How Can Donors Help Build Global Public Goods in Health?

Das Gupta, Monica; Gostin, Lawrence

How Can Donors Help Build Global Public Goods in Health?

Autores

Descripción

Aid to developing countries has largely neglected the population-wide health services that are core to communicable disease control in the developed world. These mostly non-clinical services generate "pure public goods" by reducing everyone's exposure to disease through measures such as implementing health and sanitary regulations. They complement the clinical preventive and treatment services which are the donors' main focus. Their neglect is manifested, for example, in a lack of coherent public health regulations in countries where donors have long been active, facilitating the spread of diseases such as avian flu. These services can be inexpensive, and dramatically reduce health inequalities. Sri Lanka spends less than 0.2% of GDP on its well-designed population-wide services, which contribute to the country's high levels of health equity and life expectancy despite low GDP per head and civil war. Evidence abounds on the negative externalities of weak population-wide health services. Global public health security cannot be assured without building strong national population-wide health systems to reduce the potential for communicable diseases to spread within and beyond their borders. Donors need greater clarity about what constitutes a strong public health system, and how to build them. The paper discusses gaps in donors' approaches and first steps toward closing them.

Palabras clave

ACCESS TO HEALTH CARE, ACCESS TO HEALTH CARE SERVICES, AID, ASCARIASIS, AVIAN FLU, AVIAN INFLUENZA, BULLETIN, BURDEN OF DISEASE, CANCERS, CAPACITY BUILDING, CARDIOVASCULAR DISEASES, CHILD DEATHS, CHILD HEALTH, CHILD MORTALITY, CHILD SURVIVAL, CHOLERA, CITIES, CITIZENS, CIVIL WAR, COMMUNICABLE DISEASE, COMMUNICABLE DISEASE CONTROL, COMMUNICABLE DISEASES, DEATHS, DEVELOPING COUNTRIES, DIARRHEA, DIARRHEAL DISEASES, DIARRHOEA, DISASTERS, DISEASE OUTBREAKS, DISEASE PREVENTION, DISEASE PREVENTION AND CONTROL, DISEASE SURVEILLANCE, DISEASE VECTORS, DRACUNCULIASIS, DRINKING WATER, EFFECTIVE VACCINES, EMERGENCIES, ENDEMIC DISEASES, ENVIRONMENTAL HEALTH, ENVIRONMENTAL PROTECTION, EPIDEMIC, EPIDEMIC DISEASE, EPIDEMIOLOGICAL PROFILE, EXTERNALITIES, FLU PANDEMIC, FOOD SAFETY, GLOBAL HEALTH, HAZARDS, HEALTH AUTHORITIES, HEALTH CARE, HEALTH CARE SERVICES, HEALTH CONDITIONS, HEALTH ECONOMICS, HEALTH EDUCATION, HEALTH EQUITY, HEALTH INEQUALITIES, HEALTH INFRASTRUCTURE, HEALTH INTERVENTIONS, HEALTH LEGISLATION, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH PLANNING, HEALTH POLICY, HEALTH PROGRAMS, HEALTH REFORM, HEALTH REGULATIONS, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH STRATEGIES, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTHY DEVELOPMENT, HOOKWORM, HOOKWORM INFECTION, HUMAN DEVELOPMENT, ILLNESS, IMPORTANCE OF POPULATION, INCOME, INDUSTRIALIZATION, INFECTION, INFECTIONS, INFECTIOUS DISEASE, INFECTIOUS DISEASES, INFLUENZA, INJURIES, INSTITUTIONAL MECHANISMS, INTERNATIONAL COOPERATION, INTERNATIONAL EFFORTS, INTERNATIONAL HEALTH REGULATIONS, INTERNATIONAL ORGANIZATIONS, LATRINES, LAWS, LEPROSY, LIFE EXPECTANCY, LIMITED RESOURCES, LOCAL AUTHORITIES, LOCAL GOVERNMENTS, LOW-INCOME COUNTRIES, MALARIA, MALARIA CONTROL, MATERNAL AND CHILD HEALTH, MEDICAL SERVICES, MEDICAL TECHNOLOGY, MEDICINE, MIDWIVES, MILLENNIUM DEVELOPMENT GOALS, MORBIDITY, MORTALITY, NATIONAL GOVERNMENTS, NATIONAL LEVEL, NATIONAL POPULATION, NUTRITION, OUTBREAK CONTROL, PARASITIC DISEASES, PATHOGENS, PERSONAL HEALTH, PERSONAL HYGIENE, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POLICY SERIES, POOR PEOPLE, POPULATION DISCUSSION, PREVALENCE, PREVENTION ACTIVITIES, PRIMARY HEALTH CARE, PROGRESS, PUBLIC EDUCATION, PUBLIC HEALTH, PUBLIC HEALTH INTERVENTIONS, PUBLIC HEALTH LAWS, PUBLIC HEALTH SERVICES, PUBLIC HEALTH WORKERS, PUBLIC SERVICES, SAFE WATER, SANITARY CONDITIONS, SANITATION, SANITATION FACILITIES, SCHISTOSOMIASIS, SCREENING, SERVICE DELIVERY, SEX, SMALLPOX, THERAPIES, THERAPY, TRACHOMA, TREATMENT, TREATMENT SERVICES, TROPICAL DISEASES, TROPICAL MEDICINE, URBANIZATION, VACCINATION, VACCINATION PROGRAMS, VECTOR CONTROL, WASTE, WASTE DISPOSAL, WATER SUPPLIES, WATER TREATMENT, WORKERS, WORLD HEALTH ORGANIZATION