Analyzing Global Health Through a Sustainability Lens

In the past few decades, standards for global health have been revolutionized around the world. Life expectancies have increased dramatically, infectious disease is at an all-time low, and infant mortality continues to decline. A lot of these achievements can be credited to the work of many NGOs and donor organizations who have vested personal interest in the future of global health.

With campaigns that focus on distributing malaria nets or contraception, these donor agencies have managed to yield a large effect when it comes to curbing infectious disease. But, looking back on these interventions, it becomes apparent that some issues in sustainability seem to exist.

What has come to happen in global health financing is countries that are receiving funds and benefits mainly from donor agencies rather than their own health ministries are becoming increasingly dependent on the donor organizations.

This is largely because donors have been looking to solve problems with short-term solutions and benefits rather than solutions that may require a much longer amount of time before the return on investment can be seen.

This idea is extremely prevalent in the fact that there is an overrepresentation of funding towards the “big three” infectious diseases when it comes to global health financing (HIV/AIDS, malaria, and tuberculosis) while very little funding has been focused on providing surgical care to populations.

While the latter does, of course, have a significant effect on the population, lack of surgical care continues to be a significant health burden on an area, depriving infants of cures from congenital conditions, mothers from cesarean sections, and cancer patients from viable treatments.

The reason interventions like surgery have been so underrepresented in global health financing has been because donors and NGOs look at interventions through as short-term lens and see innumerable initial benefits as well as a high cost-benefit ratio when it comes to treating infectious disease.

Contraceptives, malaria nets, and vaccines are relatively cheap and can save millions. Surgical centers require a much longer time to develop, and though it has a similar cost-benefit ratio to treating infectious disease, it takes much longer for the benefits to be seen, making it an unappealing choice for donors hoping to maximize shareholder value and their own feelings of self-efficacy.

Thus, when consulting for organizations with a global health mission, make sure to analyze the existing market. It could be true that there is a serious deprivation of funds when it comes to treating HIV/AIDS, tuberculosis, and malaria. If this is the case, low-cost inputs (such as quinine pills) at high volumes can have a drastic impact on a population’s health. But, in many cases, many NGOs are already working in these sectors.

Though investment in infectious disease could still be necessary in these instances, it could also be the case that more long-term investments like building a surgical center could have a much greater impact on the population 10, 20, and even 50 years down the line. After all, a surgical center could provide for an array of procedures to a population while also having the infrastructure in place to distribute drugs for infectious disease.

So even though it may be tempting to offer clients short-term solutions that seem to generate high amounts of value, look towards the long-term to see how different interventions would play out.

By Sireesh R.