The Conversation: Only a bottom-up approach will deliver global health development targets
Karen Daniels, specialist scientist in the Health Systems Research Unit at the South African Medical Research Council; Aku Kwamie, health systems researcher at the University of Ghana; and Fadi El-Jardali, professor of health policy and systems at the American University of Beirut

“There is an urgent need to put together a coherent goal-readiness plan to drive the Sustainable Development Goals related to health. To succeed it needs to address three critical elements: how the goals will be financed, what health systems need to be established, and how new skills, new thinking, and new ways of working together across systems can be developed. … The old system of control through vertical program targets needs to be relinquished. … Unlike in the past, governments, frontline workers and communities should not be expected to deliver on targets that are unrealistic because of constraints outside their control. This includes financial, material, human resource, and time constraints as well as a constrained way of thinking. Instead, the success of the Sustainable Development Goals requires a vision for integration that includes a clear plan, and contingencies for the plan. This will ensure ownership and accountability to the people — not only within health systems but within all global systems” (10/19).