Sometimes Less is More: Global Health Governance in Today’s World

There is no doubt that global health organizations are invaluable in the global fight against disease and improving the health of nations in need of assistance.   From the first International Sanitary Conference in 1851 until the myriad global health organizations that we have today, countless lives have been improved and/or saved by these international actors.  Diseases such as smallpox and polio, once greatly feared, are now largely a thing of the past thanks to eradication campaigns launched by groups such as the World Health Organization (WHO), or more recently the Bill and Melinda Gates Foundation who actively seek to add malaria to that list as well.

However, today organizations such as this face an interesting problem: on the one hand, the resources required to make a measurable difference are massive.  More help is always required and welcomed from as many groups as possible.  On the other hand, so many international players have emerged that the system as a whole is almost impossible to govern effectively.

The bureaucracies of some of the larger organizations move so slowly that help can take six months to a year before it even begins to arrive.  Also, in areas where many organizations pledge their help, resources tend to be wasted on redundancies due to lack of proper communication, and getting proper funding to each one becomes a nightmare for the country that requires the aid.

There are other major dilemmas as well.  Some developing nations are so close to collapse that global health and foreign aid organizations are the only things that keep them from going over the edge.  In these cases, international development groups and humanitarian NGO’s tend to even get involved in the political process and create development strategies and health policies for the nations in need.   As important as this process is, it also leads directly into many problems.  Some of these nations in question are relying so heavily on these organizations that they are barely getting involved in the process of recovery and policymaking, and thus are not developing the skills necessary to thrive as a nation if their aid organization should pull out.

Adequate funding will also always be a major problem.  There is no international mandate stating that any organization is bound to help any particular cause, so if support or awareness on one problem is lacking, the funding will certainly be lacking as well.  The major donors, such as the World Bank or the Bill and Melinda Gates Foundation, can make a major impact in areas of their choosing; however, some would argue that that is a problem in and of itself.  Major donors can support whatever causes they wish, regardless of perceived global importance or actual need, opening them up for critics to undermine their chosen causes by pointing out ways in which they do not believe the cause is worthy.

What global health organizations need is exactly what is implied in the title: organization.  They do not necessarily need more groups to flock to one place in time of crisis; instead they would do well to somehow come together under one overall banner.  Having hundreds of groups wishing to help the cause of global health is a great thing, but no situation can be helped by adding confusion.  When large-scale organizations seek to reform or several smaller organizations combine their efforts to tackle one particular country or area, a clear mission statement and set of guidelines should be established immediately.  There also should be a bigger emphasis on helping the recipient of the aid stand on their own two feet if and when that mission is completed.  There will always be a need for additional help, but scaling back in some ways will greatly improve the efficiency of global efforts as a whole.


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