Does Global Health Funding Respond to Recipients’ Needs? Comparing Public and Private Donors’ Allocations in 2005–2007

Esser, Daniel E.; Bench, Kara Keating

doi:10.1016/j.worlddev.2010.12.005

Cited by 62 publications

(57 citation statements)

References 24 publications

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“…(p. 11) In other words, the preference of both the AIDS community and private donors to seek 'partnerships' in the spirit of 'country ownership' rather than 'national ownership' is, in reality, undermined by donors' incentive to disburse funds even if the legitimacy of incountry preference formulation is dubious at best. This observation is in line with related macro-level research on persistent mismatches between private DAH flows and recipients' priorities (Esser & Keating Bench, 2011) and illustrates why the belief that private donors tailor their disbursements more in line with needs and less with overriding foreign policy objectives is false (MacKellar, 2005; see also Shiffman, 2008;Sridhar & Batniji, 2008). And yet, the track record of government donors is hardly more impressive in this regard.…”

Section: 'Ownership' In the Midst Of The Hiv Scale-upsupporting

confidence: 76%

Elusive accountabilities in the HIV scale-up: ‘Ownership’ as a functional tautology

Esser

2014

Global Public Health

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Mounting concerns over aid effectiveness have rendered 'ownership' a central concept in the vocabulary of development assistance for health (DAH). The article investigates the application of both 'national ownership' and 'country ownership' in the broader development discourse as well as more specifically in the context of internationally funded HIV/AIDS interventions. Based on comprehensive literature reviews, the research uncovers a multiplicity of definitions, most of which either divert from or plainly contradict the concept's original meaning and intent. During the last 10 years in particular, it appears that both public and private donors have advocated for greater 'ownership' by recipient governments and countries to hedge their own political risk rather than to work towards greater inclusion of the latter in agenda-setting and programming. Such politically driven semantic dynamics suggest that the concept's salience is not merely a discursive reflection of globally skewed power relations in DAH but a deliberate exercise in limiting donors' accountabilities. At the same time, the research also finds evidence that this conceptual contortion frames current global public health scholarship, thus adding further urgency to the need to critically re-evaluate the international political economy of global public health from a discursive perspective.

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Section: 'Ownership' In the Midst Of The Hiv Scale-upsupporting

confidence: 76%

Elusive accountabilities in the HIV scale-up: ‘Ownership’ as a functional tautology

Esser

2014

Global Public Health

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“…Priorities from external countries and agencies and those from African countries or from the continent as a whole do not necessarily correlate closely 82 , 83 . Thus, for Africa to take charge of its own research agenda, it will have to start investing in its own research—epidemiological and public health research included 84 , 85 .…”

Section: Discussionmentioning

confidence: 99%

Current status and future prospects of epidemiology and public health training and research in the WHO African region

Nachega

Uthman

et al. 2012

International Journal of Epidemiology

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Background To date little has been published about epidemiology and public health capacity (training, research, funding, human resources) in WHO/AFRO to help guide future planning by various stakeholders.Methods A bibliometric analysis was performed to identify published epidemiological research. Information about epidemiology and public health training, current research and challenges was collected from key informants using a standardized questionnaire.Results From 1991 to 2010, epidemiology and public health research output in the WHO/AFRO region increased from 172 to 1086 peer-reviewed articles per annum [annual percentage change (APC) = 10.1%, P for trend < 0.001]. The most common topics were HIV/AIDS (11.3%), malaria (8.6%) and tuberculosis (7.1%). Similarly, numbers of first authors (APC = 7.3%, P for trend < 0.001), corresponding authors (APC = 8.4%, P for trend < 0.001) and last authors (APC = 8.5%, P for trend < 0.001) from Africa increased during the same period. However, an overwhelming majority of respondents (>90%) reported that this increase is only rarely linked to regional post-graduate training programmes in epidemiology. South Africa leads in publications (1978/8835, 22.4%), followed by Kenya (851/8835, 9.6%), Nigeria (758/8835, 8.6%), Tanzania (549/8835, 6.2%) and Uganda (428/8835, 4.8%) (P < 0.001, each vs South Africa). Independent predictors of relevant research productivity were ‘in-country numbers of epidemiology or public health programmes’ [incidence rate ratio (IRR) = 3.41; 95% confidence interval (CI) 1.90–6.11; P = 0.03] and ‘number of HIV/AIDS patients’ (IRR = 1.30; 95% CI 1.02–1.66; P < 0.001).Conclusions Since 1991, there has been increasing epidemiological research productivity in WHO/AFRO that is associated with the number of epidemiology programmes and burden of HIV/AIDS cases. More capacity building and training initiatives in epidemiology are required to promote research and address the public health challenges facing the continent.

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“…The mismatch between the allocation of DAH and country needs (based on patterns of disease burden) or country priorities (based on health sector strategic plans) has been previously observed [59-61]. In particular, it has been argued that donor spending on HIV/AIDS appears to be in excess of need [59].…”

Section: Discussionmentioning

confidence: 99%

Aid alignment: a longer term lens on trends in development assistance for health in Uganda

Stierman

Ssengooba

Bennett

2013

Globalization and Health

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BackgroundOver the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government’s own expenditures on health. Yet primary health care and other priorities identified in Uganda’s health sector strategic plan remain underfunded.MethodsUsing data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, we examined trends in how donors channel DAH and the extent to which DAH is aligned with sector priorities. The study follows the flow of DAH from the donor to the implementing organization, specifying the modality used for disbursing funds and categorizing funds based on program area or support function.FindingsDespite efforts to improve alignment through the formation of a sector-wide approach (SWAp) for health in 1999 and the creation of a fund to pool resources for identified priorities, increasingly DAH is provided as short-term, project-based support for disease-specific initiatives, in particular HIV/AIDS.ConclusionThese findings highlight the need to better align external resources with country priorities and refocus attention on longer-term sector-wide objectives.

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Does Global Health Funding Respond to Recipients’ Needs? Comparing Public and Private Donors’ Allocations in 2005–2007

Cited by 62 publications

References 24 publications

Elusive accountabilities in the HIV scale-up: ‘Ownership’ as a functional tautology

Elusive accountabilities in the HIV scale-up: ‘Ownership’ as a functional tautology

Current status and future prospects of epidemiology and public health training and research in the WHO African region

Aid alignment: a longer term lens on trends in development assistance for health in Uganda

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