E r a n B e n d a v i d

S t a n f o r d U n i v e r s i t y

More with Less? Extending the Reach of Development Assistance in an Era

of Uncertainty

The charge for AIDS 2012• The end of AIDS• Turning the tide

• AIDS-free generation• www.2endaids.org/

$1.6$2.0

$3.6

$4.3

$5.6

$6.6

$8.7$8.7$8.7$8.8

$1.2$1.6

$2.8

$3.5$3.9

$4.9

$7.7 $7.7

$6.9

$7.6

Commitments Disbursements

AIDS Assistance from Donor Governments, Bn$

The debate over foreign health aid

A no-brainer!• In Kenya, the targets of aid agencies include:

• Increase home-based and voluntary testing (PEPFAR and Global Fund)

• Increase possession and use of insecticide-treated bed nets and long-lasting insecticidal nets (President’sMalaria Initiative and Global Fund)

• Testing and implementing clean water technologies (USAID and CDC).

• What if all these separate activities were implemented in sync?

Why it is hard to coordinate?• Donor institution targets are tightly tied to specific diseases.

For example: “The goal of PMI is to reduce malaria-related deaths by 50 percent in 19 countries in Africa that have a high burden of malaria by expanding coverage of four highly effective malaria prevention and treatment measures.”

• The US Global Health Initiative aimed to bring the various US institutions involved in health aid under one umbrella. “We cannot simply confront individual preventable illnesses in isolation. The world is interconnected, and that demands an integrated approach to global health.” Barack Obama, May 2009

• But the GHI lacked statutory or budget authority, and, to date, failed to eliminate parallel structures in the major health aid agencies

The challenge: getting past no-brainers

• A common fund for cross-agency priorities, managed by the Global Health Diplomacy office…

• Funding specific aspects of ministry campaigns could promote the breadth and ownership of ministry activities while keeping donor priorities and outlays aligned.

• The google approach: dedicate 10-20% of funds to develop creative (and disruptive) approaches to improve global health.