The panel is a driving force, intellectually and politically, for support to African efforts at health improvement. The World Bank has organized several inter- country workshops on health strategy, including the analyses and messages of Better Health in Africa, with the active participation of a wide range of domestic and external stakeholders. The Bank has signalled its willingness to hold further such events where the governments are interested and have indicated their readiness to embark on the road to reform. Three, the donor community, and the international organizations with health responsibilities, should be in a position, not of leadership but of support for African initiatives for health improvement, both nationally and internationally. Donors finance about 20 percent of total health expenditures, and over half of the total in some countries.
Donors finance virtually all health investment in Africa.
Thus, they bear a major share of the responsibility for the nature of African health systems today. It is time for the donors to fit their financial support for health improvement into coherent national programs under government leadership. Recent experience of local leadership of donors for health improvement, for example in Mozambique, suggests that donors will welcome country leadership. One specific initiative that could be undertaken to bring Africans and donors closer together on health issues is the elaboration of consensus guidelines for official and non-governmental donors regarding future assistance for health improvement in Africa. The perspectives of Ministers of Health, and of both official and private voluntary donors to health, would be essential to the formulation of any such guiding principles.