More Money, Less Cure: Why Global Health Assistance Needs Restructuring

Is more money for global health always good news? In this brief essay I argue that the answer is "No." I suggest that many of the problems that plague decision-making in global health assistance lie not in the global South but in the North, where the monetary flows originate and where most policies are conceived. In sketching several constitutive elements of the political economy of global health finance, I develop a series of arguments that show why the contemporary practice of throwing good money into a dysfunctional global health system makes neither economic nor ethical sense. What emerges is an image of global health as a deeply political arena shaped by local and global interests and incentives. I conclude with three proposals to strengthen global health assistance through the more equitable involvement of critical partners. Only thus can financial investment in global health reasonably be expected to make effective and efficient contributions to human development and global equity.

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