In the early 2000s, the international aid community started to
fund health programs through Global
Health Initiatives (GHIs) which provide
aid and support for tackling infectious diseases and for implementing
immunization programs against childhood diseases. However, priorities set by GHIs and by governments are not always the
same, an issue which is
discussed in Globalization
and Health where
‘agency theory’ is used to examine the conflicts between donor and recipient
In order to find out how GHIs have been
operating, researchers from the London School of Hygiene & Tropical
Medicine and Queen Margaret University, Edinburgh undertook detailed interviews
with policy makers and officials from GHIs and with the Ugandan government.
They also examined both published and unpublished documentation and observed
policy meetings regarding the allocation of GHIs funds.
Using agency theory, designed to look at
the conflict between two sets of people with interest in the same assets, such
as shareholders and company managers, the results from Uganda show a strong
conflict of interest between the priorities set by the GHIs, such as The President’s
Emergency Plan for AIDS Relief in Africa (PEPFAR)and the Global
Fund, which tackles HIV/AIDS, tuberculosis and malaria, and those of
the government. It seemed that while the GHIs approach was good at providing
short-term aid, the government would have preferred to have resources allocated
in a more flexible manner, allowing them to use the additional contributions as
part of their general (or health) budgets, investing in long term benefits.
Each organization is made up of different
individuals, who each have their own motivations, resulting in conflicting
priorities being pursued by the GHIs and the government. More needs to be done
to improve co-operation between aid organizations and governments and to know
that donations are getting to the right people at the right time and are being
used in the most effective way possible to improve the health status of the
people living in developing countries.