Development assistance holds promise for alleviating the death and suffering of impoverished children, women, and men from readily preventable and treatable conditions and to support global economic development, demographic sustainability, and political stability. Although the desirability of these goals is widely shared, there is little agreement on who should shoulder the financial responsibility or how best to use development assistance to achieve these goals.
How much financing should be provided and in what form, who is eligible, and what health areas and interventions should be prioritized? How should institutions balance the financing for current interventions and for future priorities? Should funding for research and development (R&D) be a health aid priority? And what exactly counts as health aid? Does a favorable loan to build a hospital in rural China count? How about in rural Mali? How much health aid flows through recognized channels, and how much falls outside well-documented channels? What criteria should be used to allocate scarce health aid resources? Which countries and populations have the strongest claims to assistance or favorable financing? This chapter provides frameworks for addressing these questions and understanding the crossroads for foreign aid to the health sector. This chapter does not provide a systematic review of current patterns of health aid allocation. The descriptive epidemiology of health aid—the patterns of sources, channels, flows, and targets of donor resources—is available from other sources, which we reference throughout this chapter. Instead, we address key questions that challenge our understanding of the present and planning for the future of international cooperation on health.
[Part 5: Intersectoral and International Topics]