Working Group Paper

Project: Centre on Global Health Security

Suerie Moon and Oluwatosin Omole
  • Recent years have witnessed rapid growth in development assistance for health and new institutional forms such as public–private partnerships, now under threat as a result of the financial crisis. Low-income countries depend on external sources for one-quarter of their health expenditures.
  • Changes in the nature of health challenges such as the growing importance of non-communicable disease in developing countries, and the growing economic importance of middle-income countries, raise questions as to the appropriate ways of sustaining international support for global health and making it more effective.
  • Concerns about the current system include volume, volatility, additionality, priority-setting, coordination, accountability and the rationale and justification for development assistance. 
  • Proposals for reform are considered including raising resources through new taxes, e.g. on financial transactions or innovative financial mechanisms; ways of reforming the institutions through which assistance is channelled; and new proposals that go beyond the current system, including the use of international law to codify mutual obligations and new institutions such as a Global Social Protection Fund.
  • Criteria are suggested for assessing reform proposals with a view to providing the foundation for building stronger and more equitable institutions for financing global health.