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Why have strategies to combat hunger in India failed so badly? How did a nation that prides itself on booming economic growth come to have half of its preschool population undernourished? This book takes up these questions and probes the issues surrounding the World Bank, development assistance, hunger, and aid and power

An even-handed and thorough empirical analysis of one of the most pressing topics in world affairs, Governing Global Health will reshape our understanding of how organizations can more effectively prevent the spread of communicable diseases like AIDS and reduce pervasive chronic health problems like malnutrition.

Anthropologists Inside Organisations: South Asian Case Studies responds. to a shift in anthropology over the past decade towards working with and studying. organisations. This book brings together seven fresh case studies on how anthropologists. have negotiated the issues related to interacting with organisations. While providing. examples of how research has been conducted inside and with organisations, the. collection also offers analyses of the methodological issues that researchers. face. All the case studies in this volume are based on South Asia or South Asians. With an emphasis on metho

This paper argues that recent global health cooperation has been marked by two trends. First, there has been a highly successful proliferation of vertical funds to fight specific diseases. These are characterised by narrower problem-based mandates; multistakeholder governance; voluntary and discretionary funding; no in-country presence for the delivery of assistance; and an output-based legitimacy (based on effectiveness, not process). The rise of new initiatives with these characteristics has dovetailed with an increase in the funding of international organizations. However, the latter has not necessarily strengthened multilateralism. Instead rapid increases in discretionary earmarked funding to the WHO and World Bank, which we call Trojan multilateralism, has replicated features of the vertical funds. With what consequences for international cooperation? Using principal-agent theory, we find a mixed picture. International organizations are being redirected by specific incentives. However, two constraints on bilateral control are not shifting. There is a persistent asymmetry of information between the WHO or the World Bank and individual member states which gives the former a degree of autonomy. Equally, there are persistent obstacles to tightening bilateral monitoring of multilateral action. We conclude that the positive lessons to be drawn from vertical initiatives need to be balanced by the risks posed from a convergence of vertical initiatives and Trojan multilateralism.

In recent years, health has risen as a strategic foreign policy and diplomatic concern across the world, becoming an important part of both formal and informal international relations. In this paper, we attempt to identify the motives behind national and regional approaches to health and foreign policy. We argue that even though the main drivers of the move towards linking health and foreign policy are traditional security concerns, some states also show signs of altruistic behaviour that extends beyond foreign policy interests. We suggest that this is likely due to strategic engagement by health advocates who have used the window of opportunity provided by recent infectious disease outbreaks to mainstream health into formal and informal strategies. As such, apparently altruistic acts towards global public health arise as positive externalities integrated into new policies that largely deal with other issues. We conclude that while national self-interest is likely to remain the main driving force behind foreign policy engagement in global public health, the strategic use of policy mechanisms by health advocates helps ensure that more altruistic behaviours are incorporated into government. These are small steps towards ensuring health and foreign policy engage in ways which are mutually beneficial.

This paper uses budgetary documents from African health and finance ministries to assess the extent to which African governments are meeting targets set at the Organisation for African Unity Summit, held in Abuja in 2001. Drawing on three case studies (Ghana, Nigeria and South Africa), the authors explore how public healthcare systems are organised; how countries allocate domestic and foreign resources; and whether governments are complying with the Abuja target of spending 15% of government income to achieve health-related Millennium Development Goals, goals for universal coverage of basic healthcare, health equity goals, and financial risk protection. Whilst recognising that this figure is not straightforward to calculate - due to substantial discrepancies in health spending data between national ministries of finance, the WHO, the World Bank and the OECD - the paper argues that South Africa largely meets the Abuja target, whereas Ghana and Nigeria fall short. The paper strongly recommends that the Abuja target may not be the most effective way to improve public health.

In this paper we examine whether Brazil, Russia and India have similar financing patterns to those observed globally. We assess how national health allocations compare with epidemiological estimates for burden of disease. We identify the major causes of burden of disease in each country, as well as the contribution HIV/AIDS, tuberculosis and malaria make to the total burden of disease estimates. We then use budgetary allocation information to assess the alignment of funding with burden of disease data. We focus on central government allocations through the Ministry of Health or its equivalent. We found that of the three cases examined, Brazil and India showed the most bias when it came to financing HIV/AIDS over other diseases. And this occurred despite evidence indicating that HIV/AIDS (among all three countries) was not the highest burden of disease when measured in terms of age-standardized DALY rates. We put forth several factors building on Reich's (2002) framework on "reshaping the state from above, from within and from below" to help explain this bias in favour of HIV/AIDS in Brazil and India, but not in Russia: "above" influences include the availability of external funding, the impact of the media coupled with recognition and attention from philanthropic institutions, the government's close relationship with UNAIDS (UN Joint Programme on HIV/AIDS), WHO (World Health Organization) and other UN bodies; "within" influences include political and bureaucratic incentives to devote resources to certain issues and relationships between ministries; and "below" influences include civil society activism and relationships with government. Two additional factors explaining our findings cross-cutting all three levels are the strength of the private sector in health, specifically the pharmaceutical industry, and the influence of transnational advocacy movements emanating from the USA and Western Europe for particular diseases.