Published on Investing in Health

Harmonization and alignment in development assistance for health: now what?

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SDM-NP-101 World Bank

The International Health Partnership (IHP+) has done an exceptional job the last three years in bringing together countries, donors, international financial institutions, civil society, the United Nations, and many other partners to agree on how, concretely, we would implement the principles of the Paris Declaration on Aid Effectiveness. It’s a complex, demanding, and crucial task.

We support countries’ efforts to improve the lives of millions of people—but we often accompany this support by burdening countries with many different reporting, fiduciary, monitoring, evaluation, and other systems. Five years ago, we didn’t have a venue to discuss, or know, what good harmonization and alignment could look like, and we hadn’t agreed to common fiduciary, monitoring, and evaluation systems.

But today, in large part to our shared efforts in the context of IHP+ and country leadership, we’ve agreed on a joint assessment of country health strategies, a common financial management approach, and on some aspects of monitoring and evaluation. And we have outstanding country examples such as Nepal.

Why, then, isn’t this happening at a speed compatible with the urgency of the task? If we have examples and agreements, what’s stopping us?

Our efforts to sustain and scale up our support to countries’ efforts to improve the health conditions of millions are undermined by many examples of lack of harmonization and alignment. It is imperative that we now must walk the walk, since for some time, we’ve talked the talk.

Through our work on the ground, we—the bilateral organizations, World Bank, Global Fund, GAVI, regional development banks, foundations, civil society—will achieve the much-needed harmonization of approaches and systems among partners and alignment with country leadership priorities. It’s through country leadership making us accountable that we will not only walk the walk, but run ahead. It is urgent.


Cristian Baeza

Former Director, Health, Nutrition, and Population

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