Graeme Chisholm discusses barriers to healthcare in middle-income countries and how to sustain investment. Middle-income country governments face choices that impact citizens' access to healthcare. Workforce issues and achieving universal health coverage are important. Countries must consider national interests but also global interdependence, as health issues know no borders. Aid effectiveness principles like respect, policy coherence, and mutual benefit are key to securing benefits for all.

1. Graeme Chisholm, Policy manager, THET
@THETlinks @graeme.chisholm
graeme@thet.org
Barriers to health in middle-income countries

2. How to sustain investment in healthcare?
Middle-income country governments
are making choices … impacting on citizen’s
ability to access healthcare
Workforce
Universal health coverage HRH
Great affluence/extreme poverty

3. International
Interdependence
“building a healthier world helps to ensure a healthier Britain”
Mutuality
UK’s attitude to aid
“There is something deeply condescending about receiving aid from a country that
ruled you for 200 years. Self-respecting nationalists should welcome the UK’s decision
to stop aid to India”
Global?

4. National interest?
Common interest? Enlightened self-interest?
Mutual interest? Striking the right balance
Careful programme design
Respect aid effectiveness
principles
Policy coherence
to secure mutual benefits
“The rise of an appreciation that aid
is given in ways, which bring mutual benefit.”

5. A comprehensive service available to all
Access to services based on clinical need, not an
individual’s ability to pay
Excellence and professionalism
Put patients at the heart of everything
Partnership
Value for money
Accountable

6. NHS is a global leader in workforce education and training
quality
value for money
leadership
Global?