A WHO malaria project in Cambodia. (Gates Foundation / flickr)
Global health programs now teeter on the edge of disaster. The world economic crisis and the politics of debt reduction are threatening everything from malaria control and AIDS treatment to well-baby programs and health-care worker training efforts. And even if the existing global public health architecture survives this time of parsimony and austerity, it will have been remodeled along the way.
Prior to 2000, the links between global health programs in poor and middle-income countries and changing foreign policy priorities in wealthy nations were weak, largely because the programs themselves were just not that large. In 1999, for example, total health spending in developing countries -- for efforts ranging from clean water provision and government clinics to vaccination campaigns and HIV treatment -- was about $5.6 billion, with the United States government providing roughly a third of that and U.S. private donors another
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