Giving Compass' Take:

• In this interview with Devex, Agnes Binagwaho explains how Rwanda channeled funding for HIV/AIDS into health system improvements to boost Rwandans' health.

• Why is funding often disease-directed, rather than system-directed? How can philanthropists most effectively fund healthcare improvements globally?

• Learn about an innovative financing structure to fund global health.

When the United States President’s Emergency Plan for AIDS Relief funds first arrived in Rwanda in 2004, the country had many people with little access to treatment. But the way the government used the funds has created a lasting legacy for its health system, in part due to the work of Agnes Binagwaho.

Binagwaho, now vice chancellor of the University of Global Health Equity and former Rwanda minister of health, is a strong advocate for countries using donor funds to further their country plans. And while it wasn’t always easy, she worked for PEPFAR funds to contribute to holistic improvements in Rwanda’s health system, rather than only serving those with HIV/AIDS or going to build parallel systems, she told Devex.

Did PEPFAR buy into the idea of supporting the whole sector, rather than focusing only on the disease?

PEPFAR was there just for the Americans to take care of the HIV people. However, in Rwanda it doesn't work like that. We take care about the health of Rwandans, so whatever things we did, we integrated and we refused vertical programs.

We created labs for everybody for instance. So that means because we have integration we built the health sector from day one. If we do a supply chain we don’t do a separate system to supply the goods and the drugs for HIV positive patients, we create a supply chain system for all.

If you tell them you will help them inside the system, then they will help inside the system, by doing so you create an international system — no parallel clinic for pregnant women, no parallel delivery for pregnant women, no parallel follow up for HIV positive mothers and children, no parallel vaccination system, no parallel pharmacy, no parallel supply chain, no parallel lab for doing diagnostic or doing follow-ups — you improve the system for all.

Read the full article about PEPFAR funds for medical systems improvements by Adva Saldinger  at Devex International Development.