By Ian Wilhelm

The Rockefeller Foundation has pledged $100-million over five years to help impoverished nations build better health-care systems.

The project, called Transforming Health Systems, represents a new approach for large foundations, which have previously focused more on fighting specific diseases rather than bolstering whole health systems.

The program will pay for international advocacy and research but will primarily assist three countries — Ghana, Rwanda, and Vietnam. Depending on the success in those nations, it will be expanded to other regions of Africa and Asia.

“This new initiative will tear down barriers preventing millions of people from accessing affordable, high-quality health services,” Judith Rodin, Rockefeller’s president, said in a speech today in Nairobi. “And it will help ensure that advances in life-saving treatment can improve the lives of more people, in more places, more fully and fairly.”

Rockefeller, in New York, has a long history of supporting global health. It led a 1913 campaign to stem the spread of yellow fever in East Africa, has paid for the development of public-health training, and has forged partnerships among drug makers, governments, and philanthropies to create new drug treatments and vaccines.

For its new effort, Rockefeller said it will try three approaches:

Training health professionals and developing better health policies, data-gathering, and financing mechanisms. Improving regulation and partnership of private hospitals and other nongovernment health players. Using mobile phones, electronic health records, and other information technology to improve access to health services and making them less expensive.

Support for global health has grown dramatically in the past 20 years. According to a recent study by the University of Washington and Harvard University, giving for overseas health efforts from foundations, federal agencies, and corporations has quadrupled to about $22-billion.

But Rockefeller said that despite the increase, many poor countries lack efficient and affordable health programs. For example, it said that the World Health Organization reports that 125 million people spend nearly half their annual income on health costs and 25 million families are forced into poverty annually because they are hit with massive health-care expenses.

What’s more, foundation spending on global health has tended to emphasize specific diseases and health problems, like HIV/AIDS or malaria. Critics have derided the approach as “stovepiping,” saying it usually doesn’t reflect the needs of poor nations.

Rockefeller’s Ms. Rodin seemed to partially agree with those concerns.

“While vertical interventions –- including revolutionary new drugs and treatments –- remain crucially important, we must also ensure that they get to the people who most need them,” she said. “We must break the bottlenecks that restrict access to quality services because no matter how powerful the drug, it won’t do any good if consumers can’t reach the doctor that prescribes it, the clinic that provides it, or pay the bill if they receive it.”