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ESSAYS ON RESEARCH -- WHO SETS THE GLOBAL HEALTH RESEARCH AGENDA?

Wednesday, 19th of June 2013

• ESSAYS ON RESEARCH -- WHO SETS THE GLOBAL HEALTH RESEARCH AGENDA?

What Is Driving the New Patterns of Global Health Funding and Governance?

Why Does This Matter for Global Health Research?

Citation: Sridhar D (2012) Who Sets the Global Health Research Agenda? The Challenge of Multi-Bi Financing. PLoS Med 9(9): e1001312. doi:10.1371/journal.pmed.1001312

Published: September 25, 2012

Copyright: © Devi Sridhar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: No specific funding was received for writing this article.

Competing interests: The author has declared that no competing interests exist.

Provenance: Invited; externally peer reviewed.

Summary Points below; full text is at http://www.ploscollections.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001312 

A major challenge in the governance of research funding is agenda-setting, given that the priorities of funding bodies largely dictate what health issues and diseases are studied.

The challenge of agenda-setting is a consequence of a larger phenomenon in global health—“multi-bi financing.”

Multi-bi financing refers to the practice of donors choosing to route non-core funding—earmarked for specific sectors, themes, countries, or regions—through multilateral agencies such as the World Health Organization (WHO) and the World Bank and to the emergence of new multistakeholder initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance.

These new multistakeholder initiatives have five distinct characteristics: a wider set of stakeholders that include non-state institutions, narrower problem-based mandates, financing based on voluntary contributions, no country presence, and legitimacy based on effectiveness, not process.

The shift to multi-bi financing likely reflects a desire by participating governments, and others, to control international agencies more tightly.

In anticipation of the 2012 World Health Report, this paper was commissioned to help contextualize and critically reflect on the theme of “no health without research.”