13. Recent Trends and Innovations in Development Assistance for Health


Richard Lord, www.rlordphoto.com

After stagnating for nearly a decade, the volume of external development assistance for health (DAH) has begun to rise, spawning innovative approaches. While this holds considerable promise for the future, DAH continues to suffer from a broad range of inefficiencies and misuses. For example, in Bangladesh funding has been provided for child nutrition projects but, as a result of weak government commitment, the priority has not been high and the project is enmeshed in conflicts between government and nongovernmental organizations (NGOs).

Factors driving the upward trend in DAH include the United Nations' Millennium Development Goals, which emphasize maternal and child health and control of communicable disease; global mobilization to confront the AIDS pandemic (for example, the International AIDS Vaccine Initiative); and expanding interest in research and development of new technologies to address disease in poor countries. New sources of funding also have appeared, most notably from the Bill & Melinda Gates Foundation. Challenges remain to get funds to the front lines and achieve effective community health programs. Stronger engagement with the private sector is recommended, based on examples of the Global Alliance for Improved Nutrition and Avahan, an innovative AIDS prevention program in India.

Recent DAH innovations include sectorwide approaches that allow multiple donors to pool funds for commonly agreed problems and use of similar, streamlined procedures for procurement, monitoring, and evaluation. Performance–based financing is now actively tested at many levels in the health care system. DAH also is being channeled to community groups and NGOs involved in running local health programs.