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How Can Disease Control Program Contribute to Health System Strengthening in Sub-Saharan Africa : A Concept Note for Engaging in the Global Debates on Health Systems StrengtheningRecently, there has been broad consensus in the global health community on the need for health systems strengthening (HSS) to make further progress toward the Millennium Development Goals (MDGs) in Sub-Saharan Africa. However, there is still divergence on how HSS should be framed, what HSS practically entails, and how it should be done. We set out to clarify HSS for managers of disease control programs (DCPs). In September 2000, the United Nations created a new movement in the fight against poverty: 189 countries in the General Assembly expressed their commitment to the Millennium Development Goals (MDGs) in the Millennium Declaration (World Health Organization 2004). The recognition of health as one of the key determinants of human development is translated in three health-related MDGs. MDG 4 and 5 focus respectively on children and women as priority target groups, and MDG 6 focuses on priority diseases (HIV/AIDS, malaria, and other major diseases), representing the bulk of the disease burden in low-income countries. In section two, the author first focuses on how national health systems can be understood, with their strengthening in mind, with a special focus on service delivery and on its pluralistic nature. In section three, the author uses the Anna Karenina principle to explain an approach to health systems assessment at the national level. Finally, in section four, the author develops an approach on how Disease Control Program (DCP) can contribute to Health systems Strengthening (HSS) at country level.
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The World Bank's Commitment to HIV/AIDS in Africa : Our Agenda for Action, 2007-2011The World Bank is committed to support
 Sub-Saharan Africa in responding to the HIV/AIDS epidemic.
 This Agenda for Action (AFA) is a road map for the next five
 years to guide Bank management and staff in fulfilling that
 commitment. It underscores the lessons learned and outlines
 a line of action. HIV/AIDS remains and will remain for the
 foreseeable future an enormous economic, social, and human
 challenge to Sub-Saharan Africa. This region is the global
 epicenter of the disease. About 22.5 million Africans are
 HIV positive, and AIDS is the leading cause of premature
 death on the continent. HIV/AIDS affects young people and
 women disproportionately. Some 61 percent of those who are
 HIV positive are women, and young women are three times more
 likely to be HIV positive than are young men. As a result of
 the epidemic, an estimated 11.4 million children under age
 18 have lost at least one parent. Its impact on households,
 human capital, the private sector, and the public sector
 undermines the alleviation of poverty, the Bank's
 overarching mandate. In sum, HIV/AIDS threatens the
 development goals in the region unlike anywhere else in the world.
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Niger's HIV Response : Targeted Investments for a Healthy FutureThe main objective of the study is to
 provide a comprehensive analysis of HIV and health financing
 needs, investment opportunities, and health system
 development in the context of the Government of Niger's
 HIV National Strategic Plan (NSP) 2013-17. The analysis
 provides support for HIV policy decision-making, investment
 scenarios and programmatic targeting and prioritization. In
 addition, the analysis helps Niger build the case for HIV
 and health impact investment including delivering estimates
 of health care savings as a result of these investments. The
 analysis was implemented by the World Bank in collaboration
 with UNAIDS from a request for analytical support from the
 Government of Niger. The study involved a desk review of
 HIV- and health-related evidence, epidemic trends and
 financial modeling. The Optima model (formerly Prevtool) was
 used to estimate optimal resource allocation during the NSP,
 and the impact and cost-effectiveness of past HIV
 investments. A financial commitment framework was used to
 estimate longer-term costs and savings of the HIV program
 and the fiscal dimension of HIV in Niger.