Misfinancing Global Health:A Case for Transparency in Disbursements and Decision Making

To address the gap between health investments and financial flows worldwide, we identified the patterns in allocation of funds by the four largest donors--ie, the World Bank, Bill and 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

Does Development Assistance for Health Really Displace Government Health Spending? Reassessing the Evidence

Rajaie Batniji and Eran Bendavid dispute recent suggestions that health aid to developing countries leads to a displacement of government spending and instead argue that current evidence about aid displacement cannot be used to guide policy

Beyond contagion : Explaning international cooperation on health

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Considerations in assessing the evidence and implications of aid displacement from the health sector.

Eran Bendavid and Rajaie Batniji provide a perspective on the ongoing debates about aid displacement - whether giving development aid to governments leads to reductions in their own domestic health financing

Widely divergent trends in the relationship between DAH and GHE-S in select countries.

<p>Both DAH and GHE-S are presented here as a percentage of GDP, with GHE-S based on IMF data. In Rwanda, GHE-S is effectively zero, regardless of DAH. In Lesotho, GHE-S appears to rise with DAH (aid is associated with additional GHE-S). Eritrea exhibits erratic response, while Zambia generally follows the predictions of Lu and colleagues about decreasing government expenditure with increasing DAH. Data source: IHME <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001214#pmed.1001214-Cheng1" target="_blank">[2]</a>.</p

Primary data scatter of the relationship between DAH and GHE-S in all countries.

<p>Both DAH and GHE-S are presented here as a percentage of GDP, with GHE-S based on IMF data. Each point on the above plot represents a country-year observation used in the analysis. Data source: IHME <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001214#pmed.1001214-Cheng1" target="_blank">[2]</a>.</p

Mental and social health in disasters: Relating qualitative social science research and the Sphere standard

Increasingly, social scientists interested in mental and social health conduct qualitative research to chronicle the experiences of and humanitarian responses to disaster We reviewed the qualitative social science research literature in relation to a significant policy document, the Sphere Handbook, which includes a minimum standard in disaster response addressing "mental and social aspects of health", involving 12 interventions indicators. The reviewed literature in general supports the relevance of the Sphere social health intervention indicators. However, social scientists' chronicles of the diversity and complexity of communities and responses to disaster illustrate that these social interventions cannot be assumed helpful in all settings and times. With respect to Sphere mental health intervention indicators, the research largely ignores the existence and well-being of persons with pre-existing, severe mental disorders in disasters, whose well-being is addressed by the relevant Sphere standard. Instead, many social scientists focus on and question the relevance of posttraumatic stress disorder-focused interventions, which are common after some disasters and which are not specifically covered by the Sphere standard. Overall, social scientists appear to call for a social response that more actively engages the political, social, and economic causes of suffering, and that recognizes the social complexities and flux that accompany disaster. By relating social science research to the Sphere standard for mental and social health, this review informs and illustrates the standard and identifies areas of needed research.Mental health Disaster Sphere Policy Anthropology Qualitative methods