The Labyrinth of Global Health Financing

In “Financing of Global Health:  Tracking Development Assistance for Health from 1990 to 2007”, Ravishankar  et al state that the purpose of their journal article is “to provide a comprehensive assessment of development assistance for health (DAH) from 1990 to 2007.”  The authors focus on “low-income and middle-income countries”.  The article looks at how the landscape of DAH has changed from 1990 to 2007.   Amongst other things, the authors undertake the herculean feat of attempting to determine how DAH is dispersed and tracked. 

The author’s research highlights the importance of donors and recipients having a more standardized method for keeping track of donations.  The authors discuss the work done by the “Development Assistance Committee of the Organization for Economic Cooperation and Development (OCED)” and note the limitations of this organization because it “provides estimates of official development assistance by sector…these estimates track only public sources and exclude private philanthropy, which is an important source of development assistance.”  I am surprised that given the increasing role that private foundations are playing in global health that there is not a central repository that monitors and tracks public and private assistance and how the assistance is being utilized. 

They discuss the shift from donor supporters being primarily governments and government organizations of higher income countries to foundations like the Bill and Melinda Gates Foundation.  The research that the authors did is funded by the Bill and Melinda Gates Foundation.  The authors include a disclaimer in their article that their funding source had no authority or influence over the scope, content, methodology or findings of the research.  The authors do present the work that the Bill and Melinda Gates Foundation is doing in a very positive and admirable light.  The aforementioned is justified given the magnitude of  economic support that the Foundation has given to developing countries.  The authors discuss how organizations like the WHO are competing with NGOs for funding from private sources.

The authors conclude their article by stating that “timely and reliable information about DAH is essential for national policy making and planning…for monitoring whether or not donors are honouring their commitments, to foster greater transparency in aid reporting, and as an essential component of assessments of effectiveness.”

—Wendy Park

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