NCPA - National Center for Policy Analysis


July 10, 2008

As the G8 gathers this week in Hokkaido, leaders will pledge billions more aid for health in Africa -- despite the fact that previous aid has had almost no impact.  In fact, countries around the world should completely rethink the way aid is delivered, bypassing corrupt and inefficient government ministries and making far greater use of private organizations, says the Campaign for Fighting Diseases (CFD).


  • Recent years have seen massive increases in foreign aid for health, rising to 13 percent of total overseas aid in 2005 and accounting for over 19 percent of all health spending in Sub-Saharan Africa.
  • In spite of this, the region is making no progress towards meeting the health-related Millennium Development Goals.

Much of this failure is due to aid going directly to ministries in developing countries, who are then supposed to use the money to deliver health care, says the CFD. 

Mismanagement, corruption and waste ensure that very little of it reaches patients.

Instead, the CFD suggests that donors should stipulate that their funds be used to finance competitive, outcome-based contracts to deliver health care.  Such contracts would see non-profit, private sector and government entities competing to provide health services, with continued funding contingent on actually delivering results.

Where they have been used, contracts have outperformed government provision in cost, effectiveness and equity, says the CFD.  For example:

  • The government of Cambodia has been so successful with their contracting program that it has now been extended to cover one in ten Cambodians.
  • Six other case studies show that contracting delivers results far superior to government provision.

Source: "G8 Should Abandon Current Model of Aid for Health - New Report," Campaign for Fighting Diseases, July 03, 2008.


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