Global Health and the New Bottom Billion: What Do Shifts in Global Poverty and the Global Disease Burden Mean for Gavi and the Global Fund?

37 Pages Posted: 15 Dec 2011

See all articles by Amanda L. Glassman

Amanda L. Glassman

Center for Global Development

Denizhan Duran

Center for Global Development

Andy Sumner

King's College, University of London - King’s International Development Institute

Date Written: October 27, 2011

Abstract

After a decade of rapid growth in average incomes, many countries have reached middle-income status. At the same time, however, poverty has not fallen so dramatically; as a result, most of the world’s poor now live in middle-income countries (MICs). In fact, up to a billion poor people — or a new bottom billion — live not in the world’s poorest countries but in MICs. As the global distribution of poverty has shifted to middle-income countries, so has the global disease burden.

This paper examines the implications of this for global health efforts and recommends a tailored middle-income strategy for global health funders. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date; revisits the rationale for health aid through agencies like GAVI and the Global Fund; and proposes a new MIC strategy and components, concluding with recommendations.

Specifically, the paper recommends (1) eliminating the country income threshold as an across-the-board criterion for allocating global health funding, (2) setting up regional pooled procurement mechanisms, or negotiating a MIC public-sector price within existing procurement mechanisms, (3) building evidence-based priority-setting institutions, and (4) establishing increased accountability mechanisms to increase public spending on cost-effective, affordable health priorities.

Keywords: global fund, global poverty, new bottom billion, global health

JEL Classification: I10, A10

Suggested Citation

Glassman, Amanda and Duran, Denizhan and Sumner, Andy, Global Health and the New Bottom Billion: What Do Shifts in Global Poverty and the Global Disease Burden Mean for Gavi and the Global Fund? (October 27, 2011). Center for Global Development Working Paper No. 270, Available at SSRN: https://ssrn.com/abstract=1972332 or http://dx.doi.org/10.2139/ssrn.1972332

Amanda Glassman (Contact Author)

Center for Global Development ( email )

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5th floor
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United States

HOME PAGE: http://www.cgdev.org

Denizhan Duran

Center for Global Development ( email )

2055 L St. NW
5th floor
Washington, DC 20036
United States

Andy Sumner

King's College, University of London - King’s International Development Institute ( email )

Strand
London, England WC2R 2LS
United Kingdom

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