IN THE JOURNAL | POINT OF VIEW
No policy coherence? No poverty reduction
July-September 2017
By: Raymond Saner and Lichia Yiu

First, supporting the precarious health conditions and health sectors of least developed countries falls on many actors, including the World Health Organization, the World Bank and Unicef; aid agencies from many countries such as the United States and Denmark; leading nongovernmental organizations like Oxfam and the Global Fund; and foundations such as the Bill and Melinda Gates Foundation. Policy coordination among these actors in the context of poverty reduction strategies in the health sector has been found to be insufficient.

Policies aimed at improving the health sector are tragically flawed, due to the tendency of leaning toward more “vertical programs” for health by international organizations, national governments and donor agencies. Vertical health programs are initiatives that are “disease specific projects.” Horizontal health programs, on the other hand, are aimed toward “more broad-based improvements in population health, such as preventive measures, primary health care services, health work force development” and strengthening health systems.

Vertical health programs alone are not enough to improve the overall health of a society. The huge amount of funding invested in vertical programs such as AIDS, tuberculosis and malaria prevention are creating inefficiency and waste, due to the neglect of other cross-cutting issues pertinent to those campaigns. The lack of communication between different health care initiatives results in program overlaps, operational confusion and the squandering of funds at the ground level. The 2014 Ebola epidemic in West Africa demonstrated the inadequate policy coordination among concerned actors.

Second, Sustainable Development Goal number eight promotes sustained, inclusive and sustainable economic growth, full and productive employment, and decent work for all. Free trade agreements concluded by the United States, the European Union and Australia often include provisions to safeguard labor rights. However, research conducted by the authors found that policy incoherence became apparent when comparing trade agreements with the countries’ interactions with their trade partners during the universal periodic review sessions and the sessions’ documents. 

The authors’ core observations were that the United States and Australia often lack a clear direction in their policy when approaching these review sessions. The recommendations by these states tend to be misaligned with those of the official review session reports. In the case of the United States, it tends to make generalized recommendations while not targeting specific areas of labor rights. In Australia’s case, it lacks labor provisions in most of its trade agreements, thus making it harder to evaluate its policy. The policy incoherence is self-evident between the labor provisions of the bilateral trade agreements and upholding human/labor rights in other policy arenas.

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