Winners and losers in global health | 

Flickr, by AMagill

Circle of money

One of the uncomfortable realities about the field of global health is that it often appears made up of many organizations championing worthy causes that compete for money.

Andrew Harmer, a researcher at the London School of Hygiene and Tropical Medicine, offers his perspective in a blog post “Winners and losers in the global health aid money go-round.”

Harmer begins by noting the recent — surprisingly successful — fund-raising effort by the Global Alliance for Vaccines and Immunization (GAVI), which raised $4.3 billion in new funds to get poor kids vaccinated, as compared to the failure of the Global Fund to Fight AIDS, TB and Malaria a while back.

The Global Fund — previously the darling of donors, governments and celebrity do-gooders — could not even obtain the bare minimum of donor funding ($13 billion) needed to stay on course, let alone expand AIDS drugs to the millions more who need them.

And next fall, Harmer notes, the UN will host a big meeting aimed at trying to expand the global health agenda for poor countries by incorporating into it a greater emphasis on diseases like cancer, diabetes, heart disease and other non-communicable diseases (NCDs) that are also big killers.

Malaria is both a winner and a loser, Harmer notes, since funding has increased for research and development of new vaccines and drugs. Yet at the same time, he notes, a new study indicates that funding for HIV/AIDS tends to divert funding from malaria control or treatment:

In a new study by Lordan et al the question was whether HIV/AIDS funding was diverting funds away from other health concerns – in their case malaria, TB, health sector, and ‘other’ (whatever was left over). The authors found that malaria was the ‘biggest loser’ (a 1% increase in funds devoted to HIV/AIDS in a particular country led to an 11% decrease in funds devoted to malaria the following year.

Overall, Harmer notes, global health is certainly receiving much more funding than it was a decade ago.

But before anyone celebrates, he emphasizes that we are still spending relatively little on global health overall.

Harmer notes a recent report by NPR on the cost of air-conditioning for military housing in Iraq and Afghanistan — $20 billion per year. I’ve cited this figure many times before, having first heard it in an interview with an assistant to Gen. David Petraeus (the next CIA chief) on PRI’s The World.

Bottom line: We still spend a piddly amount of money on global health, when compared to what we spend on our pets ($55 billion), cosmetics (estimates vary from $10-$20 billion) and especially the military.