Disease control and donor priorities: the political economy of development aid for health

Disease remains the primary threat to human life and prosperity in developing countries. Over the last two decades, development aid for health has increased substantially, yet the affects of disease remain severe in many countries. Unlike other types of development aid, health aid is often viewed as technical and apolitical. I argue that, development aid for health is subject to political influences and distributional incentives similar to other forms of foreign aid. Although allocations undoubtedly reflect some aspects of recipient need, I contend that the benefits received by donors' constituencies as a result of health aid will condition these allocations. I examine the distribution of aid across diseases using disease burden as an objective measure of need. Using variation across disease characteristics --- including geographic spread, cost of prevention and treatment, and both donor and recipient burden of disease --- I illuminate the effects of donors' interests upon disease specific health aid allocations. I then extend the analysis to the distribution of health aid across disease control activities. Donors' interests play a significant role in the distribution of aid across diseases, yet have little effect on the selection of disease control activities