Partnerships can save more lives
Domestic donors must partner with their governments to scale up health programmes
The world’s progress in improving health and development-related outcomes for people everywhere is one of the greatest success stories of the past 20 years. Two decades ago, the infectious diseases that killed or harmed millions often went unchecked. Children born in poor countries were only vaccinated against a handful of the same diseases as children born in wealthier countries. There was no access to life-saving drugs such as antiretrovirals to treat HIV. But if we look closely at the trajectory of healthcare, we realise that since the 1990s, we have nearly halved the number of women who die in childbirth and halved the number of children who die before the age of five.
There are many reasons for these gains. As countries have grown wealthier, they have increasingly invested in their own healthcare systems. Aid programmes from donor countries have helped fill critical gaps. Large global charities such as CARE and Save the Children have raised funds from government and individual donors and with those funds have run large programmes in many poorer regions of the world.
An additional important reason the world has made such large gains in improving global health in the last two decades is the emergence of the ‘Global Health Funds’.
These new and powerful mechanisms have made it possible for donor governments and United Nations agencies to partner with large private donors and civil society organisations (CSOs) to create very large pools of funds and technical capability to tackle some of the most pressing issues that poor countries face. In these funds, organisations like the Bill & Melinda Gates Foundation have contributed significantly, by way of money, deep expertise, and as catalysts, alongside other private and sovereign donors, allowing each one to multiply the impact they could have had if they had acted alone.
The ‘Global Health Funds’ currently comprise the Global Polio Eradication Initiative (GPEI); the Vaccine Alliance (Gavi); the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund); and the Global Financing Facility (GFF) and have had a remarkable impact.
In 1988, there were an estimated 350,000 cases of wild polio every year, killing or paralysing its victims. In 2017, there were just 22, with a large and complex country such as India having entirely eradicated the disease, due to the joint efforts of domestic governments, CSOs, and GPEI.
In 2000, 30 million children in poor countries were not being immunised, leading to millions of unnecessary deaths. Since then, Gavi has supported the introduction of 380 routine vaccines into the health systems of vulnerable countries and helped to immunise 690 million children, preventing 10 million future deaths.
Since the creation of the Global Fund, deaths related to AIDS and TB have fallen by a third, and malaria by half.
GFF’s ‘In Support of Every Woman Every Child’ is today tackling the more than five million maternal, newborn, and child deaths that still occur among the world’s poorest people each year.
These spectacular gains made in human health need to be sustained and accelerated. Polio is only endemic in three countries, but until we get to zero, all countries will be at risk of polio re-emerging. Following the historic progress of reductions in malaria cases and deaths, we are on the verge of a resurgence that could see millions more at risk. And, despite more children being immunised worldwide than ever before with the highest level of routine coverage in history, increasing coverage rates with children in the world’s poorest countries continues to be a challenge.
To address these ongoing concerns, a massive replenishment effort for these funds is under way. As large philanthropists emerge both at global and domestic levels, these new forms of partnerships and alliances offer a powerful way forward. While donors and governments with the capacity to provide resources at a global scale can replenish these ‘Global Health Funds’, domestic donors can partner with their respective governments to set up similar mechanisms to multiply the impact that they can have working alone. These partnerships are essential if we want to create a world in which where you live does not determine whether you live.
Joe Cerrell and Nachiket Mor are both employees of the Gates Foundation. Joe Cerrell is managing director of the Gates Foundation’s Donor Government Relations team working across Europe, the Middle East and South Asia and Nachiket Mor is country director for India. The views expressed are personal