Ebera Okereke of Chatham House argues that the America First Global Health Strategy provides potential opportunities for African countries, despite being designed as strategic asset for the benefit of the USA. She suggests that recipient countries respond strategically, to 1) reclaim the narrative regarding the dependency that was largely created by donor countries, 2) to negotiate collectively to increase the leverage and strength of the dependent countries, 3) to accelerate domestic investment in health-related activities via earmarked taxes, excise levies,…
Category: Reimagining Aid
A large proportion of aid money ends up benefiting people and institutions of the Global North rather than the Global South. The aid funds serve the agendas of the rich donors and much of the money does not even reach its intended beneficiaries. Typically, more aid funds end up in the coffers of INGOs than to institutions in the countries to which the aid is supposedly ‘allocated.’ Moreover, as donors have moved toward funding indigenous in-country organizations, the INGOs have frequently set up local their NGO subsidiaries to be better positioned to continue receiving these funds. Instead of providing direct funds to capable ministries of health – who do the bulk of the work, funds often go to INGOs to implement donor-driven health programs that often fail to align with or meet the health needs of global communities.
Time to Reimagine PEPFAR
In late July, The New York Times published an article regarding the State Department planning process for PEPFAR, indicating that they plan to discontinue the program in 2-8 years, depending on the country. PEPFAR resources would be transformed into a platform for rapid disease detection and outbreak response, establishing new markets for American pharmaceuticals and technologies, and encouraging privatization of HIV services. The plans also call for an abrupt termination of funding for most efforts to prevent new infections, especially…
Confusion and Missteps Characterize the Fall of USAID
On June 22, 2025, The New York Times released a chronological story detailing the decline of USAID. The article, derived from investigations, interviews with former agency personnels, social media, and news sources, traces the period from President Trump’s inauguration until February 3rd, the final day of the agency’s operation. Executive Order 14169 instructing USAID officials to immediately suspend new obligations and disbursements of development aid funding for a 90-day review provided ambiguous guidance, even to his own appointees. Jason Gray,…
Shifting power to transform the development paradigm
Obinna Onyekwena reminds us, in his recent opinion piece in Development today, that aid to the Global South has functioned as a mechanism of control, influence, and outsourced profit, entrenching asymmetries of power under the guise of assistance. He also notes, that following the recent aid cuts “it is not the recipients who express the greatest anxiety, but the dominant institutions and donor actors.” Given that the conventional narrative continues to be framed through the lens of a “savior complex”…
Global Health Catastrophe from 2025 U.S. Foreign Budget Freeze
The Trump administration’s 90-day freeze in January-March 2025 on U.S. foreign aid has blocked billions of dollars in funding for global health initiatives, including contraceptives, climate justice, HIV, and TB. The U.S. allocated $63.1 billion for foreign assistance in Fiscal Year 2024, with $10.5 billion for humanitarian aid and $4.1 billion for global health efforts. The freeze disrupted the continuity of essential health services, placing vulnerable populations at risk. Impacts on African Countries The freeze on U.S. foreign aid has…
Re-imagining foreign aid
Farah Stockman in her NY Times editorial decries the chaos and devastation from cuts in US foreign aid, but also calls for re-imagining a foreign aid that addresses serious flaws inherent in the current forms of aid. We know that local groups (especially under-funded government health systems) are far more cost-effective and attuned to what communities need – and stay long after foreign workers depart. Cutting out the middlemen is essential, and more cost-effective – as leaders in the global…
Wealthy Countries Profiting from Climate Funding
A recent Reuters investigation reveals that countries like Japan, France, Germany, and the United States are reaping billions in economic rewards from a global program meant to help low- and middle-income countries combat climate change. The grants and loans often come with high interest rates or binding conditions, requiring recipients to hire companies from the donor countries. Read this article on how wealthy nations turned a supposed act of climate justice into a profitable venture for themselves. Image Source:…
USAID’s $9.5B supply chain vision unraveled at the expense of lives worldwide and billions of dollars wasted
In 2015, USAID unveiled the largest contract in its history, aimed at transforming health supply chains in lower-income countries. It has not gone according to plan. In 2017, it was clear the project was failing. During its worst quarter, only 7% of its shipments arrived at their destinations on time and in full. Project leaders scrambled as multiple countries ran short of essential health products and faced stockouts. A recent public narrative of recovery is called into doubt by a new investigation, which…
Tim Schwab & “The Bill Gates Problem” Town Hall Seattle Podcast
Tim Schwab, author of the recently published “The Bill Gates Problem: Reckoning with the myth of the good billionaire,” headlined a Seattle Town Hall event in December 2024 sponsored by the Community Alliance for Global Justice. In this podcast of the event, Tim explains how Bill Gates’ uses his foundation as a vehicle for unaccountable personal power and influence, using taxpayers dollars. He describes how dogmatic belief in the primacy of the private sector and their patent interests and the…
[VIDEO] “Universities… laundromats for very wealthy people”: Anand Giridhardas
Author of book Winners Take All: The Elite Charade of Changing the World Anand Giridharadas spoke to University of Washington Department of Global Health about his book. Below is an abridged version of the conversation. Answers have been edited for length and clarity. We encourage you to watch the entire recording of his conversation with DGH. Also check out the UW Department of Global Health Blog on the event with further discussion. https://globalhealth.washington.edu/news/2023/04/03/examining-accountability-influence-and-politics-global-health-frank-conversation PANELISTS Anand Giridharadas: Author of Winners Take All: The…