Het Schelde-estuarium als filter: een bioreactor van stofstromen

The Scheldt estuary is exposed to large loads of carbon and nutrients. This leads to a eutrophication problem characterized by reduced oxygen concentrations and a huge efflux of CO2. In the coastal waters a degradation of the foodchain is noted caused by excessive nutrient supply. The capacity of the estuary to polish the water is important but can not cope with the vast scale of the immissions. Restoration and development of tidal wetlands can contribute in several ways to restore the water quality. Increase of water treatment is expected to have positive ecological results. Nevertheless, restoration of the oxygen conditions might counteract some purifying processes

The Health Systems Funding Platform : is this where we thought we were going?

Background: In March 2009, the Task Force for Innovative International Financing for Health Systems recommended "a health systems funding platform for the Global Fund, GAVI Alliance, the World Bank and others to coordinate, mobilize, streamline and channel the flow of existing and new international resources to support national health strategies." Momentum to establish the Health Systems Funding Platform was swift, with the World Bank convening a Technical Workshop on Health Systems Strengthening (HSS), and serial meetings organized to progress the agenda. Despite its potential significance, there has been little comment in peer-reviewed literature, though some disquiet in the international development community around the scope of the Platform and the capacity of the partners, which appears disproportionate to the available information. Methods: This case study uses documentary analysis, participant observation and 24 in-depth interviews to examine the processes of development and key issues raised by the Platform. Results: The findings show a fluid and volatile process, with debate over whether ongoing engagement in HSS by Global Fund and GAVI represents a dilution of organizational focus, risking ongoing support, or a paradigm shift that facilitates the achievement of targeted objectives, builds systems capacity, and will attract additional resources. Uncertainty in the development of the Platform reflects the flexibility of the recently formed global health initiatives, and the instability of donor commitments, particularly in the current financial climate. But implicit in the conflict is tension between key global stakeholders over defining and ownership of the health systems agenda. Conclusions: The tensions appear to have been resolved through a focus on national planning, applying International Health Partnership principles, though the global financial crisis and key personnel changes may yet alter outcomes. Despite its dynamic evolution, the Platform may offer an incremental path towards increasing integration around health systems, that has not been previously possible