The European ESTHER alliance contributes to the implementation of its member states policy for health sector development aid.
AN INITIATIVE TO COUNTER NORTH-SOUTH INEQUALITIES IN HEALTH
The ESTHER initiative acquired a European dimension soon after the creation of the GIP ESTHER (public French agency) in March 2002. An initial core of countries (France, Italy, Luxembourg and Spain) agreed in April 2002 to “jointly develop a programme ‘Network for Therapeutic Solidarity in Hospitals against AIDS’ in order to strengthen the skills and capacities of health structures in developing countries for the care of people living with HIV/AIDS, together with United Nations organisations and the Global Fund to fight AIDS, Tuberculosis and Malaria”.
The members agreed to set up a European Secretariat at GIP ESTHER. Two years later, in March 2004, four further countries ratified the same declaration (Austria, Belgium, Germany and Portugal) followed by Greece in September 2006. Norway joined the Alliance in November 2008, followed by Switzerland in November 2011 and Ireland in February 2012. In October 2012, the United Kingdom joined the EEA with an observer status.
The European Secretariat has advanced the extension and structuring of the network by holding a number of European and bilateral meetings. By 2012, almost all the European ESTHER Alliance’s member countries had released operating funds to define the modalities of their ESTHER work and implement activities in partner countries. Recent progress reports (European meetings in November 2011, June 2012 and October 2012) on each member country’s activities showed that the Alliance is active in nearly 40 countries in sub-Saharan Africa, North Africa, Central and South America, Central and South-East Asia.
Since its creation in 2002, the European ESTHER Alliance has strongly evolved, in respect to its health focus/mandate (1), its activities (2), its mode of action (3), its dimension (4).
(1) From HIV/AIDS, the EEA is now involved in other global health priorities (MDG 4 – child health, MDG 5 – maternal health, MDG 6 – HIV, malaria and other diseases (TB) and beyond: e.g. hygiene and patient safety, blood banks, handicap care, neglected diseases). This represents a new agenda for the ESTHER Alliance, matching with the international agenda in health.
(2) From a site to site care and treatment approach, the EEA has developed a Health System Strengthening approach through care and treatment in health facilities, psychosocial support, therapeutic education, hospital and care management, institutional capacity development, operational research, drug procurement, supply management, monitoring & evaluation, health policy design, quality management etc.
(3) From the North/South hospital partnership modus operandi, the EEA has designed a model that includes additional and complementary approaches to hospital twinnings: Twinning with institutions other than hospitals (research institutes, universities), civil society organization partnerships, Extra Hospital Technical assistance, information and communication technologies, external funding implying new modes of action and accountability.
(4) From 4 country members in 2002 (France, Italy, Luxembourg, Spain), the EEA now consists of 12 country members (Austria, Belgium, Germany, Portugal who joined in 2004; Greece in 2006; Norway in 2008; Switzerland in 2011 and Ireland in 2012) and one observer (UK).
These developments (points 1 to 3) arose out of a jointly driven process. They are the results of an independent development of each ESTHER’s national entities. An analysis of the key programs implemented by the Alliance has shown that two common denominators of all ESTHER entities is:
1. Activity: Health Human Resources capacity building
2. Mode of action: North / South & South / South hospital partnerships
This represents the evolution of the ESTHER modus operandi and the definition of a new business model that reflects member country development cooperation in health priorities and the development cooperation in health landscape more than 10 years after the launch of the ESTHER Initiative.