The Country Cooperation Strategy (CCS) is WHO’s medium-term strategic vision to guide its work in support of a country’s national health policies, strategies and plans and to support a country’s development efforts within the Sustainable Development Agenda. The CCS forms the basis for the formulation of WHO’s biennial country work plans with the Ministry of Health, and functions as a tool for harmonizing cooperation with partner United Nations (UN) organizations.
The health of Palestinians in the occupied Palestinian territory has been uniquely affected by occupation by Israel, which has been ongoing since 1967. Health concerns relate not only to the direct effects of conflict and military action but also to the impact of the occupation on human security, well-being and the wider determinants of health. Periodic escalations of violence especially affect the Gaza Strip, and geographical fragmentation and restrictive policies further compound public health risks and constrain opportunities for development. In addition to the health consequences of the occupation and frequent bouts of violence, the Palestinian people face the challenge of a rising burden of noncommunicable diseases, similar to neighbouring countries.
This current CCS, covering 2017–2020, shares similarities and maintains continuity with the previous strategic agenda developed for 2009–2013. The gap between the two strategic cycles results from the urgent response to the severe humanitarian needs caused by the Gaza conflict in 2014 and the decision to harmonize the new strategy and planning cycle with those of the government and the UN.
The latest WHO guidance for developing the CCS, issued in 2014, emphasizes the need for a more inclusive process at country level to ensure co-ownership by the government and the WHO Secretariat. This document focuses on strategic priorities that link to related WHO and UN strategies and planning processes (WHO biennial plans, Common Country Assessment, UN Development Assistance Framework) and align with the WHO Twelfth General Programme of Work and the regional strategic plans. The CCS also aligns with national planning strategies for Palestine, including the National Policy Agenda and the National Health Sector Strategy for 2017–2022.
Since the previous CCS in 2009, the global policy debate on development and humanitarian aid has evolved from the recognition that the Millennium Development Goals did not sufficiently target the poorest and those living in fragile, conflict-torn states. Key global initiatives and events have marked progress in building on the experience of the Millennium Development Goals, such as the High Level Forum on Aid Effectiveness in Busan in 2011, the agreement on Sustainable Development Goals in New York in 2015 and the first World Humanitarian Summit in Istanbul in 2016. One common denominator of these initiatives has been consensus on the need for equity and for focusing aid on vulnerable, fragile countries that present a higher risk of instability and insecurity at national, regional and global levels. Within countries, there is equally a need to focus on the most disadvantaged groups, as underlined by the UN SecretaryGeneral’s call to “leave no one behind”.
Since 2010, most development agencies, including WHO, have been negatively affected by the global financial crisis. With fewer financial resources available, WHO’s leadership and its Member States agreed that the agency must improve its performance and efficiency in order to be responsive to challenges of the changing environment. Hence, WHO embarked on reforms at the programmatic, governance and managerial levels, with the overall aims of improving people’s health; increased coherence in global health; and organizational excellence, including a stronger human rights approach to health. The Ebola crisis of 2014–2015 in Western Africa highlighted gaps and challenges for WHO, and a further aim of the reforms is to enhance WHO’s capacity to prepare for and respond to public health emergencies.
Universal health coverage is a global priority target for health. It is specifically promoted through Sustainable Development Goal 3 : “Countries are urged to achieve financial risk protection, access to quality essential health care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all”, with particular attention to ensuring financial protection for all disadvantaged and excluded groups. Removing financial barriers, increasing the proportion of the population covered and the quality and extent of health services included are all necessary dimensions to attaining universal health coverage and ensuring a health system that is equipped to respond to crises and emerging health needs. The World Bank and WHO completed a mission in 2016 to evaluate the existing situation for universal health coverage in Palestine, including a situational analysis and appraisal of some of the key challenges facing the health system. Based on this evaluation, the mission proposed strategic directions and actions to improve health financing and health service delivery for universal health coverage in the West Bank and Gaza.
At country level, the Palestine National Development Plan 2014–2016 has identified health system strengthening and equity among its social protection and development strategic objectives: “A more integrated health care system, providing high-quality and equitable public health care services for all”. Health system strengthening is also a cornerstone of the National Policy Agenda 2017–2022, reflected in national policy priority 9: “Quality health care for all”.
This CCS aims to incorporate these major developments in global and national priorities and forge a way forward to improve the health of Palestinians. Section 2 describes the achievements and challenges in the current health context, looking specifically at the development framework, health status and system, and the contributions of major stakeholders. Section 3 focuses on the review carried out by the WHO Office in the occupied Palestinian territory in late 2015 through participatory consultations with key partners (foremost with the Ministry of Health) on the technical achievements and challenges of the previous CCS and recommendations for future work. Section 4 lays out the four strategic priorities and the focus areas within each priority that define the Strategic Agenda for WHO’s cooperation in the West Bank and Gaza Strip for 2017–2020. Section 5 outlines the human and financial resources required for WHO’s implementation of the CCS. Finally, Section 6 details WHO’s plans for stakeholder engagement to implement an effective and relevant framework for monitoring and evaluating the CCS in preparation for mid-term and final reviews.