News / Africa

    Donors Set Health Priorities

    Health policy and research could be affected by donor funding.Health policy and research could be affected by donor funding.
    x
    Health policy and research could be affected by donor funding.
    Health policy and research could be affected by donor funding.
    Joe DeCapua
    A new article in PLOS Medicine says large donors have a major influence on which health issues get funded. The author says it’s an attempt by governments and others to exert more control over international agencies.

    Oxford University’s Dr. Devi Sridhar says large donors have shifted to a practice called multi-bi financing.



    “Multi-bi financing is funds that at first glance look multilateral. They’re given to multilateral agencies. You know, the WHO, the World Bank or new initiatives that look multilateral at the surface, but that actually have more characteristics that are bilateral in that they’re often earmarked. They’re often limited in duration. It’s this new area and it’s been growing. It’s been estimated to account for 40 percent of total multilateral funding,” she said.

    Agencies like the World Health Organization are relying more on this type of funding, rather than on a standard annual budget. In fact, Sridhar said almost 80 percent of the WHO’s budget comes from voluntary contributions, which would be classified as multi-bi financing.

    “Within the World Health Organization, there have been concerns raised, particularly by developing countries and emerging countries such as Brazil, over how much influence voluntary contributions are having, rather than the assessed budget – what countries are required to pay each year through kind of a U.N. formula,” she said.

    Sridhar is a university lecturer in Global Health Politics and co-director of the Center for AIDS Interdisciplinary Research. She said the major donors are the U.S., Britain, Japan, the European Commission and the Bill and Melinda Gates Foundation.

    “Well, what you get is actually priorities being skewed in a way that perhaps fits the priorities of the donor in question - whether it’s taxpayers - whether it’s the priorities of a particular organization. And it differs from how priorities are set within, let’s say, a body like the World Health Organization, where you have all member states come together in the World Health Assembly to decide collaboratively through deliberation what the priorities should be for the organization. So, in a way, it’s priorities being decided by the few for the many,” she said.

    She said it’s also generating debate on how funds should be spent within the Global Fund to Fight AIDS, Tuberculosis and Malaria. Since the global financial crisis, donors are demanding that projects not only improve health, but be cost-effective, as well.

    “So you are seeing much more reliance in actually trying to monitor these international agencies more closely - being able to decide the priorities, to realign them with those of a particular donor," said Sridhar.

    Sridhar said one of the main issues is that short-term health concerns might take priority over long term objectives.

    “Part of the rationale for creating the World Health Organization was that countries would compromise their short term differences in order to obtain the long term benefits of collaboration," she said. "For example, international health regulations, which require countries to report on, let’s say, disease outbreaks in their country. It’s not necessarily in the short term interest of a country to do that, but it’s in the long term collective interest of the global community for this to happen.”

    She said when large donors set health priorities, input from technocrats – such as public health experts, economists and lawyers – may not be included in discussions. Also, many of the new initiatives are funded by the private sector, such as pharmaceutical companies. The question arises as to how much influence the private sector should wield.

    “How actually do we include these powerful stakeholders, but in a way that controls conflict of interest? And make sure that actually public health is the primary concern – not opening new markets or profit motives,” she said.

    But Sridhar did say that multi-bi financing “has shown a light on how and where multilateral institutions might do better” and bring about reforms.

    You May Like

    Chechen Suspected in Istanbul Attack, but Questions Remain

    Turkish sources say North Caucasus militants involved in bombing at Ataturk airport, but name of at least one alleged attacker raises doubts

    With Johnson Out, Can a New ‘Margaret Thatcher’ Save Britain?

    Contest to replace David Cameron as Britain’s prime minister started in earnest Thursday with top candidates outlining strategy to deal with Brexit fallout

    US Finds Progress Slow Against Human Trafficking in Africa

    Africa continues to be a major source and destination for human trafficking of all kinds -- from forced labor to sexual slavery, says State Department report

    By the Numbers

    Featured Videos

    Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
    Clinton Leads Trump, But Many Voters Don't Like Eitheri
    X
    Jim Malone
    June 29, 2016 6:16 PM
    In the U.S. presidential race, most recent polls show Democrat Hillary Clinton with a steady lead over Republican Donald Trump as both presumptive party nominees prepare for their party conventions next month. Trump’s disapproval ratings have risen in some recent surveys, but Clinton also suffers from high negative ratings, suggesting both candidates have a lot of work to do to improve their images before the November election. VOA National correspondent Jim Malone has more from Washington.
    Video

    Video Clinton Leads Trump, But Many Voters Don't Like Either

    In the U.S. presidential race, most recent polls show Democrat Hillary Clinton with a steady lead over Republican Donald Trump as both presumptive party nominees prepare for their party conventions next month. Trump’s disapproval ratings have risen in some recent surveys, but Clinton also suffers from high negative ratings, suggesting both candidates have a lot of work to do to improve their images before the November election. VOA National correspondent Jim Malone has more from Washington.
    Video

    Video Slow Rebuilding Amid Boko Haram Destruction in Nigeria’s Northeast

    Military operations have chased Boko Haram out of towns and cities in Nigeria’s northeast since early last year. But it is only recently that people have begun returning to their homes in Adamawa state, near the border with Cameroon, to try to rebuild their lives. For VOA, Chris Stein traveled to the area and has this report.
    Video

    Video New US Ambassador to Somalia Faces Heavy Challenges

    The new U.S. envoy to Somalia, who was sworn into office Monday, will be the first American ambassador to that nation in 25 years. He will take up his post as Somalia faces a number of crucial issues, including insecurity, an upcoming election, and the potential closure of the Dadaab refugee camp in Kenya. VOA’s Jill Craig asked Somalis living in Kenya’s capital city Nairobi how they feel about the U.S. finally installing a new ambassador.
    Video

    Video At National Zoo, Captivating Animal Sculptures Illustrate Tragedy of Ocean Pollution

    The National Zoo in Washington, D.C., is home to about 1,800 animals, representing 300 species. But throughout the summer, visitors can also see other kinds of creatures there. They are larger-than-life animal sculptures that speak volumes about a global issue — the massive plastic pollution in our oceans. VOA's June Soh takes us to the zoo's special exhibit, called Washed Ashore: Art to Save the Sea.
    Video

    Video Baghdad Bikers Defy War with a Roar

    Baghdad is a city of contradictions. War is a constant. Explosions and kidnappings are part of daily life. But the Iraqi capital remains a thriving city, even if a little beat up. VOA's Sharon Behn reports on how some in Baghdad are defying the stereotype of a nation at war by pursuing a lifestyle known for its iconic symbols of rebellion: motorbikes, leather jackets and roaring engines.
    Video

    Video Melting Pot of Immigrants Working to Restore US Capitol Dome

    The American Iron Works company is one of the firms working to renovate the iconic U.S. Capitol Dome. The company employs immigrants of many different cultural and national backgrounds. VOA’s Arman Tarjimanyan has more.
    Video

    Video Testing Bamboo as Building Material

    For thousands of years various species of bamboo - one of the world's most versatile plants - have been used for diverse purposes ranging from food and medicine to textiles and construction. But its use on a large scale is hampered because it's not manufactured to specific standards but grown in the ground. A University of Pittsburgh professor is on track to changing that. VOA’s George Putic reports.
    Video

    Video Orphanage in Iraqi City Houses Kids Who Lost their Parents to Attacks by IS

    An orphanage in Iraqi Kurdistan has become home to scores of Yazidi children who lost their parents after Islamic State militants took over Sinjar in Iraq’s Nineveh Province in 2014. Iraqi Kurdish forces backed by the U.S. airstrikes have since recaptured Sinjar but the need for the care provided by the orphanage continues. VOA’s Kawa Omar filed this report narrated by Rob Raffaele.
    Video

    Video Re-Opening Old Wounds in a Bullet-Riddled Cultural Landmark

    A cultural landmark before Lebanon’s civil war transformed it into a nest of snipers, Beirut’s ‘Yellow House’ is once again set to play a crucial role in the city.  Built in a neo-Ottoman style in the 1920s, in September it is set to be re-opened as a ‘memory museum’ - its bullet-riddled walls and bunkered positions overlooking the city’s notorious ‘Green Line’ maintained for posterity. John Owens reports from Beirut.
    Video

    Video Brexit Resounds in US Presidential Contest

    Britain’s decision to leave the European Union is resounding in America’s presidential race. As VOA’s Michael Bowman reports, Republican presumptive nominee Donald Trump sees Britain’s move as an affirmation of his campaign’s core messages, while Democrat Hillary Clinton sees the episode as further evidence that Trump is unfit to be president.
    Video

    Video NASA Juno Spacecraft, Nearing Jupiter, to Shed Light on Gas Giant

    After a five-year journey, the spacecraft Juno is nearing its destination, the giant planet Jupiter, where it will enter orbit and start sending data back July 4th. As Mike O'Sullivan reports from Pasadena, California, the craft will pierce the veil of Jupiter's dense cloud cover to reveal its mysteries.
    Video

    Video Orlando Shooting Changes Debate on Gun Control

    It’s been nearly two weeks since the largest mass shooting ever in the United States. Despite public calls for tighter gun control laws, Congress is at an impasse. Democratic lawmakers resorted to a 1960s civil rights tactic to portray their frustration. VOA’s Carolyn Presutti explains how the Orlando, Florida shooting is changing the debate.

    Special Report

    Adrift The Invisible African Diaspora