ArticleGlobal public health2014
The GAVI Alliance and the 'Gates approach' to health system strengthening.
Article in Global public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers against and strategies for malaria control during the COVID-19 pandemic in low- and middle-income countries: a systematic review.Malaria journal · 2023Pooled it
- 'I Think From the Beginning, the Ambitions Were Compromised': A Case Study of COVAX as Vaccine Equity Policy Operationalisation.The International journal of health planning and management · 2026Article
- Global Health Initiatives and Universal Health Coverage in Pakistan-Aligned for the Future?The International journal of health planning and management · 2026Article
- Human Rights Accountability in Global Health Multi-Stakeholder Partnerships: The Case of the Access to COVID-19 Tools Accelerator.Health and human rights · 2025Article
- The landscape of public-private partnerships in global health governance: introducing a new dataset.Globalization and health · 2025Article
- Institutional quality, aid flows, and malaria burden: a geospatial analysis of sub-Saharan Africa.Malaria journal · 2025Article
- Ideas matter: An analysis of the effects of framing on health system strengthening in Zimbabwe.Health research policy and systems · 2025Article
- Understanding the political economy of reforming global health initiatives - insights from global and country levels.Globalization and health · 2025Article
- The Gates Foundation's network diplomacy in European donor countries.Globalization and health · 2025Article
- Navigating authoritarian politics: towards reflexive framing in healthcare research.Globalization and health · 2025Article
- Evaluating geographic accessibility to COVID-19 vaccination across 54 countries/regions.BMJ global health · 2025Article
- Health Alliances: a new way of working internationally.BMC health services research · 2025Article
- Equivocal diagnostics: Making a 'good' point-of-care test for elimination in global health.Social studies of science · 2024Article
- Holy grail or convenient excuse? Stakeholder perspectives on the role of health system strengthening evaluation in global health resource allocation.Globalization and health · 2024Article
- An evaluation of a multi-partner approach to increase routine immunization coverage in six northern Nigerian States.BMC health services research · 2024Article
- 'We thought supporting was strengthening': re-examining the role of external assistance for health systems strengthening in Zimbabwe post-COVID-19.Health policy and planning · 2024Article
- [Determinants of vaccine acceptance in Makokou, Gabon].The Pan African medical journal · 2024Article
- Decolonising global health research: Shifting power for transformative change.PLOS global public health · 2024Review
- The Gates Foundation's new AI initiative: attempting to leapfrog global health inequalities?BMJ global health · 2023Article
- Evaluating Country Performance After Transitioning From Gavi Assistance: An Applied Synthetic Control Analysis.Global health, science and practice · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS). This article critically analyses this development through an ethnographic case study of the GAVI Alliance, which funds vaccines in poor countries. Despite GAVI's self-proclaimed 'single-minded' focus on vaccines, HSS support is fronted as a key principle of GAVI's mission. Yet, its meaning remains unclear and contested understandings of the health systems agenda abound, reflecting competing public health ideologies and professional pressures within the global health field. Contrary to broader conceptualisations of HSS that emphasise social and political dimensions, GAVI's HSS support has become emblematic of the so-called 'Gates approach' to global health, focused on targeted technical solutions with clear, measurable outcomes. In spite of adopting rhetoric supportive of 'holistic' health systems, GHIs like GAVI have come to capture the global debate about HSS in favour of their disease-specific approach and ethos.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.