Ethics of Development Assistance for Health

Ruger, Jennifer Prah

doi:10.1002/hast.447

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…DAH should conform to principles of global health justice. To improve prospects for global health equity, DAH should abandon the donor-recipient dichotomy and replace it with equal respect for all person’s capabilities [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

From conceptual pluralism to practical agreement on policy: global responsibility for global health

Ruger

Hammonds

Ooms

et al. 2015

BMC Int Health Hum Rights

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BackgroundAs the human cost of the global economic crisis becomes apparent the ongoing discussions surrounding the post-2015 global development framework continue at a frenzied pace. Given the scale and scope of increased globalization moving forward in a post-Millennium Development Goals era, to protect and realize health equity for all people, has never been more challenging or more important. The unprecedented nature of global interdependence underscores the importance of proposing policy solutions that advance realizing global responsibility for global health.DiscussionThis article argues for advancing global responsibility for global health through the creation of a Global Fund for Health. It suggests harnessing the power of the exceptional response to the combined epidemics of AIDS, TB and Malaria, embodied in the Global Fund to Fight AIDS, Tuberculosis and Malaria, to realize an expanded, reconceptualized Global Fund for Health. However this proposal creates both an analytical quandary embedded in conceptual pluralism and a practical dilemma for the scope and raison d’etre of a new Global Fund for Health. To address these issues we offer a logical framework for moving from conceptual pluralism in the theories supporting global responsibility for health to practical agreement on policy to realize this end. We examine how the innovations flowing from this exceptional response can be coupled with recent ideas and concepts, for example a global social protection floor, a Global Health Constitution or a Framework Convention for Global Health, that share the global responsibility logic that underpins a Global Fund for Health.ConclusionsThe 2014 Lancet Commission on Global Governance for Health Report asks whether a single global health protection fund would be better for global health than the current patchwork of global and national social transfers. We concur with this suggestion and argue that there is much room for practical agreement on a Global Fund for Health that moves from the conceptual level into policies and practice that advance global health. The issues of shared responsibility and mutual accountability feature widely in the post-2015 discussions and need to be addressed in a coherent manner. Our article argues why and how a Global Fund for Health effectuates this, thus advancing global responsibility for global health.

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Section: Discussionmentioning

confidence: 99%

From conceptual pluralism to practical agreement on policy: global responsibility for global health

Ruger

Hammonds

Ooms

et al. 2015

BMC Int Health Hum Rights

Self Cite

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show abstract

“…It is estimated that sub-Saharan Africa receives the largest share of DAH, with the largest share going to low-income countries [3]. In 2009, developing countries constituted 84% of the world's population and 92% of the burden of disease, but just 29% of Gross Domestic Product and 16% of health expenditure [4]. In 2016, DAH accounted for 34.6% of total health expenditure in low-income countries where significant amount of DAH is required [5].…”

Section: Introductionmentioning

confidence: 99%

Perspectives of frontline health workers on transition from development assistance for health in Ghana: A qualitative study

Appiah-Kubi

Mao

Koduah

et al. 2022

PLOS Glob Public Health

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Many Low-income countries depend on development assistance for health (DAH) to finance the health sector. The transition of these countries to middle-income status has led to reduction in effective aid from development partners while these countries are expected to graduate from global funding agencies such as Gavi the vaccine alliance, with implications for service delivery. The aim of this study was to explore the perspectives of frontline health workers regarding the implications of Ghana’s transition to middle-income status on service delivery, the likely impact and opportunities it presents to the country. This exploratory qualitative study employed in-depth interviews to collect data from 16 health workers at three hospitals in the Greater Accra Region; one at the regional level and two at the district level. The study was conducted from December 2019 to July 2020. Data from interviews were transcribed, coded and analysed using thematic analysis in NVivo Qualitative Analysis Software version 12. The level of awareness among frontline workers about the transition and decline in DAH was generally low. Nonetheless, frontline health workers perceived that the country seems inadequately prepared for transition as donors continue to be major financiers for the sector and even for emergencies such as the current COVID-19 global pandemic. Potential challenges facilities would face due to transition may include difficulty in funding health programs, human resource challenges and delays in logistics and medicines. The implications for these will be poor health outcomes, defective monitoring and evaluation, and lapses in training programs. In addition, the perceived barriers to transition identified were poor management of resources, political interference and lack of technical expertise. While opportunities such as improvement of the health sector prioritization and efficiency, private sector involvement and autonomy could be gained. Gaps in the health intervention monitoring resulting from DAH transition could pose affect health outcomes, particularly in respect of HIV, tuberculosis and malaria. The country’s preparedness to transition from DAH could be better improved with development of a clear transition plan agreed by stakeholders, including government and in-country development partners. For the health sector, the eligibility for DAH transition should not simply be based on economic growth, but importantly on a country’s ability to sustain ongoing and upcoming health programs.

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A means of improving public health in low- and middle-income countries? Benefits and challenges of international public–private partnerships

et al. 2017

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Ethics of Development Assistance for Health

Cited by 4 publications

References 13 publications

From conceptual pluralism to practical agreement on policy: global responsibility for global health

From conceptual pluralism to practical agreement on policy: global responsibility for global health

Perspectives of frontline health workers on transition from development assistance for health in Ghana: A qualitative study

A means of improving public health in low- and middle-income countries? Benefits and challenges of international public–private partnerships

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