Premed Perspective From Switzerland: Part II
Last month, our public health class visited the Global Fund and UNAIDS, and the subsequent discussion on the involvement of the private sector in global health is the inspiration for this post.
Until now, I’ve only ever really thought of the involvement of private actors as a positive thing. I’ve always thought that the Gates Foundation has been essential to the breakthrough in vaccine delivery, and would love to sit down with former president Bill Clinton to discuss his foundation’s innovative programs on increasing access to medicines and diagnostics. While I still love their work and think it is critical to success in the global health sphere, yesterday’s discussion opened my eyes to the caveats of having such powerful private organizations actively engaged in the global health.
Turns out that the amount of money the Gates Foundation spent in 2007 is equivalent to the WHO’s entire budget. I imagine other large philanthropic organizations have similar financial capability. While that is incredible in terms of funding opportunities, it also raises the question: who controls the global health agenda?
While the WHO is undoubtedly the center of the global health initiatives and coordination, I can’t help but wonder at the balance of power between organizations like the WHO/UNICEF/etc and private organizations. The intersection of these actors is what’s allowed us to make progress in so many subfields, but it also must result in some interesting politics that influence which issues have a voice in global health. What is the transparency
While I got the general sense that private organizations definitely influence which issues get the most funding for research, treatment, and prevention (in HIV/AIDS, Malaria, TB, for example), I would be interested in viewing the exact breakdown.
Swiss flag
Image Source: Bernard Jaubert
Here’s the [very rough] idea I had:
I think it would be incredibly powerful to create a platform that acts as a database for different funding sources, organizations, and actors in global health. Not only would it bring transparency to the problem of which issues are getting funding and which aren’t, but it would be interesting to understand realtime the flow of money across the world. For example, I envision a database which allows anyone to search by sector and see:
-which countries are donating how much money
-where the money is flowing to
-which sector (sanitation, communicable diseases, noncommunicable diseases, etc) is getting the most/least money
-what organizations in a specific sector are doing and where they are working
Obviously this is a tiny kernel of an idea, but I think that this would be really helpful to also allow consolidation and coordination among programs that are doing similar projects. For example, one thing that I noticed in college that has really confused/bothered me is the similarity between organizations like Global Medical Brigades, Volunteers Around the World, Dr. Interns, and Project Rishi, etc. They all do such similar things, that I can’t help but wonder if it would be more efficient for them to work together? What are the pros and cons of breaking up a large task like healthcare access into hundreds of little organizations? Unfortunately I have more questions than answers, but I hope that as time goes on, I’ll have a better sense of the consequences of the fragmentation in global health, as well as the benefit and feasibility of creating a platform like the one I briefly outlined above. And, of course, if any of you have any thoughts/comments/concerns on my idea, please feel free to comment! I love discussion.
