Though GHIs have been instrumental in bringing national and international attention to crucial global health issues, existing debates suggest that they can also negatively impact country health systems. As such, disease-specific GHIs such as GAVI have worked to integrate health system strengthening (HSS) measures into programmatic implementation. However, the existing global debate questions the efficacy of HSS programs aimed at targeting technical solutions with clear measurable outcomes versus those more broadly focused on supporting holistic health systems.[22]