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

Could Nemtsov Threaten Putin in Death as in Life?

Dynamic and debonair opposition leader had supported liberal economic reforms, criticized Russian president's aggression in Ukraine More

Oil Smuggling Highlights Challenges in Shutting Down IS Finances

Pentagon spokesman says Islamic State 'certainly continues to get revenue from the oil industry black market' but that airstrikes have made a dent More

India Focuses on Infrastructure, Investment to Propel Economy

Government expects economy to grow at 8 to 8.5 percent in next fiscal year More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
US Supreme Court Hears Hijab Discrimination Casei
X
Katherine Gypson
February 25, 2015 11:30 PM
The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video US Supreme Court Hears Hijab Discrimination Case

The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video Falling Gas Prices Hurt Nascent Illinois Hydraulic Fracturing Industry

Falling oil prices are helping consumers purchase cheaper petroleum at the pump. But that’s made hydraulic fracturing or “fracking” less economically viable for the companies in the United States invested in the process. VOA’s Kane Farabaugh reports on one Midwestern town that was hoping to change its fortunes by cashing in on the next big U.S. oil boom.
Video

Video Fighting in Sudan's South Kordofan Fuels Mass Displacement

Heavy fighting in Sudan's South Kordofan state is causing hundreds of thousands to flee into uncertain conditions. Local aid organizations estimate as many as 400,000 civilians have been internally displaced since the conflict began more than three years ago, while another 250,000 have fled across the border to refugee camps in South Sudan. VOA's Adam Bailes reports.
Video

Video Lao Dam Project Runs Into Opposition

A Lao dam project on a section of the Mekong River is drawing opposition from local fishermen, international environmental groups and neighboring countries. VOA's Say Mony visited the region to investigate the concerns. Colin Lovett narrates.
Video

Video A Filmmaker Discovers Her Biracial Identity in "Little White Lie

Lacey Schwartz grew up in an upper middle-class Jewish family, in a town in upstate New York where almost everyone she knew was white. She assumed that she was, as well. Her recent documentary, Little White Lie, tells the story of how she uncovered the secret of her true racial background. VOA’s Carolyn Weaver has more on the film.
Video

Video Deep Under Antarctic Ice Sheet, Life!

With the end of summer in the Southern hemisphere, the Antarctic research season is over. Scientists from Northern Illinois University are back in their laboratory after a 3-month expedition on the Ross Ice Shelf, the world’s largest floating ice sheet. As VOA’s Rosanne Skirble reports, they hope to find clues to explain the dynamics of the rapidly melting ice and its impact on sea level rise.
Video

Video US-Cuba Normalization Talks Resume Friday

Negotiations aimed at normalizing diplomatic relations between the U.S. and Cuba resume Friday. On the table: lifting a half-century trade embargo and easing banking and travel restrictions. There's opposition in Congress, but some analysts say there may be sufficient political and economic incentives in both nations for a potential breakthrough this year. VOA's Mil Arcega reports.
Video

Video Pakistan's Deadline For SIM Registration Has Cellphone Users Scrambling

Pakistani cell phone users have until midnight Thursday to register their SIM cards, or their service will be cut off. While some privacy experts worry about government intrusion, many Pakistanis are just worried about keeping their phone lines open. VOA Deewa reporter Arshad Muhmand has more from Peshawar.
Video

Video Myanmar Warns Factory Workers to End Strikes

Outside Myanmar's main city Yangon, thousands of workers walked off their jobs earlier this month demanding a doubling of their wages, pay raises after a year and input from labor unions on industrial regulations. Since Friday, the standoff has grown more tense as police moved in to disrupt the sit-ins, resulting in clashes that injured people from both sides. VOA correspondent Steve Herman visited industrial zones which have become a focus of Myanmar's fledgling workers rights movement.
Video

Video Oscar Winners Do More Than Thank the Academy

The Academy Awards presentation is Hollywood’s night to reward the best movies from the previous year. It’s typically a lot of glitter, a lot of thank you’s, a lot of speeches. But many of this year’s speeches carried messages beyond the thank you's. VOA’s Carolyn Presutti takes a look.

All About America

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More