ABSTRACT
This chapter describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date, revisits the rationale for health aid through institutions. Global health institutions will need to adjust their outlook to remain effective, looking at their approaches to eligibility, partnerships and staffing to run the more complex middle-income country (MIC) programs. Particularly for institutions like Global Alliance for Vaccines and Immunizations (GAVI) and the Global Fund, the control and elimination of preventable infectious diseases would be a public good with benefits that are strongly universal in terms of countries, peoples and generations. The chapter examines the implications of this new bottom billion the fact that up to a billion of the world's poorest people now live in MICs for global health efforts and recommends a tailored middle-income strategy for the Global Fund and GAVI.
