Debating Aid…

Earlier this month Laura Freschi and Alanna Shaikh published a piece in Alliance magazine that raises some interesting and thought-provoking question about the role of the Gates Foundation in setting the global health agenda.

Since the end of the last century, it has been evident that a new way to tackle global health problems was needed. A new way emerged – spurred on by the rise of many vertical funds that took the problem out of the hands of large pharmaceutical companies and governments and into the hands of donors that went after specific problems. The result was a largely fragmented global health landscape, and over the years the Bill & Melinda Gates Foundation has risen to the top.

In their Alliance magazine article they elude to the global health agenda being set by Bill Gates.

It is not inconceivable that you might find yourself some day reading a story about a Gates-funded health project, written up in a newspaper that gets its health coverage underwritten by Gates, reported by a journalist who attended a Gates-funded journalism training programme, citing data collected and analysed by scientists with grants from Gates.

You might feel like that was hyperbole just for the sake of it but, really, it’s not all that unthinkable. But you have to ask yourself why. Perhaps Gates is the only one that cares enough to put his money to publicise and get people talking about the development issues he’s interested in. That was a simplistic answer. The more complicated answer is simply… money talks. The aid world, like everything else, is rule by money.

Certain things jump out at me when reading the piece. Firstly, many in the aid world see aid as a problem within a social context. Cue mentions of Bill Easterly and Dambisa Moyo. Aid in that context has failed those it is trying to help.

It’s easier to develop a diarrhoea vaccine than to get the faeces out of the water supply, but clean water provides benefits far beyond diarrhoea prevention.

Yes, some diseases are caused by poverty — and attacking the roots will go a long way to alleviating the problem.

I sit at the aid and development table purely on the scientific side. Disease is disease. In the aid world they call them diseases of poverty. The term “diseases of poverty” is a term far too glib for my liking. Yes, there are elements of poverty linked to many of these diseases, but for some diseases — people don’t get them because they are poor… they die from them because they are poor.

They go on to say “But if malaria can’t be eradicated and must instead be managed or contained, as many scientists believe, then four years and hundreds of millions of dollars may have gone towards answering the wrong research question.

Is there really such a thing as the wrong research question? No one was seriously talking about a Malaria vaccine before Gates cames along. There are benefits in striving for technological and purely scientific solutions to problems. Some of the drugs we’ve been using to tackle some of the deadliest diseases across the aid world have been used for the better part of a century. There was no development for better drugs and treatments. We can claim that reinventing the toilet is a step too far but some problems of the development world will require that magic bullet, that perfect vaccine, that one-a-day pill… that miracle drug.

Surely with all the problems, social and political, that come along with traditional aid efforts a purely technological/scientific approach is worthwile. Cut out the middle man and head straight to the problem.


What had I twaught…

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