Global Health and Foreign Policy

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

The character and amount of development assistance for health has major implications for the health of populations in poor countries, because external donor support can comprise a large percentage of their health spending (28, 44) . This makes development assistance for health that is guided more by donor interests than by scientific evidence or the priorities of recipients a concern for global health proponents (45) . While there is some evidence of increasing correlation between development assistance and recipient countries' overall burdens of disease (25) , multiple studies demonstrate a continuing and significant disconnect between aid and the burden of health conditions, including maternal mortality (46) and malaria (47) , and the disability-adjusted life years measure (48) . However, even in cases where development assistance for health has been driven primarily by narrow foreign-policy concerns, health benefits can be realized; for example, US health aid for Egypt, an integral part of US Middle East policy, has helped the country achieve dramatic declines in child mortality (49) . Thus, foreign policy's powerful influence on development assistance for health leaves many pressing global health battles underresourced but allows global health efforts that do align with foreignpolicy interests to receive significant political support and funding.