A Few Buckets of Ice Cold Water

This summer, we were entertained with numerous videos of famous and not so famous people emptying buckets of ice cold water over their heads and challenging others to do the same in all kinds of situations (#ALSIceBucketChallenge). All of these people and this activity generated more discussion about amyotrophic lateral sclerosis (ALS) than has ever been heard ever before. The campaign on the social networks in support of the ALS Association raised over US$115 million in just three months—money that will be used to combat the disease and, even more importantly, to further research on new diagnostic methods and treatments.

The #ALSIceBucketChallenge campaign raised over US$115 million in just three monthsA good cause is certainly worth a bucket of ice cold water. And an innovative bucket of cold water could, it seems, help organisations working in the field of global health to establish a clear position for themselves among thousands of other organisations. Today, every cause has to compete globally for the gradually diminishing resources allocated to global health and development cooperation. The strategies and administrative tools of organisations working in global health, which are mainly in the nonprofit private sector, must evolve rapidly to remain competitive in the current continuously changing environment, or simply to continue to exist.

The legitimacy of intelligently administered good causes makes it possible for us to mobilise resources and commitment to deal with the many health problems that affect the world's population. Thanks to the excellent viral promotion of the ice bucket challenge, the ALS campaign has had an enormous impact and has captured resources that were not previously available.

The governance of global health, which for some years has been undergoing a process of reform, is a key factor in the effort to improve coordination between the different actors and the effectiveness of all the work being undertakenOne of the first challenges facing organisations working in global health is to capture and mobilise funds and support in an environment characterised by a multiplicity—a cacophony one might say—of different actors and stakeholders, as well as the dilution of roles and responsibilities between the state, international agencies, the private sector and civil society in a economic conjuncture marked by a prolonged crisis. The second and no less important challenge, however, is how to establish the criteria and mechanisms that will determine how the available resources are allocated to the long list of global health concerns.

In some cases, universal emotions, solidarity and human rights values act as a social and institutional stimulus, even influencing the political agenda. In others, an attempt is made to distribute the effort and resources according to policies and initiatives based on criteria such as burden of disease, mortality rates or health risks. The governance of global health, which for some years has been undergoing a process of reform, is a key factor in the effort to improve coordination between the different actors and the effectiveness of all the work being undertaken.

The debates and on how to improve governance, proposals for improving it, and discussions about how good administration fosters good decisions and develops effective global health strategies will all be analysed in a combined course on Governance and Management for Global Health. In these times, the best contribution effective management and governance can make to the impact of global health programmes is to provide the answer to a single question: How can we do more and achieve better results with the same (or less) resources?

[Enric Grau is the coordinator of the Governance and Management for Global Health course].