ABSTRACT
UNICEF is widely seen as having shifted over the last quarter of a century from a horizontal approach to global health, in line with the WHA, to a more selective, vertical strategy (Werner 2001, Koivusalo and Ollila 1997: 209). From standing ‘shoulder to shoulder’ with the WHO at Alma Ata in 1978 when the ‘Health for All’ crusade was launched, by the mid 1990s UNICEF had moved closer to the World Bank in focusing on the implementation of specific projects rather than the gradualist advancement of primary health care. Werner considers this not to be a shift in ideology by the organization but, rather, the effect of UNICEF being a voluntary fund and so constrained by the preference of its donors for programmes of vaccinations and drug administrations over education and structural improvement. A key factor in the rise to prominence of UNICEF and particularly the World Bank has been that their point of contact with governments is through finance rather than health ministries, which are usually more politically powerful (Koivusalo and Ollila 1997: 207-208, Abbasi 1999, Godlee 1994: 1495).
