Environmental Engineering Reference
In-Depth Information
Foreign Aid in the National Interest
largely sets out a view that future health issues
will relate to the pursuit of a public versus private healthcare system, the treatment of
chronic disease such as diabetes, cancer, and cardiovascular problems, and the rising
costs of health care associated with these non-communicable diseases in developing
countries. this analysis is more relevant to the situation in middle-income countries
than in the poorest countries, and it is most interested in the opportunities arising from
current trends in demography, urbanisation, and markets. the report recognises that
there will be global growth in the health industry and encourages the decentralisation
and privatisation of health systems in developing countries. while the concern over
non-communicable diseases is a real one for the developing world (and recognised
by the wHo), it is overemphasised in these documents meant to frame development
issues, at the cost of dismissing the challenges facing the lowest-income countries.
the result is a more market-oriented view of global health governance.
The Canadian International Development Agency's Statement
In 2005, the canadian government issued its far-reaching International Policy
Statement (IPS), which included a substantial section on development (cIDa
2005b). Although this document was never officially adopted, it remains a reasonable
indication of Canada's official position on ODA in the context of health. The IPS
emphasises meeting the challenge of HIv/aIDS, as do subsequent documents
(cIDa 2007a, 2007b). canada has taken this challenge seriously, as demonstrated
by it being the 'lead donor in providing $100 million to the wHo 3 by 5 Initiative'
(cIDa 2005b). cIDa's (2001) earlier Social Development Priorities Strategy also
indicates a dedication to the HIv/aIDS crisis as it sets out an action plan completely
separate from the action Plan for Health and nutrition of the same strategy.
In terms of addressing health challenges beyond the matter of infectious disease,
neither the IPS nor the
Sustainable Development Strategy
discuss the problem of
brain drain of health practitioners or the lack of research capacity for the South.
CIDA (2005a) was noted for dedicating CA$5 million over five years to a WHO
programme to address the shortage of workers. although this effort was claimed to
be generous, it is tiny compared to the existing need and the contributions of other
agencies. additionally, cIDa does not allow its project funds to be used for hospital
infrastructure and operating costs or for the salaries of health practitioners.
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the earlier cIDa (2001, 35-37, 45) strategy considered the status of primary
health care in the developing world and referred to both the shortage of health
practitioners and inadequate research capacity. For cIDa, it appears that efforts
to resolve these matters fall under the umbrella of strengthening health systems,
which is ultimately left to the developing country government. In the 2001 strategy,
cIDa places a strong emphasis on supporting governments to build their core health
services and in ensuring their assistance programmes fit into a domestic sector-wide
approach that suits the needs of the country (43, 54-56). this approach is taken
because the sustainability and progress of primary health care require government
leadership and commitment; donors in this case simply play a part.
