 March
2, 2004, Washington DC, USA.- The World Bank's Latin
America and Caribbean Region Health Unit teamed up with
GDLN to launch the Milestone Dialogue series. The Milestone
Dialogue is a series of virtual, interactive sessions
through which innovative contributions in the field of
public health are shared and discussed with stakeholders
from the region. The idea to develop and offer these dialogues
arises from the need for sharing innovative knowledge
in the area of health throughout the region and to disseminate
it on national levels.
 The
first Milestone Dialogue featured Dr. Daniel Cotlear,
World Bank Human Development Sector Leader for Bolivia,
Ecuador, Peru and Venezuela, as the keynote speaker
who presented, "The
Accountability Framework for Health in the Andean Region."
The presentation was done in virtual mode which allowed
Dr. Cotlear to engage in an enriching dialogue with
health sector policy makers, experts, and professionals
based in Bolivia, Ecuador, and Peru. The Latin American
based experts had the opportunity to hear Dr. Cotlear's
presentation first-hand, share their related experiences,
and present comments for further consideration and discussion.
The overarching theme of Dr. Cotlear's presentation
raised the issue of how to improve health services for
the poor in the Andean region. Within this theme, Dr.
Cotlear elaborated on how the poor tend to have the
worst results in health due to poor coverage, the slow
progress in serving the indigenous population, geographical
and epidemiological targeting to reach the poor, improving
the provision of services to the poor, and strengthening
the power and voice of the client. Dr. Cotlear concluded
his presentation by presenting three questions for the
international panelists to reflect on: (1) Does decentralization
strengthen accountability? (2) How can we provide better
services to the indigenous population? (3) How can we
strengthen services for the poor in a volatile economic
and political climate?
Bolivia's Minister of Health, Dr. Fernando Antezana
was the first panelist to present his comments and underscored
the importance of the framework in addressing the universalization
of health services and of complementary accessible education.
The second panelist, Dr. Guillermo Cuentas, Bolivia's
former Minister of Health, stressed the importance of
constructing public policies based on evidence that
generates human development and the need to introduce
reforms in the area of human resources. Ecuador's panelist,
Dr. Francisco Rigail, Director of Ecuador's Health Modernization
Program (MODERSA) shared his perspective on strengthening
accountability by bringing in municipalities and local
communities as part of the process. Peru's first panelist,
Econ. Mario Arrospide, of the Multi-annual Planning
Area of the Ministry of Economics contributed to the
discussion by highlighting the need to determine society's
commitment and participation in helping to determine
needs while entrusting the definition of technical criteria
to experts. Finalizing the panelists' comments, Dr.
Lyda de Sulovich, Advisor to Peru's Minister of Health,
addressed the issue of evaluating the possibility of
maintaining these services accessible to the poor.
Participants in each of the three countries then had
the opportunity to present questions and additional
comments for discussion with Dr. Cotlear and the featured
panelists. In Bolivia and Ecuador, national connections
were established which allowed national-level stakeholders
to participate from three and fifteen cities respectively.
The commonalities the three countries share came to
light as questions and comments centered around the
issue of the fragmentation of the health sector, the
lack of human resources, the need for institutional
democratic reforms relating to the sector, and the challenges
of expanding coverage to the poor.
The dialogue concluded with the brief, congratulatory
words of Ecuador's Vice President, Dr. Alfredo Palacio
who directly participated from Ecuador and recognized
the innovative dialogue and stressed the importance
of communication between the state and its citizens
in ensuring that the program characteristics are explicit
and clear for the citizens. Lastly, Dr. Palacio shared
his firm hope for better solutions for the problems
and challenges the Andean region faces.
The Milestone Dialogue can be viewed in its entirety
by visiting: http://onions.worldbank.org:8080/ramgen/vid/Health/HealthMD1.rm
For additional information regarding this activity
or to learn of future health related programs to be
offered by GDLN, please contact Carmen Carpio (ccarpio@worldbank.org).
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