Health-related charity and foreign aid - is it helping?

[Darth Wong]

http://www.cbc.ca/health/story/2009/06/ ... ms-un.html

Little proof $196B US health programs work
Last Updated: Friday, June 19, 2009 | 11:12 AM ET
The Associated Press

In the last two decades, the world has spent more than $196 billion US trying to save people from death and disease in poor countries.

But it remains unclear whether or not donating countries are getting good value for their money, according to two studies published Friday in the medical journal Lancet.

Millions of people are now protected against diseases such as yellow fever, sleeping under anti-malaria bed nets and taking AIDS drugs. But beyond that, it's tough to gauge the effectiveness of pricey programs led by the United Nations and its partners, and in some cases, big spending may even be counterproductive, the studies found.

Trying to show health campaigns actually saved lives is "a very difficult scientific dilemma," said Tim Evans, a senior World Health Organization official who worked on one of the papers.

In one paper, WHO researchers examined the impact of various global health initiatives during the last 20 years.

They found some benefits, such as increased diagnosis of tuberculosis cases and higher vaccination rates. But they also concluded some U.N. programs actually hurt health care in Africa by disrupting basic services and causing some countries to slash their health spending.

In another paper, Chris Murray of the University of Washington and colleagues tracked how much has been spent in public health in the last two decades — the figure jumped from $5.6 billion US in 1990 to $21.8 billion US in 2007 — and where it's gone. Much of that money is from taxpayers in the West. The United States was the biggest donor, contributing more than $10 billion US in 2007.

They found donations didn't always go to countries that needed the money most. Ethiopia and Uganda both receive more money than countries with bigger health crises, such as Nigeria, Pakistan and Bangladesh.

Some experts were surprised how long it took to simply consider if the world's health investment paid off.

Richard Horton, the Lancet's editor, labelled it "scandalous" and "reckless" that health officials haven't carefully measured how they used the world's money.

Experts said that in some cases, the U.N. was propping up dysfunctional health systems. "If you've got rotten governments, no amount of development aid is going to fix that," said Elizabeth Pisani, an AIDS expert who once worked for the U.N., citing Zimbabwe as a prime example.

Murray and colleagues also found AIDS gets at least 23 cents of every health dollar going to poor countries. Globally, AIDS causes fewer than four per cent of deaths.

When Cambodia asked for help from 2003-2005, it said less than 10 percent of aid was needed for AIDS. But of the donations Cambodia received, more than 40 percent went to diseases including AIDS.

"Funds in global health tend to go to whichever lobby group shouts the loudest, with AIDS being a case in point," said Philip Stevens of International Policy Network, a London think-tank.

Effectiveness of donations difficult to gauge

In WHO's study, researchers admitted it "is not known" whether health campaigns address countries' most pressing needs.

WHO acknowledged change was necessary, but insisted it needed even more money, warning fewer donations would jeopardize children's lives.

U.N. agencies, universities and others working on public health routinely take from two to 50 per cent of a donation for "administrative purposes" before it reaches needy countries.

Others said there is little incentive for health officials to commission an independent evaluation to find out what their programs have achieved.

"The public health community has convinced the public the only way to improve poor health in developing countries is by throwing a ton of money at it," Stevens said. "It is perhaps not coincidental that thousands of highly paid jobs and careers are also dependent on it."

It's funny how charity becomes an industry unto itself, and can start to generate its own priorities.

[Andrew_Fireborn]

I've always been against these programs for two very strong reasons:

1) Even if we are allevieating their temporary discomfort, the fact remains that these areas generally have absolutely nothing of value and these programs generally don't construct infrastructure.

2) They have always seemed terribly susceptible for corruption, from workers abusing the people they're helping to managers just flat out embezelling.



Call me heartless, but we have an extreme surplus of people already, especially as the first world moves toward more automation. Not to even factor in, as the artivle mentions, that most of these areas are war torn shitholes, we'd probably have gotten a hell of a lot more for our money paying to move these people to liveable areas and set them up.

[ray245]

Call me heartless, but we have an extreme surplus of people already, especially as the first world moves toward more automation. Not to even factor in, as the artivle mentions, that most of these areas are war torn shitholes, we'd probably have gotten a hell of a lot more for our money paying to move these people to liveable areas and set them up.

I would rather divert those money into building infrastructure for nations that is less war-torn, say India, some southeast Asian nations or some south American nations.

Helping those nations like Indonesia for example to set up a better healthcare system, use the money to provide trainings for doctors as opposed to simply sending more medical care packages down there.

[Guardsman Bass]

Call me heartless, but we have an extreme surplus of people already, especially as the first world moves toward more automation. Not to even factor in, as the artivle mentions, that most of these areas are war torn shitholes, we'd probably have gotten a hell of a lot more for our money paying to move these people to liveable areas and set them up.

The disease-prevention programs (such as AIDS) tend to be the best, simply because they have heavily focused priorities and a simple set of goals.

As for the "population" issue, keep in mind that you're helping to lower rates of mortality - and that it turn, particularly in the case of infant and child mortality, means that parents can choose to have less children. It's sort of like how the West switched away from a period in which families had lots of children because one-third of them would die before the age of five.

[Darth Wong]

Did you not see the part about how AIDS tends to get disproportionately large funding, compared to other health issues?

[Guardsman Bass]

Call me heartless, but we have an extreme surplus of people already, especially as the first world moves toward more automation. Not to even factor in, as the artivle mentions, that most of these areas are war torn shitholes, we'd probably have gotten a hell of a lot more for our money paying to move these people to liveable areas and set them up.

I would rather divert those money into building infrastructure for nations that is less war-torn, say India, some southeast Asian nations or some south American nations.

Keep in mind that it's not as if all of Africa is a war-torn shithole. Certain areas do a lot better than others - while Zimbabwe has been going down the shitter, many of its neighbors having been doing much better, such as Zambia (which also got a boost from importing a number of the farmers kicked off their lands in Zimbabwe).

[Guardsman Bass]

Did you not see the part about how AIDS tends to get disproportionately large funding, compared to other health issues?

I saw the "23% of funding for 4% of fatalities", but missed the "10% only needed" part. My bad.

[Solauren]

I've never been a big fan of the 'help those poor people' programs.

And no, it's not because I'm a evil heartless bastard. I would honestly like to see everyone survive, live, and prosper.

It's because I'm a practical evil heartless bastard.

Simply put, just handing people money or help, has rarely, rarely worked in the history of the civilized world.

It's like giving an unemployed homeless alcholic a job and house. Unless you force him to attend addictions councilling, and address any other problems he might have, you're just treating the symptom, and not the cause. That persons problems could, and probably will, resurface.

People generally can't be helped until they want to be helped, and are trying to help themselves.

Now, this may not apply on a scale like what we are discussing, but there are parellels.

(At this point, I'm focusing entirely on third world countries)
Simply helping to feed a starving child isn't going to do anything in the long run until that region is self-sufficient in supplying it's own food, and protecting it's food supplies from those that would steal them. (i.e warlords, rebels, terrorists, bad guys in general).

I'm all for feeding that child. But if you really, really, want to help the child, either get the child out of the country, or transform the country the child is in.

Unfortunately, alot of those third-world shit holes are shit holes because the people in power like it that way, or are too comfortable to want the status quo to change. Worse yet, they may be corrupt (and usually are), and will intercept the fund and relief ment for suffering people, and take it for themselves, or the miltiary, or their pet dog.

This applies to just about all the problems in third-world countries, but they have other factors blocking them.

i.e
Transmission of Sexual Diseases; The problem is the Church (discussed at length on this board)
Rebuilding projects; Local Human Scum coming along and claiming it for themselves, or taking people hostages for ransom money.

In other words; We can try to help those areas, but until the people there that don't want to be helped are dealt with, it's almost pointless.


Anyway...

Most of the time, sending aid to a third-world country is a waste. Not because we shouldn't help the less fortunate, but because we are not giving them the help they really need. They don't need us giving them a sandwich. They need us to help them plant and water the field so they can grow the bread + fixing's to make the sandwich, and keep the local scum from tearing up the field.

[Aaron]

Anyway...

Most of the time, sending aid to a third-world country is a waste. Not because we shouldn't help the less fortunate, but because we are not giving them the help they really need. They don't need us giving them a sandwich. They need us to help them plant and water the field so they can grow the bread + fixing's to make the sandwich, and keep the local scum from tearing up the field.

Every time I see an ad from an NGO or a thread on this I can't help but think of the stories from the guys overseas who tell me about the warehouses of aid sitting rotting in places like Kanadahar and Yugoslavia because the aid can't get out, gets stolen or destroyed after we leave. I'd rather the money go into things like digging wells and education, which is probably the only way to get out of the mess.