Global health funding: a glass half full?

Kates, J; Morrison, J. S.; E, Lief

doi:10.1016/s0140-6736(06)69018-1

Cited by 17 publications

(10 citation statements)

References 3 publications

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“…Yet nowhere is the effect of this disease felt more deeply than in sub-Saharan Africa, where nearly two-thirds of the estimated 33 million people worldwide infected with HIV live [ 1 ]. As part of the global response to HIV, there has been a significant increase in funding to low- and middle-income countries to strengthen treatment, prevention and research programmes [ 2 , 3 ]. Nearly US$10 billion in funding was earmarked in 2008 for HIV/AIDS in low- and middle-income countries, representing an approximate 20-fold increase from a decade ago [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Duber

Coates

Szekeras

et al. 2010

Journal of the International AIDS Society

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BackgroundThe US President's Emergency Plan for AIDS Relief (PEPFAR) was reauthorized in June 2008 with a three-fold increase in funds, and a broader, more explicit mandate to improve health in the low- and middle-income countries that it funded. However, the ability of a disease-specific, or vertical, programme to have a spill-over effect and improve health outcomes has been questioned. In this study, we sought to examine associations between being designated as a PEPFAR focus country (and receiving increased PEPFAR funding) and non-HIV-specific health outcomes in the World Health Organization (WHO) Africa Region, the area most affected by the HIV/AIDS epidemic.MethodsA retrospective analysis of publicly available health outcomes data published by the World Health Organization was performed for all countries in the WHO Africa Region. Fractional changes in health indicators between 2000 and 2006 were calculated, and PEPFAR focus and non-focus countries were then compared.ResultsOverall, countries in the WHO Africa Region showed a small worsening in health outcomes status when all indicators were analyzed together and weighted equally. However, more health indicators improved than worsened over this six-year period. A comparison of PEPFAR focus and non-focus countries found no significant difference in the fractional change among 13 of 14 health indicators during the study period.ConclusionsThis study suggests that vertical programmes, even one that is the scale of PEPFAR, may have little or no impact on health outcomes not explicitly targeted.

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Section: Introductionmentioning

confidence: 99%

Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Duber

Coates

Szekeras

et al. 2010

Journal of the International AIDS Society

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“…Although estimates are diffi cult to obtain, the 2004 estimate for international health funding was about US$14 billion, and is rapidly increasing, largely because of the emergence and growth of the Bill & Melinda Gates Foundation (BMGF) and the US Government's AIDS initiative. 1 In parallel with increased fi nancial commitment, the consensus for technical strategies for global health is increasing, 2 an emerging though controversial, epidemiological evidence-base might provide information about the disbursement of the health funds. 3 Clarifi cation of technical and social strategies for disease prevention and treatment, though perhaps fl awed, can facilitate cooperation and political commitment.…”

Section: Introductionmentioning

confidence: 99%

Misfinancing global health: a case for transparency in disbursements and decision making

2008

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To address the gap between health investments and fi nancial fl ows worldwide, we identifi ed the patterns in allocation of funds by the four largest donors-ie, the World Bank, Bill & Melinda Gates Foundation (BMGF), the US Government, and the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria-in 2005. We created a disbursement database with information gathered from the annual reports and budgets. Funding per death varied widely according to type of disease-eg, US$1029·10 for HIV/AIDS to $3·21 for non-communicable diseases. The World Bank, US Government, and Global Fund provided more than 98% of their funds to service delivery, whereas BMGF gave most of its funds to research. BMGF grants in 2005 were given largely to private research organisations, universities, and civil societies in rich countries, whereas the US Government and Global Fund primarily disbursed grants to sub-Saharan Africa. Publicly available data for global health disbursements is incomplete and not standardised. Continued attention is needed to develop country ownership, particularly in planning and priority setting.

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“…For example, a review of global health spending on development of health personnel, medical education, and training—which influence capacity building most directly—showed discouraging trends between 2000 and 2004; spending decreased from an already low 3% in 2000 to a mere 2% by 2004 [61]. Short-term rotations supported by discretionary funds or individual residency programs—as most are frequently established —are not pathways towards building sustainable global health leadership and a global health workforce.…”

Section: Investing In Health Leaders From All Educational Settingsmentioning

confidence: 99%

Managing the Demand for Global Health Education

et al. 2011

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Global health funding: a glass half full?

Cited by 17 publications

References 3 publications

Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Is there an association between PEPFAR funding and improvement in national health indicators in Africa? A retrospective study

Misfinancing global health: a case for transparency in disbursements and decision making

Managing the Demand for Global Health Education

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