This document discusses development assistance for global health issues like AIDS. It shows that while funding for AIDS assistance increased from 2002 to 2008, it has declined since. It also discusses the debate around coordinating different donor agencies that provide health aid for specific diseases separately. While increased coordination seems obvious, different agencies have separate targets and structures that have made overall coordination challenging to achieve. The document argues that a common fund and allowing donors to support ministry campaigns while keeping priorities could help address this issue and get past obvious solutions to actually achieve more coordination.

1. More with Less? Extending the Reach
of Development Assistance in an Era
of Uncertainty
Eran Bendavid
Stanford University

2. The charge for AIDS 2012
• The end of AIDS • AIDS-free generation
• Turning the tide • www.2endaids.org/
AIDS Assistance from Donor Governments, Bn$
$8.7 $8.7 $8.7 $8.8
$7.7 $7.7 $7.6
$6.9
$6.6
$5.6
$4.9
$4.3
$3.9
$3.6 $3.5
$2.8
$2.0
$1.6 $1.6
$1.2
02
03
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07
08
09
10
11
02
03
04
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08
09
10
11
20
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Commitments Disbursements

3. The debate over foreign health aid

4. A no-brainer!
• In Kenya, the targets of aid agencies include:
• Increase home-based and voluntary testing (PEPFAR and Global
Fund)
• Increase possession and use of insecticide-treated bed nets and
long-lasting insecticidal nets (President’s
Malaria Initiative and Global Fund)
• Testing and implementing clean water
technologies (USAID and CDC).
• What if all these separate activities were
implemented in sync?

5. Why it is hard to coordinate?
• Donor institution targets are tightly tied to specific diseases.
For example: “The goal of PMI is to reduce malaria-related
deaths by 50 percent in 19 countries in Africa that have a high
burden of malaria by expanding coverage of four highly
effective malaria prevention and treatment measures.”
• The US Global Health Initiative aimed to bring the various US
institutions involved in health aid under one umbrella. “We
cannot simply confront individual preventable illnesses in
isolation. The world is interconnected, and that demands an
integrated approach to global health.” Barack Obama, May
2009
• But the GHI lacked statutory or budget authority, and, to
date, failed to eliminate parallel structures in the major health
aid agencies

6. The challenge: getting past no-brainers
• A common fund for cross-agency priorities, managed by
the Global Health Diplomacy office…
• Funding specific aspects of ministry campaigns could
promote the breadth and ownership of ministry activities
while keeping donor priorities and outlays aligned.
• The google approach: dedicate 10-20% of funds to
develop creative (and disruptive) approaches to improve
global health.