Monitoring global health
http://www.100md.com
《英国医生杂志》
EDITOR—Murray et al identify the need for better health information, but their solution is misguided.1 How would their proposal for a richly funded "independent" organisation, primarily concerned with global monitoring be useful to countries?
Such top down, technocratic approaches emphasise global comparability at the expense of countries' ownership. Murray et al assume a priori that addressing the problems with global reporting will also fuel greater commitment among countries to strengthening national health information systems. This approach was used in the work of the World Health Organization that was led by Murray, on burden of disease, health system performance, and the world health survey. The results were an over-emphasis on model building and global comparability, with tenuous links to empirical evidence and a notable absence of involvement from countries. WHO is now working to support the building of country information systems from the ground up while not neglecting its global monitoring role.
Bottom up approaches will not only generate data for country decision making but also produce the information needed by donors and international organisations for global monitoring. This is the underlying premise of the Health Metrics Network, a new global alliance aiming to increase the availability and use of sound data through the reform of country health information systems.
Examples abound of productive interaction between global monitoring and country information systems. Estimates of the AIDS epidemic are generated by countries themselves using standardised methods.2 3 In addition to empowering countries and stimulating the use of data for health action, this approach shows the importance of solid surveillance systems to countries. Capacity building in countries is therefore producing not only better country data but also better global monitoring. It would be wise to build on the current momentum of partnership and collaboration led by the Health Metrics Network and WHO.
Tuberculosis advocacy in Lima, Peru
Credit: WHO/STB/COLORS MAGAZINE/J.MO
Ties Boerma, director, Measurement and Health Information Systems
boermat@who.int, World Health Organization, 1245 Geneva, Switzerland
Carla Abou-Zahr, interim executive secretary, Health Metrics Network
World Health Organization, 1245 Geneva, Switzerland
Competing interests: TB and CAZ work for WHO in Geneva and are involved in the Health Metrics Network.
References
Murray CJL, Lopez AD, Wibulpolprasert S. Monitoring global health: time for new solutions. BMJ 2004;329: 1096-100. (6 November.)
Walker N, Stanecki KA, Brown T, et al. Methods and procedures for estimating HIV/AIDS and its impact: the UNAIDS/WHO estimates for the end of 2001. AIDS 2003;17: 2215-25.
Garnett GP, Grassly NC, Boerma JT, Ghys PD. Maximising the global use of HIV surveillance data through the development and sharing of analytical tools. Sex Transm Infect 2004;80: i1-i4.
Such top down, technocratic approaches emphasise global comparability at the expense of countries' ownership. Murray et al assume a priori that addressing the problems with global reporting will also fuel greater commitment among countries to strengthening national health information systems. This approach was used in the work of the World Health Organization that was led by Murray, on burden of disease, health system performance, and the world health survey. The results were an over-emphasis on model building and global comparability, with tenuous links to empirical evidence and a notable absence of involvement from countries. WHO is now working to support the building of country information systems from the ground up while not neglecting its global monitoring role.
Bottom up approaches will not only generate data for country decision making but also produce the information needed by donors and international organisations for global monitoring. This is the underlying premise of the Health Metrics Network, a new global alliance aiming to increase the availability and use of sound data through the reform of country health information systems.
Examples abound of productive interaction between global monitoring and country information systems. Estimates of the AIDS epidemic are generated by countries themselves using standardised methods.2 3 In addition to empowering countries and stimulating the use of data for health action, this approach shows the importance of solid surveillance systems to countries. Capacity building in countries is therefore producing not only better country data but also better global monitoring. It would be wise to build on the current momentum of partnership and collaboration led by the Health Metrics Network and WHO.
Tuberculosis advocacy in Lima, Peru
Credit: WHO/STB/COLORS MAGAZINE/J.MO
Ties Boerma, director, Measurement and Health Information Systems
boermat@who.int, World Health Organization, 1245 Geneva, Switzerland
Carla Abou-Zahr, interim executive secretary, Health Metrics Network
World Health Organization, 1245 Geneva, Switzerland
Competing interests: TB and CAZ work for WHO in Geneva and are involved in the Health Metrics Network.
References
Murray CJL, Lopez AD, Wibulpolprasert S. Monitoring global health: time for new solutions. BMJ 2004;329: 1096-100. (6 November.)
Walker N, Stanecki KA, Brown T, et al. Methods and procedures for estimating HIV/AIDS and its impact: the UNAIDS/WHO estimates for the end of 2001. AIDS 2003;17: 2215-25.
Garnett GP, Grassly NC, Boerma JT, Ghys PD. Maximising the global use of HIV surveillance data through the development and sharing of analytical tools. Sex Transm Infect 2004;80: i1-i4.