“Well, what you get is actually priorities being skewed in a way that perhaps fits the priorities of the donor in question - whether it’s taxpayers - whether it’s the priorities of a particular organization. And it differs from how priorities are set within, let’s say, a body like the World Health Organization, where you have all member states come together in the World Health Assembly to decide collaboratively through deliberation what the priorities should be for the organization. So, in a way, it’s priorities being decided by the few for the many,” she said.
She said it’s also generating debate on how funds should be spent within the Global Fund to Fight AIDS, Tuberculosis and Malaria. Since the global financial crisis, donors are demanding that projects not only improve health, but be cost-effective, as well.
“So you are seeing much more reliance in actually trying to monitor these international agencies more closely - being able to decide the priorities, to realign them with those of a particular donor," said Sridhar.
Sridhar said one of the main issues is that short-term health concerns might take priority over long term objectives.
“Part of the rationale for creating the World Health Organization was that countries would compromise their short term differences in order to obtain the long term benefits of collaboration," she said. "For example, international health regulations, which require countries to report on, let’s say, disease outbreaks in their country. It’s not necessarily in the short term interest of a country to do that, but it’s in the long term collective interest of the global community for this to happen.”
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