ABSTRACT

Advocates for the Millennium Development Goals, generally, and the health-related MDGs in particular, have in recent years called on the major donor countries to live up to their prior commitments and increase their levels of foreign aid. The goals, which all 192 United Nations member states and at least 23 international organizations agreed to achieve by the year 2015, were certainly laudable and include reducing by half the numbers of people living in extreme poverty, reducing child mortality rates and fighting disease epidemics such as AIDS. Calling for such increased donor aid is absolutely essential, and such advocates deserve credit for doing so. However, by primarily looking to such external solutions, donors and global health advocates alike have tended to neglect the actual reasons for under-development and insufficient health financing in developing countries. The presumption is that the countries simply need more money. They frequently neglect to address the other side of the health-financing coin: domestic financing. And where the domestic financing is insufficient, many global health advocates tend to neither ask why it is insufficient, nor do anything about it.