Developing Countries Divert Donations

A recent study conducted in part by researchers at Harvard Medical School suggests that developing countries may not be receiving the full benefit of intended international health aid.

The governments of many sub-Saharan African countries receive aid from other countries and international organizations to supplement their domestic health spending. But according to the study, published in The Lancet earlier this month, the addition of these funds often leads governments to divert the money they planned to dedicate to health to other areas.

The researchers found that for every dollar governments are given, they divert between $0.43 and $1.14 away from their original domestic health budgets.

In contrast, the study also discovered that when funding is sent to non-governmental organizations instead of to the government directly, government health spending tends to increase.

Although the findings raise serious concerns about whether or not health aid may be a zero sum game, Claude Bruderlein, a lecturer on international health at the Harvard School for Public Health, said that the mere dollar amounts do not show the full extent of the benefits of international aid.

Bruderlein explained that, along with accounting statistics, international health funding carries with it necessary standards of accountability and productivity that may not be coming from the local populations, especially in non-democratic countries.

The researchers said they noticed a gap in data on how governments were spending money that they had received from external sources to go toward health care priorities, which motivated them to conduct the study.

“We found that a lot of money has been sent to developing countries in the health sector and that there was no evidence regarding the effectiveness,” said Chunling Lu, an instructor in social medicine at the Medical School and the paper’s lead author. “We wanted to know how this investment worked.”

The team urged caution when looking at their findings, however, noting that important data about health care spending was often entirely missing from government records, and thus not accounted for in their results.

Going forward, the researchers suggested that countries should establish clear ways of reporting government health spending and keeping track of all domestic spending on health issues. In addition, each government should establish a target for a minimum amount of health spending, which should either remain constant or increase annually.