True, for major disease eradication programs you need the grand strategy approach... though even there the effort hinges on effective local implementation. Actually delivering effective health care at the local level requires more than that. If the Cubans can do it, and if individuals can do it in other places, it can be done, and if it can be done with limited resources in some places, it can be replicated.
Sometimes the priorities get skewed. HIV gets more attention than malaria or TB, both of which are arguably bigger problems. Even those get more attention than the combination of invisible combination of malnutrition and parasitism... invisible because it shows up in the data as death from respiratory or GI infections. Grand strategy could be useful in dealing with these problems, especially if it focused on clean water and sanitation (less sexy, alas, than eradication of dreaded diseases), but again effective local primary health care will always be the most cost-effective response.
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