The New Realities of Global Health: Dynamics and Obstacles

Abstract

Published by Palgrave Macmillan The past 15 years have seen the arrival of new actors in the field of global health and an increase in development aid in the healthcare sector. These actors have claimed a significant share of the additional public and private resources available becoming the driving force in this new paradigm, often at the expense of traditional institutions, which have gradually lost their policy hegemony. Making choices and formulating policies on the matter of healthcare have ceased to be the sole prerogative of the institutions that had hitherto held the mandate and the responsibility for doing so. Entire areas of the healthcare sector are now dominated by private funders, which have become the de facto decision-makers on public health policy. This new situation raises fundamental questions about governance and accountability. Who decides policy? How are decisions made? All too often, countries in receipt of aid continue to suffer from inadequate coordination between donors and from the lack of a common agenda. With this in mind, it is worth exploring a number of ways of ensuring that global healthcare policies best reflect the beneficiary countries’ actual needs and aspirations.