Who pays for cooperation in global health? A comparative analysis of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and Gavi, the Vaccine Alliance

被引:34
作者
Clinton, Chelsea [1 ]
Sridhar, Devi [2 ]
机构
[1] Columbia Univ, Mailman Sch Publ Hlth, New York, NY USA
[2] Univ Edinburgh, Edinburgh Med Sch, Edinburgh EH8 9AG, Midlothian, Scotland
关键词
D O I
10.1016/S0140-6736(16)32402-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In this report we assess who pays for cooperation in global health through an analysis of the financial flows of WHO, the World Bank, the Global Fund to Fight HIV/AIDS, TB and Malaria, and Gavi, the Vaccine Alliance. The past few decades have seen the consolidation of influence in the disproportionate roles the USA, UK, and the Bill & Melinda Gates Foundation have had in financing three of these four institutions. Current financing flows in all four case study institutions allow donors to finance and deliver assistance in ways that they can more closely control and monitor at every stage. We highlight three major trends in global health governance more broadly that relate to this development: towards more discretionary funding and away from core or longer-term funding; towards defined multi-stakeholder governance and away from traditional government-centred representation and decision-making; and towards narrower mandates or problem-focused vertical initiatives and away from broader systemic goals.
引用
收藏
页码:324 / 332
页数:9
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