Development assistance for health: critiques, proposals and prospects for change.
After a 'golden age' of extraordinary growth in the level of development assistance for health (DAH) since 1990, funding seems to have reached a plateau. With the launch of the Sustainable Development Goals, debate has intensified regarding what international financing for health should look like in the post-2015 era. In this review paper, we offer a systematic overview of problems and proposals for change. Major critiques of the current DAH system include: that the total volume of financing is inadequate; financial flows are volatile and uncertain; DAH may not result in additional resources for health; too small a proportion of DAH is transferred to recipient countries; inappropriate priority setting; inadequate coordination; weak mechanisms for accountability; and disagreement on the rationale for DAH. Proposals to address these critiques include: financing-oriented proposals to address insufficient levels and high volatility of DAH; governance-oriented proposals to address concerns regarding additionality, proportions reaching countries, priority setting, coordination and accountability; and proposals that reach beyond the existing DAH system. We conclude with a discussion of prospects for change.
1Lecturer on Global Health,Department of Global Health and Population,Harvard T.H. Chan School of Public Health,Boston,MA,USA.
Suerie
S
Moon
2Resident Physician,Department of Community and Family Medicine,Howard University Hospital,Washington,DC,USA.
Oluwatosin
O
Omole
D005381:Financing, Organized; D014943:Global Health; D005102:Health Expenditures; D006801:Humans; D007391:International Cooperation