Aid Accountability and Effectiveness: A code of conduct

Health systems in many countries are characterized by shortages of health workers, inadequate supplies, and limited ability to respond to a growing disease burden. Foreign assistance from government and private programs such as the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have not significantly contributed to strengthening public health systems. NGO growth has led to a proliferation of projects and approaches, creating a growing management burden for Ministries of Health. Some donors have tried to address these issues through the Paris Declaration for Aid Effectiveness. International NGOs have grown and multiplied dramatically as donors favor NGOs over government for aid packages.

A Code of Conduct for Health Systems Strengthening will be launched in late May, 2008 when the initial list of signatories will be unveiled. In the growing concern about aid effectiveness and health systems strengthening, this new code has been increasingly referenced as an important tool for international actors, including donors, governments, and of course NGOs themselves. International NGOs have an opportunity to support health system strengthening through sustainable practices promoted in a new code of conduct. There is a growing consensus that the strongest health systems are those operated by highly functional ministries of health, with strong government oversight and adequate funding, supplemented in some areas by the private sector. Key topics covered in the code include: hiring practices, compensation, training and support, government management burden, and integrating communities into the formal health system.