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Unformatted text preview: beware what you wish for Less than a decade ago,the biggest problem in global health seemed to be the lack of resources available to combat the multiple scourges ravaging the worlds poor and sick.Today, thanks to a recent extraordi- nary and unprecedented rise in public and private giving,more money is being directed toward pressing heath challenges than ever before. But because the eorts this money is paying for are largely uncoordi- nated and directed mostly at specific high-profile diseasesrather than at public health in generalthere is a grave danger that the current age of generosity could not only fall short of expectations but actually make things worse on the ground. This danger exists despite the fact that today, for the first time in history, the world is poised to spend enormous resources to conquer the diseases of the poor.Tackling the developing worlds diseases has become a key feature of many nationsforeign policies over the last five years, for a variety of reasons. Some see stopping the spread of hiv , tuberculosis ( tb ), malaria, avian inuenza, and other major killers as a moral duty. Some see it as a form of public diplomacy. And some see it as an investment in self-protection, given that microbes know no borders. Governments have been joined by a long list of private donors,topped by Bill and Melinda Gates and Warren Buett,whose contributions to todays war on disease are mind-boggling. [ 14 ] The Challenge of Global Health Laurie Garrett Laurie Garrett is Senior Fellow for Global Health at the Council on Foreign Relations and the author of Betrayal of Trust: The Collapse of Global Public Health. Thanks to their eorts,there are now billions of dollars being made available for health spendingand thousands of nongovernmental organizations ( ngo s) and humanitarian groups vying to spend it. But much more than money is required.It takes states,health-care systems, and at least passable local infrastructure to improve public health in the developing world. And because decades of neglect there have rendered local hospitals, clinics, laboratories, medical schools, and health talent dangerously deficient, much of the cash now ooding the field is leaking away without result. Moreover, in all too many cases, aid is tied to short-term numerical targets such as increasing the number of people receiving specific drugs, decreasing the number of pregnant women diagnosed with hiv (the virus that causes aids ), or increasing the quantity of bed nets handed out to children to block disease-carrying mosquitoes. Few donors seem to understand that it will take at least a full generation (if not two or three) to substantially improve public healthand that eorts should focus less on particular diseases than on broad measures that aect populations general well-being....
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- Spring '10