Donor money for health care in developing countries could be spent more effectively if it were channeled through a single global fund, experts said Friday.A steady flow of funds is essential for health sector improvements, Gorik Ooms from Belgium’s Institute of Tropical Medicine said.
Research by Ooms and other experts published in The Lancet medical journal Friday said the amount and regularity of international aid was often unpredictable, making it hard for governments to plan ahead.Another study, by Harvard Medical School and the University of Washington, found that in some recipient countries, mainly in sub-Saharan Africa, foreign health aid was partly replacing — not supplementing — domestic health budgets.
In such countries, for every $1 given in aid, governments move between 43 cents and $1.14 of their own health funds to other sectors, such as education or sanitation.”Governments compensate for exceptional international generosity to the health sector by reallocating government funding to other sectors,” Ooms wrote in The Lancet.He said governments also compensated for the unreliability of aid by spreading it over several years.One way to make health aid more stable would be to disburse it via a common pool, similar to the Global Fund To Fight AIDS, Tuberculosis and Malaria set up in 2002.
“If a young institution such as the Global Fund already stands out as delivering stable and predictable financing, it shows the potential advantage of pooling international aid,” Ooms wrote.In a news briefing, he said countries with high dependency on aid usually received pledges from donors for two to four years ahead.”When we in our own countries consider reforming health care, we make estimates for 20, 30, 40 years ahead: how much money will we have? what will happen with the population? what will be the health needs?,” he said.
Another issue is donors’ delivery on their promises.Madalo Nyambose, assistant director at the debt and aid division in Malawi’s Finance Ministry, said aid money was often disbursed later than promised, forcing recipient governments to borrow from financial markets and incur interest payments.
Ooms said a new global health fund could borrow ideas from the Global Fund, which pools donors’ money and allocates it in consultation with the countries in need and independent experts. Its board includes representatives of donors and recipient governments, non-governmental organizations (NGOs), businesses and affected communities.The U.S. researchers examined data on 113 developing countries from 1995 to 2006.(Reuters)
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