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A New, Exhaustive Accounting of Global Health Funding

A paper in the 20 June issue of The Lancet offers the most comprehensive analysis yet done of the financing of global health. Led by economist Christopher Murray, head of the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, the study looks at development assistance for health between 1990 and 2007. During those 17 years, assistance jumped from $5.6 billion to $21.8 billion. Funding for HIV/AIDS, followed by malaria and tuberculosis, drove the huge increase. By their calculations, in 2007, $5.1 billion went to HIV/AIDS, $0.8 billion to malaria, and $0.7 billion to TB. These totals differ substantially from the estimates made by others, but Murray says this may be because his team focused on disbursements, not just commitments. The researchers also analyze the relationship between funding to countries and their disease burden, with some surprising disconnects. “It does for health something that’s never been done: It takes all of the data from every source and checks it thoroughly for inconsistencies and looks for obvious missing values and tries to impute them,” says economist Mead Over of the Center for Global Development in Washington, D.C. “It’s something we very badly needed.” Yet Over also notes that “imputation”—which he says is basically guess work—also limits the accuracy of even this analysis, which he writes about on his blog.