05.03.2024
Transition to sunset: the future of foreign aid for basic health services in Africa
Global health institutions, controlled by a small group of countries and private foundations, have a fundamental design flaw and they are not fit for purpose. Olusoji Adeyi of Johns Hopkins and Justice Nonvignon of African CDC offer a prescription for donors.
Development Today "After decades of lofty promises, mixed successes, catastrophic failures, and billions of dollars spent, the time is ripe to fundamentally change the construct and duration of global health grant-financing institutions and initiatives (GHIs). We acknowledge that GHIs – including multilaterals, bilaterals, and foundations – have contributed to some short-term progress in health service delivery and elements of health system development in Africa, but there remain questions about the sustainability of such progress. Our reflections and propositions address the more fundamental issue of medium-to-long term effects of the GHIs’ status quo on Africa: given the power imbalances and collective dysfunctions of GHIs, cui bono? In seeking answers to this puzzle, we encourage readers to ponder the implications for global health of Wole Soyinka’s searing wisdom: “Truth for me is freedom, is self-destination. Power is domination, control, and therefore a very selective form of truth, which is a lie.”
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