“It appears to be part of the colonial legacy,” Murray says.
This study was released as many world leaders in global health gather in Seattle for the Pacific Health Summit. The summit’s focus this year was on the threat of multidrug resistant tuberculosis, which kills an estimated 1.7 million people each year, but rarely makes the headlines or evening news like HIV does. When I left the Summit around noon today, there was a fair bit of grumbling about how there are a lot of people talking (some might say whining) about it, yet there’s not enough people taking groundbreaking action to do the basic research and development needed to create new drugs, diagnostics, and vaccines.
Part of the problem is that money tends to follow attention from society—which was reflected in the global health financial analysis. HIV—even though it’s not a bigger cause of suffering and death than TB and malaria—grabbed the lion’s share of resources, with $5.1 billion in support, according to the study. That compares with $800 million for malaria, and $700 million for tuberculosis. Another $900 million goes to financing new clinics, doctor training, and prevention programs—the all-around systemic improvements that many experts say are needed to make a dent in these diseases.
One last fact I found extremely interesting: If you were to poll people on the street in Seattle and ask “Who pays for global health?” I bet most would say the Bill & Melinda Gates Foundation and stop there. But that’s only part of the story. Seattle’s most famous couple actually write smaller checks than U.S. taxpayers like you and me. The U.S. government provided one-fourth of the world’s global health budget in 2007, or $5.7 billion, while just 4 percent of the total pie came from the Gates Foundation ($1.1 billion). The U.S. as a whole, when adding up public and private money, pays for more than half of all global health aid.
“It’s surprising that the U.S. is such a dominant force in global health spending, because so many people like to cast the U.S. as being miserly, at least for health,” Murray says. “It’s not really true.”
But Murray and his co-authors agreed, after looking through the financial data, that it was also surprising that this field involves so many more players than just a few committed philanthropists and public health officials.
“Although, the scale-up of global health resources from the Bill & Melinda Gates Foundation is striking, the magnitude of resources that U.S. non-governmental organizations mobilized from other private philanthropy was greater,” the researchers said in The Lancet. “Corporate drug and equipment donations have expanded substantially.”
