National Efforts To Deal With Specific Diseases Undermined By Disease-specific Aid Programs

As billions of well-intentioned dollars are poured into disease-specific aid programs in the developing world, an article published in the British Medical Journal (BMJ) argues that the programs are undermining the efforts the target countries are making to tackle their problems.


Roger England, Chairman of Health Systems Workshop, expresses his views as the International Health Partnership is launched - a partnership Prime Minister Gordon Brown hopes will boost efforts to accomplish the UN's millennium development targets for health. Roger England wonders whether the partnership will really have any impact.


The United Kingdom's international aid to the developing world has doubled since 2000 to ??7bn ($14bn; ?‚¬10bn). A large part of the aid is focused on specific diseases and is delivered outside the receiving countries' planning and budgeting systems - complicating things for them, England writes.


England explains that money for tackling HIV/AIDS is the worst as it undermines countries' efforts to sort out their problems. As most of the extra help is delivered off budget, the country is faced with separate/parallel plans, operations and monitoring.


Ideally, a country should be helped to expand and strengthen its national healthcare systems so that it can run a range of badly needed services - services specific to the countries' needs, not those of outside lobby groups. This is not being funded satisfactorily, he argues.


The only organization that could assume the role of helping provide technical support that countries need is the World Health Organization (WHO). However, WHO is under-funded and riddled with institutional and constitutional flaws, he writes.


England offers Mr. Brown some ideas on how the new International Health Partnership might rectify this.


Firstly, funding that does not put its money through the recipient countries' planning and budgeting processes should be stopped.


Secondly, countries that are seriously reforming their systems should be helped more.


Lastly, he argues that the millennium development goals need a complete overhaul. He does not think the goals are too high, he simply believes they are more trouble than they are worth.


England stresses that without better national health systems in developing countries to fund and deliver health care, not much will be achieved. A better international system of aid that targets better national health systems is needed. Disease specific programs serve only as obstacles to this objective, and the International Health Partnership should recognize this and be courageous enough to do something about it.


"Personal View: The dangers of disease specific aid programs"

Roger England

BMJ 335, p 565

bmj


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