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They
didn’t look at what had been happening to health systems in each developing country over
the past 100 years to see what progress had been made or why it had been stalled or put in
reverse. What they saw were health systems that were falling apart, that they believed had
no acceptable system for determining priorites or allocating resources, and that were
poorly organised and managed. They had a great sales pitch: they were going to improve
ownership and accountability, increase responsiveness to local needs, improve quality and
effectiveness, promote equity and cut costs. I support all those good things, just as all
of you do -- who wouldn’t? |