Putting the Gateses’ mission shift in context

I could really use a pie chart here, showing all the promised slices of international aid that remain missing or get removed as global priorities shift.

In the previous post, I noted Melinda Gates’ clarion call — and her accompanying $1.5 billion philanthropic pledge — for more to be done for women and children’s health worldwide. The Gates Foundation, Obama Administration and other governments or donor organizations appear to be turning more philanthropic and foreign aid attention to the terrible inequity of maternal and child deaths worldwide.

This a very worthy cause, but of course there are many worthy causes. And not all of them are receiving the funding or attention they deserve. AIDS was once the world’s top global health priority, but now it appears that funding for many existing projects aimed at battling the pandemic will remain flat or decline even as the number of those afflicted continues to increase.

The Gates Foundation claimed this is not so much a shift in focus as an expansion of an existing priority, but most observers did see it as a shift and a new focus. Some also noted that when you decide to emphasize one thing, it often means you de-emphasize something else.

The Gates Foundation has, for example, decided not to renew funding for a number of projects it helped launch years ago looking for an effective AIDS vaccine. The Global Fund for AIDS, Tuberculosis and Malaria is now struggling to merely respond to existing needs — trying to convince donors not to reduce funds and pointing out it needs something like $15 billion merely to keep on pace for the next few years. Meanwhile, people still die from AIDS and HIV still spreads as most still don’t receive the drugs they need to survive and prevent transmission.

This kind of “cause inequity” and mission shift is often shrugged off as inevitable given we do not exist in a world of unlimited resources.

But what is perhaps less excusable is when donors and governments make promises they don’t keep. In her Monday remarks, Melinda Gates noted that later this month leaders of the most powerful nations on the planet will convene in Canada at the G8 summit in Muskoka, Ontario. The Gateses and members of the Obama administration say they intend to especially push for new commitments to invest in improving maternal and child health.

Maybe someone should take a hard look at how many members of the G8 kept their previous global health commitments — and whether these new commitments represent true progress or sort of a shell game.

Side note: I couldn’t find any illustration showing all of the broken promises, but for those who like to think the U.S. does more than others when it comes to foreign aid, below is a bar chart that shows otherwise. We give much less, per capita and as a percentage of our GDP, than most developed countries:

Tom Paulson covered science, medicine and global health as reporter for the Seattle Post Intelligencerfrom 1987 to 2009, before the print version of the paper closed and PI became the online news site. Now he continues to report as a freelance and blogs about the local global health scene at his website: A Page from Tom Paulson.

Tags: G8, Gates Foundation

Category: Global Health, Global Health Seattle, Tom Paulson