) (

16)

GA

VI s

ends

app

roxi

mat

ely

650,

000

dose

s of

vac

cine

s ag

ains

t dip

hthe

ria, t

etan

us,

who

opin

g co

ugh

and

hepa

titis

M

ozam

biqu

e. (A

pril)

(16)

Th

e G

loba

l Fun

d to

Fig

ht

HIV

/AID

S, T

B, a

nd M

alar

ia, a

fin

anci

ng m

echa

nism

, is

esta

blis

hed

to fo

ster

pa

rtner

ship

s be

twee

n go

vern

men

ts, c

ivil

soci

ety,

the

priv

ate

sect

or, a

nd a

ffect

ed

com

mun

ities

to in

crea

se

reso

urce

s an

d di

rect

fina

ncin

g to

war

ds e

fforts

to e

radi

cate

H

IV/A

IDS

, TB,

and

mal

aria

. (7

1)

Par

tner

s ga

ther

in W

ashi

ngto

n,

DC

to fu

rther

com

mit

to

oper

atio

naliz

e th

e A

mst

erda

m

Dec

lara

tion.

The

Glo

bal P

lan

to S

top

TB is

laun

ched

, cal

ling

for t

he e

xpan

sion

of a

cces

s to

D

OTS

and

incr

ease

d fin

anci

al

back

ing

for t

he p

rogr

am fr

om

gove

rnm

ents

thro

ugho

ut th

e w

orld

. (O

ctob

er) (

67)

The

Mea

sles

Initi

ativ

e is

fo

rmed

by

the

Am

eric

an R

ed

Cro

ss, U

NF,

UN

ICE

F, W

HO

, C

DC

and

the

Inte

rnat

iona

l Fe

dera

tion

of R

ed C

ross

and

R

ed C

resc

ent S

ocie

ties.

It

wor

ks w

ith c

ount

ries

impl

emen

t hig

h qu

ality

, one

-tim

e-on

ly c

atch

-up

mea

sles

va

ccin

atio

n ca

mpa

igns

. (72

)

Wes

tern

Pac

ific

regi

on

certi

fied

polio

-free

. (35

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

85

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2002

The

Wor

ld S

umm

it on

S

usta

inab

le D

evel

opm

ent i

s he

ld in

Joh

anne

sbur

g. A

pl

an o

f im

plem

enta

tion

appr

oved

at t

he s

umm

it in

clud

ed s

peci

fic g

oals

to

reco

mm

it re

duce

pov

erty

an

d hu

nger

, and

impr

ove

acce

ss a

nd e

ffect

ive

use

of

wat

er s

uppl

y an

d sa

nita

tion

serv

ices

, am

ong

othe

rs.

(S

epte

mbe

r) (7

3)

Inte

rnat

iona

l Con

fere

nce

on

Fina

ncin

g D

evel

opm

ent i

n M

onte

rrey

focu

ses

on w

ays

to fi

nanc

e at

tain

men

t of

MD

Gs

and

head

s of

sta

te

adop

t the

"Mon

terre

y C

onse

nsus

." (1

) U

N S

ecre

tary

Gen

eral

, Kof

i A

nnan

, com

mis

sion

s Th

e M

illenn

ium

Pro

ject

. A

pr

ivat

e ad

viso

ry b

ody

head

ed b

y P

rofe

ssor

Jef

frey

Sac

hs, i

t aim

s to

re

com

men

d a

conc

rete

ac

tion

plan

for t

he w

orld

to

mee

t the

Mille

nniu

m

Dev

elop

men

t Goa

ls. (

74)

Don

atio

ns fr

om C

anad

a,

Japa

n, th

e N

ethe

rland

s, th

e U

nite

d K

ingd

om a

nd th

e U

nite

d S

tate

s cl

ose

The

Glo

bal

Pol

io E

radi

catio

n In

itiat

ive'

s 20

02-2

005

fund

ing

gap.

(35)

D

FID

pas

ses

the

Inte

rnat

iona

l D

evel

opm

ent A

ct w

hich

es

tabl

ishe

s po

verty

elim

inat

ion

as th

e ov

erar

chin

g pu

rpos

e of

its

wor

k. (7

5)

Ford

Fou

ndat

ion

expa

nds

its

wor

k in

sex

ual a

nd

repr

oduc

tive

heal

th, l

aunc

hing

a

new

glo

bal i

nitia

tive

on

hum

an s

exua

lity.

Its

goal

is to

su

ppor

t the

em

erge

nce

of

regi

onal

reso

urce

cen

ters

that

de

velo

p kn

owle

dge

abou

t se

xual

ity, t

rans

late

kno

wle

dge

into

pra

ctic

e an

d fo

ster

pub

lic

unde

rsta

ndin

g. (5

) A

$20

mill

ion

gran

t fro

m th

e B

ill an

d M

elin

da G

ates

Fou

ndat

ion

supp

orts

con

tinue

d la

b w

ork

and

clin

ical

tria

ls o

f the

P

opul

atio

n C

ounc

il's le

ad

cand

idat

e m

icro

bici

de,

Car

ragu

ard.

(6)

Rot

ary

Inte

rnat

iona

l lau

nche

s se

cond

fund

rais

ing

cam

paig

n to

era

dica

te p

olio

. (35

)

The

Glo

bal P

ublic

-Priv

ate

Par

tner

ship

for H

andw

ashi

ng

with

Soa

p is

form

ed b

y th

e Lo

ndon

Sch

ool o

f Hyg

iene

and

Tr

opic

al M

edic

ine,

the

Aca

dem

y fo

r Edu

catio

nal

Dev

elop

men

t, U

SAID

, U

NIC

EF, t

he W

orld

Ban

k-N

ethe

rland

s W

ater

P

artn

ersh

ip, a

nd th

e pr

ivat

e se

ctor

. (73

)

Glo

bal A

llianc

e fo

r Im

prov

ed

Nut

ritio

n (G

AIN

) cre

ated

at a

sp

ecia

l UN

ses

sion

for

child

ren.

Est

ablis

hed

by a

S

wis

s fo

unda

tion,

its

mai

n so

urce

s of

fund

ing

are

the

Gat

es F

ound

atio

n, U

SA

ID a

nd

CID

A (C

anad

a). T

he W

orld

B

ank

is a

key

par

tner

. (76

) Th

e In

tern

atio

nal P

artn

ersh

ip

for M

icro

bici

des

is fo

rmed

to

acce

lera

te th

e de

velo

pmen

t an

d av

aila

bilit

y of

saf

e an

d ef

fect

ive

mic

robi

cide

s fo

r w

omen

in d

evel

opin

g co

untri

es. I

t is

a no

n-pr

ofit,

pr

oduc

t dev

elop

men

t pa

rtner

ship

. (77

)

Eur

opea

n re

gion

cer

tifie

d po

lio fr

ee. (

35)

Pol

io o

utbr

eak

in In

dia.

(35)

2003

Lead

ers

of m

ultil

ater

al

deve

lopm

ent b

anks

, in

tern

atio

nal a

nd b

ilate

ral

orga

niza

tions

, and

don

or

and

reci

pien

t cou

ntry

re

pres

enta

tives

gat

here

d in

R

ome

for t

he H

igh-

Leve

l Fo

rum

on

Har

mon

izat

ion.

Th

ey c

omm

itted

to th

e R

ome

Dec

lara

tion

on

Har

mon

izat

ion,

est

ablis

hing

a

prog

ram

of a

ctiv

ities

to

impr

ove

the

man

agem

ent

and

effe

ctiv

enes

s of

aid

. (F

ebru

ary)

(78)

New

gui

delin

es u

pdat

e U

SA

ID's

199

9 P

rogr

amm

atic

Te

chni

cal G

uida

nce

on

inte

grat

ing

fam

ily p

lann

ing

and

mat

erna

l/chi

ld h

ealth

with

se

rvic

es fo

r pre

vent

ing

HIV

/AID

S a

nd o

ther

sex

ually

tra

nsm

itted

dis

ease

s. T

he

guid

elin

es in

clud

e ne

w

info

rmat

ion

abou

t effe

ctiv

e in

tegr

atio

n of

fam

ily p

lann

ing

into

HIV

pro

gram

s an

d H

IV

coun

selin

g an

d se

rvic

es in

to

fam

ily p

lann

ing

prog

ram

s. (1

1)

Clin

ton

Foun

datio

n se

cure

s pr

ice

redu

ctio

ns fo

r HIV

/AID

S dr

ugs

from

gen

eric

m

anuf

actu

rers

to b

enef

it de

velo

ping

cou

ntrie

s. (7

1)

Ban

k, G

ates

Fou

ndat

ion,

R

otar

y In

tern

atio

nal,

and

UN

F la

unch

the

Inve

stm

ent

Par

tner

ship

for P

olio

to

erad

icat

e po

lio b

y 20

05. T

he

Par

tner

ship

will

pro

vide

fu

ndin

g to

con

vert

an ID

A cr

edit

into

a g

rant

onc

e pa

rtici

patin

g go

vern

men

ts

have

ach

ieve

d pr

ojec

t ob

ject

ives

. (A

pril)

(16)

Sev

ere

acut

e re

spira

tory

sy

ndro

me

(SA

RS

) re

cogn

ized

afte

r epi

dem

ic

begi

ns N

ovem

ber 2

002

in

Chi

na a

nd la

sts

thro

ugh

July

200

3. (F

ebru

ary)

(80)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

86

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2003

At t

he M

DG

mee

ting

in

Otta

wa,

a F

ram

ewor

k fo

r A

ctio

n to

Acc

eler

ate

Pro

gres

s on

HN

P M

DG

s is

en

dors

ed. (

May

) (76

) W

HO

and

UN

AID

S la

unch

th

e "3

by

5" in

itiat

ive.

The

in

itiat

ive

sets

a g

loba

l tar

get

to p

rovi

de 3

milli

on p

eopl

e liv

ing

with

HIV

/AID

S in

de

velo

ping

cou

ntrie

s w

ith

AR

T by

the

end

of 2

005.

(D

ecem

ber)

(79)

U

NFP

A la

unch

es th

e C

ampa

ign

to E

nd F

istu

la,

wor

king

in m

ore

than

35

coun

tries

to p

reve

nt a

nd

treat

fist

ula,

and

to h

elp

reha

bilit

ate

and

empo

wer

w

omen

afte

r tre

atm

ent.

(15)

W

orld

Hea

lth A

ssem

bly

endo

rses

Fra

mew

ork

Con

vent

ion

on T

obac

co

Con

trol.

The

inte

rnat

iona

l tre

aty

deve

lope

d by

the

WH

O in

clud

es p

rovi

sion

s to

im

plem

ent c

ompr

ehen

sive

ba

ns o

n to

bacc

o ad

verti

sing

, an

d en

forc

e la

belin

g re

gula

tions

. (1)

Le

e Jo

ng-w

ook

(Sou

th

Kor

ea) b

ecom

es W

HO

D

irect

or-G

ener

al. (

2)

USA

ID's

new

MEA

SUR

E D

HS

proj

ect e

xpan

ds d

ata

colle

ctio

n ef

forts

and

acc

ess

to a

nd u

se

of d

emog

raph

ic a

nd h

ealth

da

ta o

n de

velo

ping

cou

ntrie

s.

(21)

In

ter-A

mer

ican

Dev

elop

men

t B

ank'

s B

oard

app

rove

s a

Soc

ial D

evel

opm

ent S

trate

gy.

It ai

ms

to li

nk re

form

s to

hea

lth

obje

ctiv

es; p

riorit

ize

publ

ic

heal

th is

sues

and

the

effic

ienc

y, e

quity

and

qua

lity

of

com

mun

ity s

ervi

ces;

en

cour

age

dece

ntra

lizat

ion

whe

n po

ssib

le; c

orre

ct

defic

ienc

ies

in re

sour

ces

and

supp

lies;

and

bal

ance

pr

even

tion

and

dise

ase

cont

rol.

(50)

Pop

ulat

ion

Cou

ncil

and

Acru

x si

gn a

join

t agr

eem

ent w

ith to

de

velo

p a

wom

en’s

spr

ay-o

n co

ntra

cept

ive.

(6)

Glo

bal m

easl

es d

eath

s dr

op

to a

n es

timat

ed 5

30,0

00

from

873

,000

in 1

999.

(56)

2004

Key

don

ors

reco

mm

it to

st

reng

then

ing

coun

try e

fforts

to

lead

nat

iona

l AID

S

resp

onse

s an

d en

dors

e th

e "T

hree

One

s" p

rinci

ple.

Thi

s is

: one

fram

ewor

k fo

r co

ordi

natio

n, o

ne N

atio

nal

AID

S C

oord

inat

ing

Aut

horit

y,

and

one

coun

try-le

vel

mon

itorin

g an

d ev

alua

tion

syst

em. (

Apr

il) (8

1)

US

Con

gres

s ap

prop

riate

s re

sour

ces

to s

uppo

rt th

e P

resi

dent

's E

mer

genc

y P

lan

for A

IDS

Rel

ief (

PEPF

AR).

A fiv

e-ye

ar, $

15 b

illio

n co

mm

itmen

t to

fight

HIV

/AID

S w

ith a

mul

tifac

eted

app

roac

h in

fif

teen

cou

ntrie

s. (8

2)

DFI

D la

unch

es U

K's

new

st

rate

gy to

figh

t HIV

/AID

S

whi

ch o

utlin

es it

s pl

an to

wor

k w

ith d

evel

opin

g co

untri

es,

othe

r don

ors

and

mul

tilat

eral

D

onor

s fu

nd o

ver $

3 m

illio

n to

er

adic

ate

river

blin

dnes

s at

a

Riv

er b

lindn

ess

Con

fere

nce

in

Afri

ca. (

June

) (20

)

R

epor

ts o

f hum

an c

ases

of

avia

n flu

A (H

N51

) fro

m

Vie

tnam

, Tha

iland

, C

ambo

dia,

Chi

na,

Indo

nesi

a, T

urke

y, Ir

aq,

Aze

rbai

jan,

Egy

pt, a

nd

Djib

outi.

(Jan

uary

) (84

)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

87

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2004

WH

O a

nd th

e B

ank

co-

spon

sor t

he 1

st H

igh-

Leve

l Fo

rum

on

the

Hea

lth M

DG

s.

Hea

ds o

f dev

elop

men

t ag

enci

es, b

ilate

ral a

genc

ies,

gl

obal

hea

lth in

itiat

ives

, and

he

alth

and

fina

nce

min

iste

rs

agre

e on

4 a

ctio

n ar

eas:

1)

reso

urce

s fo

r hea

lth a

nd

pove

rty re

duct

ion

pape

rs; 2

) ai

d ef

fect

iven

ess

and

harm

oniz

atio

n; 3

) hum

an

reso

urce

s; 4

) mon

itorin

g pe

rform

ance

. (Ja

nuar

y) (1

6)

orga

niza

tions

to c

oord

inat

e in

tern

atio

nal e

fforts

, clo

se th

e fu

ndin

g ga

p an

d im

prov

e he

alth

, edu

catio

n an

d hu

man

rig

hts

for t

he p

oore

st a

nd m

ost

vuln

erab

le. A

n H

IV/A

IDS

tre

atm

ent a

nd c

are

polic

y, n

ew

sexu

al a

nd re

prod

uctiv

e he

alth

an

d rig

hts

posi

tion

pape

r, an

d po

licy

and

plan

s to

incr

ease

ac

cess

to e

ssen

tial m

edic

ines

in

dev

elop

ing

coun

tries

are

al

so la

unch

ed in

con

junc

tion.

(7

0)

The

Inte

r-A

mer

ican

D

evel

opm

ent B

ank

rele

ases

its

first

hea

lth s

trate

gy. I

ts tw

o pr

imar

y ob

ject

ives

are

: (1)

to

impr

ove

the

heal

th o

f the

po

pula

tion

and

atta

in h

ealth

ob

ject

ives

thro

ugh

impr

oved

pu

blic

pol

icy

to re

duce

risk

and

im

prov

e he

alth

sys

tem

s; a

nd

(2) t

o re

duce

ineq

uitie

s in

he

alth

sta

tus

by im

prov

ing

acce

ss fo

r the

poo

r and

so

cial

ly e

xclu

ded.

(50)

Pop

ulat

ion

Cou

ncil

and

Sch

erin

g AG

par

tner

to c

reat

e th

e In

tern

atio

nal C

ontra

cept

ive

Acc

ess

Foun

datio

n. (6

)

At t

he S

econ

d S

top

TB's

P

artn

er F

orum

in N

ew D

elhi

, pa

rtner

s re

affir

m th

eir

com

mitm

ents

to m

eetin

g th

e 20

05 ta

rget

s an

d de

velo

p a

glob

al p

lan

to g

uide

effo

rts to

m

eet M

DG

targ

ets

for T

B b

y 20

15. (

Mar

ch) (

67)

Hea

lth M

etric

s N

etw

ork

laun

ched

. It i

s a

glob

al

partn

ersh

ip o

f cou

ntrie

s,

deve

lopm

ent a

genc

ies,

fo

unda

tions

, and

glo

bal h

ealth

in

itiat

ives

that

aim

s to

impr

ove

the

qual

ity, a

vaila

bilit

y an

d di

ssem

inat

ion

of d

ata

for

deci

sion

-mak

ing

in h

ealth

. (J

une)

(83)

Wor

ld le

ader

s pr

esen

t The

W

orld

Lea

ders

Sta

tem

ent t

o th

e U

N-D

eput

y S

ecre

tary

G

ener

al w

hich

reaf

firm

s th

e co

mm

itmen

ts o

f all

of th

e 17

9 or

igin

al g

over

nmen

ts t

o 19

94

ICP

D P

lan

of A

ctio

n. (O

ctob

er)

(59)

A m

assi

ve e

arth

quak

e ne

ar

the

Indi

an O

cean

cau

ses

tsun

amis

whi

ch d

evas

tate

la

rge

parts

of I

ndia

, Sri

Lank

a, In

done

sia,

Tha

iland

an

d ot

her I

ndia

n O

cean

st

ates

. The

re a

re n

early

14

0,00

0 ca

sual

ties

in

doze

ns o

f Asi

an a

nd A

frica

n na

tions

, and

milli

ons

are

left

hom

eles

s. (1

6)

Res

ults

from

sev

en y

ears

of

coun

try-b

ased

eva

luat

ions

of

the

IMC

I stra

tegy

indi

cate

so

me

of a

ppro

ache

s th

e ba

sic

expe

ctat

ions

wer

e no

t m

et. S

ever

al le

sson

s fo

r ch

ild s

urvi

val s

trate

gies

em

erge

d re

late

d to

the

need

fo

r tar

getin

g, p

rovi

ding

ad

equa

te g

uide

lines

, tra

inin

g an

d su

perv

isio

n,

and

publ

ic a

ccou

ntab

ility

for

cove

rage

. (85

)

2005

The

Mille

nniu

m

Dev

elop

men

t Pro

ject

pr

esen

ts it

s fin

al re

port,

In

vest

ing

in D

evel

opm

ent:

A P

ract

ical

Pla

n to

Ach

ieve

the

Mill

enni

um D

evel

opm

ent

Goa

ls, t

o th

e S

ecre

tary

-G

ener

al. T

he M

illenn

ium

P

roje

ct is

ask

ed to

con

tinue

op

erat

ing

in a

n ad

viso

ry

capa

city

thro

ugh

the

end

of

2006

. (Ja

nuar

y) (7

4)

Inte

rnat

iona

l Hea

lth

Reg

ulat

ions

(IH

R 2

005)

are

re

vise

d an

d ad

opte

d by

the

Wor

ld H

ealth

Ass

embl

y. I

t is

an in

tern

atio

nal l

egal

in

stru

men

t to

prev

ent,

prot

ect a

gain

st, c

ontro

l and

pr

ovid

e a

publ

ic h

ealth

re

spon

se to

the

inte

rnat

iona

l sp

read

of d

isea

se. (

86)

At t

he G

lene

agle

s S

umm

it, G

-8

natio

ns p

ledg

e to

incr

ease

aid

fo

r dev

elop

ing

coun

tries

by

$50

billio

n a

year

by

2010

, of

whi

ch a

t lea

st $

25 b

illion

mor

e pe

r yea

r is

prom

ised

to A

frica

. (J

uly)

(87)

S

wed

ish

gove

rnm

ent d

ecla

res

HIV

/AID

S a

s on

e of

top

four

pr

iorit

y ar

eas

for i

ts b

udge

t bill

in

200

5; S

IDA

decl

ares

H

IV/A

IDS

as

one

of it

s th

ree

Stra

tegi

c Pr

iorit

ies

for 2

005-

2007

. (88

)

The

Clin

ton

Foun

datio

n la

unch

es th

e C

linto

n G

loba

l In

itiat

ive

and

esta

blis

hes

Glo

bal H

ealth

as

one

of fo

ur

focu

s ar

eas.

(89)

Dev

asta

ting

earth

quak

e in

In

dia

and

Pak

ista

n ki

lls o

ver

25,0

00. (

92)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

88

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

C-P

RIV

ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2005

Ado

ptin

g th

e P

aris

D

ecla

ratio

n on

Aid

E

ffect

iven

ess,

dev

elop

men

t in

stitu

tions

est

ablis

h go

als

and

mea

sura

ble

targ

ets

desi

gned

to im

prov

e th

e ow

ners

hip,

har

mon

izat

ion,

al

ignm

ent,

and

mut

ual

acco

unta

bilit

y of

aid

ef

fect

iven

ess.

(Mar

ch) (

87)

Den

mar

k re

leas

es n

ew

stra

tegy

for 2

005-

08 w

hich

re

com

mits

to fi

ghtin

g H

IV/A

IDS

w

ith a

par

ticul

ar fo

cus

on S

ub-

Sah

aran

Afri

ca. (

69)

Bill

and

Mel

inda

Gat

es

Foun

datio

n do

nate

$75

0 m

illion

to G

AV

I to

supp

ort

child

hood

vac

cina

tions

glo

bally

ov

er 1

0 ye

ars.

(90)

Glo

bal T

ask

Team

(GTT

) on

impr

ovin

g A

IDS

Coo

rdin

atio

n am

ong

Inte

rnat

iona

l Don

ors

and

Mul

tilat

eral

Inst

itutio

ns is

fo

rmed

to a

ccel

erat

e pr

ogre

ss

to a

chie

ve th

e "T

hree

One

s".

It de

velo

ped

reco

mm

enda

tions

to

stre

amlin

e, s

impl

ify a

nd

harm

oniz

e do

nor p

roce

dure

s an

d pr

actic

es, t

o re

duce

the

burd

en o

n co

untri

es, a

nd

impr

ove

the

effe

ctiv

enes

s of

co

untry

-led

resp

onse

s. It

als

o re

ache

d ag

reem

ents

on

impr

oved

coo

rdin

atio

n be

twee

n th

e G

loba

l Fun

d an

d th

e W

orld

Ban

k, a

nd th

e di

visi

on o

f lab

or a

mon

g th

e U

NA

IDS

co-

spon

sors

. (M

arch

) (9

1)

2006

Inte

rnat

iona

l Ple

dgin

g C

onfe

renc

e on

Avi

an a

nd

Hum

an In

fluen

za is

hel

d in

B

eijin

g to

ass

ess

finan

cing

ne

eds

at c

ount

ry, r

egio

nal

and

glob

al le

vels

. The

in

tern

atio

nal c

omm

unity

pl

edge

s U

S$1

.9 b

illion

in

finan

cial

sup

port

and

disc

usse

s co

ordi

natio

n m

echa

nism

s at

this

co

nfer

ence

. (Ja

nuar

y) (9

3)

Gen

eva

Glo

bal P

artn

ers

Con

fere

nce

on A

vian

and

H

uman

Pan

dem

ic In

fluen

za

sets

key

are

as fo

r act

ion

to

resp

ond

to th

e A

vian

and

H

uman

Pan

dem

ic In

fluen

za

and

mak

es a

n ur

gent

cal

l for

fin

anci

ng. (

Nov

embe

r) (9

4)

WH

O p

ublis

hes

new

in

tern

atio

nal C

hild

Gro

wth

S

tand

ards

whi

ch

dem

onst

rate

that

gro

wth

to

age

five

is in

fluen

ced

prim

arily

by

nutri

tion,

feed

ing

prac

tices

, env

ironm

ent,

and

heal

th c

are.

(95)

The

Inte

rnat

iona

l Dru

g P

urch

ase

Faci

lity,

UN

ITA

ID, i

s es

tabl

ishe

d by

Bra

zil,

Chi

le,

Fran

ce, N

orw

ay, a

nd th

e U

K to

gu

aran

tee

a re

liabl

e an

d su

stai

nabl

e su

pply

of d

rugs

an

d di

agno

stic

s fo

r mos

t co

mm

on d

isea

ses.

(S

epte

mbe

r) (9

5)

DFI

D e

stab

lishe

s an

inte

r-m

inis

teria

l gro

up o

n he

alth

ca

paci

ty in

dev

elop

ing

coun

tries

. (96

) D

FID

pro

vide

s su

ppor

t (20

06-

2009

) to

the

Trop

ical

Hea

lth

Edu

catio

n Tr

ust f

und

to

supp

ort p

artn

ersh

ips

to

deve

lop

thei

r pot

entia

l in

stre

ngth

enin

g he

alth

sys

tem

s,

brok

erin

g ne

w p

artn

ersh

ips

and

prom

otin

g go

od p

ract

ices

. (9

6)

Bui

ldin

g P

artn

ersh

ip fo

r D

evel

opm

ent (

BP

D)

in W

ater

an

d S

anita

tion

is e

stab

lishe

d as

an

inte

rnat

iona

l cro

ss-

sect

or le

arni

ng n

etw

ork

to

The

Bill

and

Mel

inda

Gat

es

Foun

datio

n re

orga

nize

s in

to

thre

e pr

ogra

ms—

Glo

bal

Dev

elop

men

t, G

loba

l Hea

lth,

and

Uni

ted

Stat

es—

and

a co

re-o

pera

tions

gro

up. (

47)

U.S

. inv

esto

r War

ren

Buf

fett

pled

ges

to g

ive

10 m

illion

B

erks

hire

Hat

haw

ay c

lass

B

shar

es to

the

Bill

and

Mel

inda

G

ates

Fou

ndat

ion.

(47)

Fo

rd F

ound

atio

n an

noun

ces

$45

mill

ion

initi

ativ

e fo

r H

IV/A

IDS

to e

nsur

e th

at g

loba

l in

vest

men

ts in

med

icin

e an

d te

chno

logy

are

mat

ched

by

a fo

cus

on th

e so

cial

, pol

itica

l an

d cu

ltura

l fac

tors

of t

he

dise

ase.

(5)

The

Inte

rnat

iona

l Fin

ance

Fa

cilit

y fo

r Im

mun

izat

ion

Com

pany

(IFF

im),

esta

blis

hed

to a

ccel

erat

e th

e av

aila

bilit

y of

fu

nds

to b

e us

ed b

y G

AVI

in

the

wor

ld's

70

poor

est

coun

tries

, ann

ounc

es it

s in

augu

ral b

ond.

(Jul

y) (1

00)

Wor

ld p

opul

atio

n es

timat

ed

to b

e 6.

5 bi

llion

. (8)

G

loba

l mea

sles

dea

ths

fall

by 6

0% fr

om 1

999.

(59)

A

nnex

D:

Glo

bal H

NP

Even

ts T

imel

ine

89

YEAR

IN

TER

NA

TIO

NA

L O

RG

ANIZ

ATI

ON

S

BIL

ATE

RA

L AG

ENC

IES

and

D

EVEL

OPM

ENT

BAN

KS

FOU

ND

ATI

ON

S/ N

GO

s PU

BLI

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ATE

PA

RTN

ERSH

IPS

DEV

ELO

PIN

G C

OU

NTR

IES

EXTE

RN

AL

EVEN

TS

2006

And

ers

Nor

dstro

m (S

wed

en)

beco

mes

WH

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irect

or-

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eral

. (2)

impr

ove

acce

ss to

saf

e w

ater

an

d ef

fect

ive

sani

tatio

n in

poo

r co

mm

uniti

es.

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D, t

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utch

M

inis

try o

f For

eign

Affa

irs, t

he

Fren

ch D

evel

opm

ent A

genc

y ar

e am

ong

prim

ary

dono

rs

alon

g w

ith p

rivat

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mpa

nies

. (9

7)

DFI

D a

nd th

e W

orld

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k es

tabl

ish

the

Glo

bal

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tner

ship

on

Out

put-B

ased

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BA

), a

mul

ti-do

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rust

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fund

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mon

stra

te a

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s to

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sust

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deliv

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of

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here

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ally

whe

re p

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y co

ncer

ns w

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just

ify p

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fu

ndin

g to

com

plem

ent o

r re

plac

e us

er-fe

es. T

he IF

C, t

he

Net

herla

nds

Gov

ernm

ent,

and

Aus

tralia

n G

over

nmen

t O

vers

eas

Aid

Age

ncy

(Aus

AID

) joi

n in

the

first

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r. (9

9)

2007

Sca

ling

Up

for B

ette

r Hea

lth

initi

ativ

e la

unch

ed to

ac

cele

rate

pro

gres

s to

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ds

the

heal

th M

DG

s. T

his

initi

ativ

e w

as th

e re

sult

of th

e co

nclu

sion

s dr

awn

by th

e H

igh-

Leve

l For

um fo

r the

H

ealth

MD

Gs.

(99)

M

arga

ret C

han

(Hon

g K

ong)

be

com

es W

HO

Dire

ctor

-G

ener

al. (

2)

Mul

tilat

eral

and

inte

r-go

vern

men

tal o

rgan

izat

ions

es

tabl

ish

the

Afri

ca M

DG

S

teer

ing

Gro

up. I

t will

coor

dina

te a

nd re

doub

le

effo

rts to

sup

port

the

MD

Gs,

fo

cusi

ng o

n im

plem

enta

tion

to a

ccel

erat

e ex

istin

g co

mm

itmen

ts to

reac

hing

the

goal

s ac

ross

Afri

ca. (

101)

Prim

e M

inis

ter o

f Nor

way

la

unch

es th

e G

loba

l Cam

paig

n fo

r the

Hea

lth M

illen

nium

D

evel

opm

ent G

oals

, whi

ch

enco

mpa

sses

sev

eral

in

terr

elat

ed a

ctiv

ities

wor

king

to

reac

h th

e he

alth

MD

Gs.

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C

ampa

ign

focu

ses

on c

hild

an

d m

ater

nal h

ealth

, MD

Gs

4 an

d 5.

(Sep

tem

ber)

(102

) B

ritis

h go

vern

men

t ple

dges

10

0 m

illion

pou

nds

to U

NFP

A

to a

chie

ve u

nive

rsal

acc

ess

for

repr

oduc

tive

heal

th a

t Wom

en

Del

iver

con

fere

nce

in L

ondo

n.

(103

)

Hig

h-le

vel M

eetin

g of

sec

ond

repl

enis

hmen

t con

fere

nce

of

GFA

TM d

onor

s to

geth

er in

B

erlin

whe

re th

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omm

it $9

.7

billi

on to

GFA

TM.

(Sep

tem

ber)

(104

)

Bur

undi

, Cam

bodi

a, E

thio

pia,

K

enya

, Moz

ambi

que,

Nep

al

and

are

the

first

cou

ntrie

s to

jo

in th

e ne

w In

tern

atio

nal

Hea

lth P

artn

ersh

ip.

The

Inte

rnat

iona

l Hea

lth

Par

tner

ship

is c

ompo

sed

of

deve

lopi

ng a

nd d

onor

co

untri

es a

long

with

maj

or

heal

th a

genc

ies

and

foun

datio

ns. I

ts o

bjec

tives

are

to

impr

ove

the

way

that

in

tern

atio

nal a

genc

ies,

don

ors

and

poor

cou

ntrie

s w

ork

toge

ther

to d

evel

op a

nd

impl

emen

t hea

lth p

lans

, cr

eatin

g an

d im

prov

ing

heal

th

serv

ices

for p

oor p

eopl

e an

d ul

timat

ely

savi

ng m

ore

lives

. (1

06)

The

revi

sed

Inte

rnat

iona

l H

ealth

Reg

ulat

ions

, ad

opte

d in

200

5 by

the

Wor

ld H

ealth

Ass

embl

y,

ente

r int

o fo

rce

on 1

5 Ju

ne.

(107

)

ANNEX D: SOURCES 1 As reported in Walt and Buse 2006. 2 WHO Web site. “Former Director Generals.” (http://www.who.int/dg/former/en/). 3 IPPF Web site. “The IPPF Time Wheel.” (http://ippfnet.ippf.org/pub/TimeLine/index1.htm). 4 CDC Web site. Malaria. “The History of Malaria, an Ancient Disease.” (http://www.cdc.gov/malaria/history/index.htm). 5 Ford Foundation Website. “The Ford Foundations Work in Population.” (http://www.fordfound.org/elibrary/documents/0190/toc.cfm). 6 Population Council Web site. “About the Population Council.” (http://www.popcouncil.org/about/timeline.html). 7 The Global Family Planning Revolution, “Overview and Perspective” chapeter by Steve Sinding, p. 2 8 U.S. Census Bureau Web site. “Total Midyear Population for the World: 1950-2050.” (http://www.census.gov/ipc/www/worldpop.html). 9 UN Web site. "Key conference outcomes on population." (www.un.org/esa/devagenda/population.html). 10 WFP Web site (http://www.wfp.org/policies/Introduction/mission/index.asp?section=6&sub_section=1). 11 USAID Website. “USAID Family Planning Program Timeline: Before 1965 to the Present.”

(http://www.usaid.gov/our_work/global_health/pop/timeline.html). 12 As reported in Zavier and Padmadas 2000. 13 WHO Web site. “Smallpox.” (http://www.who.int/mediacentre/factsheets/smallpox/en/). 14 Manoff Group Web site. (http://www.manoffgroup.com). 15 UNFPA Web Site. (http://www.unfpa.org/ ). 16 As reported in World Bank Group Archives 2005. 17 PSI Web site. “About PSI.” (http://www.psi.org/about_us/). 18 As reported in Golladay and Liese 1980. 19 As reported in Kapur and others 1997. 20 Medecins sans Frontiers Web site. “TheDoctors without Borders Timeline.” (http://www.doctorswithoutborders.org/aboutus/timeline.cfm). 21 MEASURE DHS Web site. “DHS History.” (http://www.measuredhs.com/aboutdhs/history.cfm). 22 As reported in WHO 1974. 23 WHO Web site. “About TDR.” (http://www.who.int/tdr/about/mission.htm). 24 As reported in OPEV 2006 25 IFPRI Web site. (http://www.ifpri.org/about/about_menu.asp). 26 UNICEF Web site. “Fifty Years for Children.” http://www.unicef.org/sowc96/yearsfor.htm). 27 CDC Web Site. Special Pathogens Branch. “Ebola Hemorrhagic Fever.”

(http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/ebotabl.htm). 28 United Nations System Website. “Standing Committee on Nutrition.” (http://www.unsystem.org/SCN/Publications/html/mandate.html). 29 The Rockefeller Foundation Web site. “The Rockefeller Timeline.” (http://www.rockfound.org/about_us/history/timeline.shtml.). 30 PAHO Website. “Primary Health Care- 25 Years of the Alma-Ata Declaration.” http://www.paho.org/English/dd/pin/almaata25.htm). 31 Asian Development Bank Web site. “Health Sector at a Glance.” (http://www.adb.org/Health/glance.asp). 32 CDC Web Site. “CDC Timeline.” (http://www.cdc.gov/od/oc/media/timeline.htm). 33 Save the Children Web site. “Our History.” (http://www.savethechildren.org/about/mission/our-history/). 34 OXFAM Web Site. “History of OXFAM.” (http://www.oxfam.org.uk/about_us/history/history9.htm). 35 Global Polio Eradication Initiative Web Site. “The History.” (http://www.polioeradication.org/history.asp). 36 The Carter Center Web site. “Health Programs.” (http://www.cartercenter.org/health/index.html). 37 As reported in OED 2005. 38 Eldis Web site. Health Systems Resource Guide. User Fee Section “The Bamako Initiative.”

(http://www.eldis.org/healthsystems/userfees/background.htm.). 39 The Safe Motherhood Initiative Web Site. (http://www.safemotherhood.org). 40 DKT International Web site. (http://www.dktinternational.org). 41 Freedom from Hunger Website (http://www.freedomfromhunger.org/programs/). 42 As reported in World Bank 1997a. 43 Micronutrient Initiative Web site. (http://www.micronutrient.org/about/origin.asp). 44 As reported in World Bank 1999b. 45 As reported in USAID 1994. 46 DANIDA. 1994. “Summary of a Developing World: Strategy for Danish Development Policy Towards the Year 2000.¨ Copenhagen,

Denmark: DANIDA. (http://www.euforic.org/dk/adw.htm). 47 Bill and Melinda Gates Foundation Web site. “Foundation Timeline.” (http://www.gatesfoundation.org/AboutUs/QuickFacts/Timeline/). 48 World Bank Group Archives. “James D. Wolfensohn Presidency Timeline of Major Developments.” 49 PAHO Web Site. ¨About Integrated Management of Childhood Illness.¨ (http://www.paho.org/english/hcp/hct/imci/imci-aiepi.htm). 50 As reported in Inter-American Development Bank 2004. 51 As reported in Vaillancourt (Forthcoming). 52 IAVI Web Site (http://www.iavi.org). 53 ECA, UNICEF and World Bank. 1998. "Addis Ababa Consensus on principles of cost sharing in education and health." New York: UNICEF. 54 WHO Web site. “Tobacco Free Initiative.” (http://www.who.int/tobacco/about/en/index.html). 55 Roll Bank Malaria Partnership Web Site (http://www.rollbackmalaria.org/aboutus.html). 56 CIDA Web site. “Strategy for Health.” http://www.acdi-cida.gc.ca/CIDAWEB/acdicida.nsf/En/STE-42485038-HDF#sec1a 57 French Development Agency Web site. Health Sector. “The Evolution of French Aid in the Sector.”

(http://www.afd.fr/jahia/Jahia/home/NosProjets/PortailSante/pid/1558). 58 The Global Forum for Health Research Web site (http://www.globalforumhealth.org). 59 UNF Web site. Newsroom: Press Releases. (http://www.unfoundation.org/media_center/press/2000/index.asp). 60 The International Benchmarking Network for Water and Sanitation Utilities Web Site, (http://www.ib-net.org). 61 MMV Web site (http://www.mmv.org/rubrique.php3?id_rubrique=15).

91

62 Public-Private Infrastructure Advisory Facility Web Site. (www.ppiaf.org). 63 As reported in World Bank 2007a. 64 DFID. 2000. "Better Health for Poor People." Target strategy paper. (http://www.dfid.gov.uk/pubs/files/tsphealth.pdf) 65 WHO Website. Press Release. “Children’s Immunization Campaign Launched at World Economic Forum: Gates Foundation money used to

spur fight against preventable diseases.” (http://www.who.int/inf-pr-2000/en/pr2000-GAVI.html). 66 Valid International. 2006. "Community-based Therapeutic Care: A Field Manual."

(http://www.aed.org/ToolsandPublications/upload/CTC_Manual_v1_Oct06.pdf).

67 Stop TB Partnership Web site. (http://www.stoptb.org/stop_tb_initiative/). 68 Commission on Macroeconomics and Health Web site (http://www.cmhealth.org/). 69 Ministry of Foreign Affairs of Denmark Web site. “HIV-AIDS New Danish Policy.”

(http://www.um.dk/en/menu/DevelopmentPolicy/DanishDevelopmentPolicy/HIVAIDSNewDanishPolicy/). 70 DFID Web site. “Launch of HIV and AIDS Strategy.” (http://www.dfid.gov.uk/news/files/update-aids-full.asp). 71 Kaiser Family Foundation Web site (www.kff.org/hivaids/timeline). 72 Measles Initiative Web site (http://www.measlesinitiative.org/index3.asp). 73 Global Public-Private Partnership for Handwashing with Soap Web site. (http://www.globalhandwashing.org/) 74 UN Millennium Project Web Site (http://www.unmillenniumproject.org/who/index.htm). 75 DFID Web site. About DFID:History. “International Development Act 2002.”( http://www.dfid.gov.uk/aboutdfid/ida.asp). 76 GAIN Web site (http://www.gainhealth.org/gain/ch/en-en/index.cfm?page=/gain/home/about_gain/history). 77 International Partnership for Microbicides Web site (http://www.ipm-microbicides.org/about_ipm/english/index.htm). 78 World Bank Web Site. “Rome Declaration on Harmonization.” (http://siteresources.worldbank.org/NEWS/Resources/Harm-

RomeDeclaration2_25.pdf). 79 WHO Web site. “The 3 by 5 Initiative.” (http://www.who.int/3by5/en/). 80 WHO Web Site. Epidemic and Pandemic Alert and Response. “SARS.” (http://www.who.int/csr/sars/en/). 81 UNAIDS Web site. “The Three Ones.” (http://www.unaids.org/en/Coordination/Initiatives/three_ones.asp). 82 PEPFAR Web site. (http://www.pepfar.gov/about/). 83 WHO Web site. “Health Metrics Network.” (http://www.who.int/healthmetrics/en/). 84 As reported in Wagstaff and Claeson 2004. 85 As reported in Bryce and others. 2005. 86 WHO Web site. "International Health Regulations." (http://www.who.int/csr/ihr/en/). 87 As reported in Gottret and Schieber 2006. 88 SIDA Web Site. “SIDA’s fight against HIV/AIDS.” (http://www.sida.org/sida/jsp/sida.jsp?d=422&language=en_US). 89 Clinton Global Initiative Web site (http://www.clintonglobalinitiative.org/NETCOMMUNITY/Page.aspx?&pid=392&srcid=393#gen2). 90 GAVI Web site. Media Center. (http://www.gavialliance.org/Media_Center/Press_Releases/pr_newfunds_24Jan2005_en.php). 91 World Bank website. “Making Money Work.”

(http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/ECAEXT/0,,contentMDK:20922718~pagePK:146736~piPK:146830~theSitePK:258599,00.html).

92 Intute Web site. “Timeline of Natural Disasters.” (http://www.intute.ac.uk/sciences/hazards/timeline.html). 93 World Bank Web site. Projects and Operations. ’International Pledging Conference on Human and Avian Flu.”

(http://web.worldbank.org/WBSITE/EXTERNAL/PROJECTS/0,,contentMDK:20765526~pagePK:41367~piPK:51533~theSitePK:40941,00.html).

94 WHO Web site. Media Center. “Global influenza meeting sets key action steps, agrees on urgent need for financing.” (http://www.who.int/mediacentre/news/releases/2005/pr58/en/index.html).

95 WHO Website. 2006 “2006: A year of challenges and achievements.” (http://www.who.int/mediacentre/news/notes/2006/np38/en/print.html). 96 97

As reported in Crisp 2007. Building Partnerships for Development in Water and Sanitation Web Site. (www.bpd-waterandsanitation.org).

98 The Global Partnership on Output-Based Aid Web Site. (www.gpoba.org). 99 High-Level Forum on the Health MDGs Web site (http://www.hlfhealthmdgs.org/HLF5Paris/Sept2006). 100 IFFim Web site. (http://www.iff-immunisation.org/01_about_iffim.html). 101 World Bank Web site. “Joint Statement by the Members of the MDG Africa Steering Group.”

(http://intranet.worldbank.org/WBSITE/INTRANET/UNITS/INTPRESIDENT2007/0,,contentMDK:21477815~menuPK:64821535~pagePK:64821348~piPK:64821341~theSitePK:3915045,00.html).

102 WHO Web site. “International Health Partnership.” (http://www.regjeringen.no/Upload/SMK/Vedlegg/Rapporter/The%20Global%20%20Campaign%20for%20the%20Health%20Millenium%20Development%20Goals.pdf).

103 Women Deliver Web site. (http://www.womendeliver.org/pdf/UK_Pledges.pdf). 104 GFATM Web Site. “Voluntary Replenishment Mechanism 2007.” (http://www.theglobalfund.org/en/about/replenishment/berlin/). 105 DFID Web Site. “International Health Partnership launched today.” (http://www.dfid.gov.uk/news/files/ihp/default.asp). 106 WHO Europe Web site. “International Health Regulations Enter into Force.” (http://www.euro.who.int/mediacentre/PR/2007/20070614_1).