Achieving the United Nations Millennium Development Goals for health
will require that programs supporting health in developing countries focus
on strengthening national health care systems. However, the dominant
neoliberal model of development mandates reduced public spending on
health and other social services, often resulting in increased funding for
nongovernmental organizations (NGOs) at the expense of support for government
systems. East Timor, later Timor-Leste, is an example of a post-crisis
country where international NGO efforts were initially critical to providing
relief efforts to a traumatized population. Those groups were not prepared to
help develop and support a standardized Timorese national health plan,
however, and the cost of their support was unsustainable in the long term.
In response, local authorities designed and implemented a post-crisis NGO
phase-over plan that addressed risks to service disruption and monitored
the process. Since then, some NGOs have worked collaboratively with the
Ministry of Health to support specific efforts and initiatives under a framework
provided by the ministry. Timor-Leste has shown that ministries of
health can facilitate an effective transition of NGO support from crisis to
development if they are allowed to plan and manage the process.