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Transforming Health Systems

The Rockefeller Foundation (RF) continues to support projects intended to improve public health through two major initiatives: disease surveillance and transforming health systems.

Creating Health Equity

The Transforming Health Systems initiative seeks to promote the adoption of national health insurance programs and to increase accessibility to health care in some of the world’s poorest regions. Currently, the Foundation works actively in Bangladesh, Ghana, Rwanda and Vietnam, promoting national health insurance programs and investing in programs to foster accessibility, including e-health initiatives.

Rufiji District, Tanzania, 2006

Rufiji District, Tanzania, 2006

E-health programs encourage the use of information and communication technologies to improve the performance of health systems. The ultimate goals of programs in e-health are to improve access to and the efficiency of health care.  This can include any number of activities, including telemedicine, the creation of electronic health records, e-learning, online patient support and disease surveillance.

Tracking Disease in the Developing World

Disease surveillance programs provide poor, high-risk regions with the knowledge and technical capacity to monitor and report on outbreaks of disease within their borders and to coordinate the communication of information with neighboring countries. The RF has committed $20 million toward disease surveillance programs, including the Mekong Basin Disease Surveillance (MBDS) Project and the East African Integrated Disease Surveillance Network (EAIDSNET).

Dontal hospital in Northern Thailand, 2009

Dontal hospital in Northern Thailand, 2009

MBDS includes six participating countries from the Mekong Basin area, including Cambodia, Laos, Thailand, Vietnam, Myanmar and the Yunnan Province of China. Dengue fever, cholera, polio and malaria number among the diseases being monitored. MBDS enhances communication and data sharing across borders in a more organized attempt to track and prevent the spread of communicable diseases.

EAIDSNET was founded in 2000 and includes the countries of Kenya, Tanzania and Uganda. EAIDSNET focuses on diseases of particular significance to East Africa, including HIV/AIDS, malaria, diarrheal diseases, meningitis and tuberculosis. Disease monitoring is especially important in border villages where sick individuals seeking treatment are often transported over borders without notification to medical offices.[1]  Problems in disease surveillance in this area of the world have included

  1. Poor transport and communications systems that cause delays in reporting disease outbreaks and other pertinent data
  2. Failure by health facilities to utilize such data to its full potential
  3. Local doctors and nurses who are uncertain how to handle the data or to use it to the best advantage[2]

Global Benefits

The RF’s investment in technology and training and the creation of health systems designed for data sharing and collaboration are intended to provide a new way forward for public health in the developing world. The Transforming Health Systems initiative is designed to create equity of access to health care for patients and knowledge for medical professionals. Disease surveillance programs can provide worldwide benefits by tracking potential epidemics quickly and efficiently.


[1] Minutes of the East African Integrated Disease Surveillance Network Local Meeting, September 18, 2001, Rockefeller Archive Center (RAC), Unprocessed, Box R3782, File 2000, HE 051.

[2] Minutes of the East African Integrated Disease Surveillance Network Local Meeting.