Vertical interventions and system effects; have we learned anything from past experiences?

Abstract

The recent Ebola Virus Outbreak had a devastating effect on West Africa's already feeble national health  systems. We suggest that such an impact turned out to be catastrophic because it hit particularly hard human resources for health and the delivery of primary healthcare services, which are cross-sectional to any health system. National and international interventions failed to understand the nature of this interaction, and  concentrated on attending urgent specific vertical functions to fight the outbreak - the pillars - such as  surveillance, logistics, safe burials etc. Such patchwork and vertical intervention strategy was always going to fail to tackle a system-wide problem, particularly in already fragile systems. We suggest that future interventions will have to learn from the experience of past initiatives for the introduction of HIV-AIDS  services, which started as vertical programs and ended up including ever growing health system strengthening components.

Key words: Ebola Outbreak Response, vertical interventions, global health initiatives