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Commentary & Opinion
Large Donors Dictating Direction of Global Health Research, Financing, Essay Says

September 27, 2012

"When it comes to getting aid right, an all-too-familiar problem seems to be balancing the priorities of rich governments with what communities actually want," AlertNet reports in an article examining an essay written by Oxford University researcher Devi Sridhar and published in PLOS Medicine. The essay "assesses the system of financing for health research," according to the news service (Nguyen, 9/26). "Sridhar argues that since the priorities of funding bodies largely dictate what health issues and diseases are studied, a major challenge in the governance of global health research funding is agenda-setting, which in turn is a consequence of a larger phenomenon -- 'multi-bi financing,'" according to a PLOS press release (9/25). "Multi-bi financing refers to the practice of donors choosing to route non-core funding -- earmarked for specific sectors, themes, countries, or regions -- through multilateral agencies such as the World Health Organization (WHO) and the World Bank and to the emergence of new multi-stakeholder initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance," she writes.

Sridhar examines the driving forces behind new patterns of global health funding and governance, and discusses three possible consequences of multi-bi financing for global health research governance (9/25). "Sridhar argues that the risk of multi-bi financing is that difficult choices about priority-setting in health will be made in the marketplace of global initiatives, rather than in the community that will have to live with those choices," the press release states. She writes, "The shift to multi-bi financing likely reflects a desire by participating governments, and others, to control international agencies more tightly," according to the press release. However, she adds that "one major impact of multi-bi financing has been to shine a clear light on how and where multilateral institutions, such as the World Bank and the World Health Organization, might do better," the press release notes (9/25).

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