Exploring the role of corruption and democratic accountability on HIV/AIDS aid effectiveness

Over the past two decades, the role of good governance in aid effectiveness has been a topic of debate. Both donor and recipient countries have questioned why investments of official development assistance (ODA) over many years have not resulted in stronger economic and health outcomes. This blog post focuses on health aid (in particular HIV/AIDS aid) and the impact control of corruption and democratic accountability may have on improving health outcomes.

More than 95% of HIV infections are in developing countries. As a result, global communities have invested billions of dollars in the fight against HIV/AIDS using funding from ODA and other substantial donors. Although AIDs-related deaths have decreased by 35% and HIV infections have decreased by 40% since 2000, the decrease has not been significant and millions of new HIV cases are still diagnosed each year. The World Bank’s 1998, “Assessing Aid,” report is part of a body of literature that proposes that good economic policies in recipient countries are associated with (and may be necessary for) successful outcomes like preventing disease  and building stronger  economies. Furthermore, control of corruption in government leadership can be a major factor for growth and poverty reduction, due to good fiscal and trade policies that seek to invest in growth-promoting activities.

According to findings stated in the Hwa-Young Lee et al. article titled, “Control of corruption, democratic accountability,  and effectiveness of HIV/AIDS official development assistance,” control of corruption contributes to aid effectiveness in healthcare delivery. HIV/AIDS is a strong example of this since large amounts of funding are needed to control the illness due to the stigma associated with it, the price of drugs, and the breadth of the epidemic. Corruption at any level can weaken health outcomes by raising the price of services or weakening the quality of treatment . This can, in turn ,  discourage further investment from donors. Consequently, HIV/AIDS policies have to involve broad, democratic consensus about how to invest resources in a way that ensures improved health outcomes.

Hwa-Young Lee et al. used data from 2001-2010 to measure the role control of corruption and democratic accountability on improving HIV/AIDS outcomes. General Methods of Moments estimation showed that control of corruption and democratic accountability had independent effects on the amount of HIV/AIDS aid and the incidence of HIV/AIDS. Furthermore, democratic accountability had a negative interaction with the amount of HIV/AIDS aid on new cases of the disease. The results indicate that more funding may not lead to better outcomes in countries that do not have strong democratic accountability. The authors also propose that HIV/AIDS aid is effective because it focuses on preventing new   cases.  Although prevalence of HIV/AIDS was explored,  an increase in prevalence can be attributed to better treatments and prolonged life. As a result, looking at the relationship between HIV/AIDS prevalence and corruption or democratic accountability may not paint an accurate picture of aid effectiveness.

The debate over the effectiveness of aid in developing countries will likely not be going away soon. Now more than ever, it is important for recipient countries to share their success stories and for donors to work with them to deliver effective economic and health outcomes. At the same time, donors should evaluate their roles in helping alleviate or exacerbate corruption and democratic accountability in developing countries.

According to the International Institute for Democracy and Electoral Assistance’s (IDEA’s) Democracy and Development programme, democratic accountability refers to: ways in which citizens, political parties, parliaments and other democratic actors can provide feedback to, reward or sanction officials in charge of setting and enacting public policy. Well functioning accountability mechanisms are believed to provide incentives for governments to work in the best interests of citizens…Read more in their discussion paper titled, “Democratic Accountability in Service Delivery: A Synthesis of Case Studies.”



Professional Certificate Program: Health & Humanitarian Supply Chain Management (May 15-20)

Georgia Tech’s Center for Health and Humanitarian Services (CHHS) is offering an upcoming Professional Certificate Program in Health & Humanitarian Supply Chain Management, to be held May 15-20th, 2017 at GA Tech’s Global Learning Center. 

2017 courses include:

  • Pre-planning Strategy for Health and Humanitarian Organizations MAY 15-16
  • Tactical Decision Making in Public Health and Humanitarian Response MAY 17-18
  • Systems Operations in Health and Humanitarian Response MAY 19-20

Program overview:

The certificate program is designed for practitioners in private industry, non-governmental organizations (NGOs), government, military, and others who are active participants or interested in health and humanitarian operations, including both disaster response and long-term development. The goal of the program is to enhance the knowledge and experience of participants on logistics and supply-chain topics related to a broad range of activities including preparation, response, and recovery from natural and man-made disasters as well as ongoing humanitarian crises due to war, famine, infectious diseases, and chronic health problems. Click here for a summary of the May 2016 certificate program with reviews from past participants or watch the course webinar for further details about the topics covered.

Courses include many interactive components, such as case studies, simulations and games, which help professionals to link the challenges and decision-making tradeoffs they face in everyday practice with the systematic approaches, tools, and techniques presented in the course. Upon completion of the requirements for the three courses, participants will receive an official certificate from Georgia Tech in Health & Humanitarian Supply Chain Management.

Attendees who complete the course series will be able to:

  • Provide immediate impact to their organization through knowledge gained from applied and real-world case studies Interact with others from NGOs, businesses, and/or government entities, enhancing collaboration, cooperation, and communication
  • Build a critical knowledge base to apply analytical models to aid in supply chain management decisions such as forecasting, inventory management, and distribution
  • Develop strategies for the management and allocation of scarce resources accounting for specific product characteristics and supply chain network structure
  • Deliver best-practices for improving system outcomes of humanitarian relief efforts through coordination and collaboration among strategic partners
  • Ultimately transform the humanitarian sector with increased capacity to participate in planning and strategic decision-making for effective supply chain management

Scholarships and Sponsors:

The HHS Center is fortunate to provide a limited number of scholarships for applicants from NGOs and developing countries only, which were made possible through the generosity of The UPS Foundation, Andrea L. Laliberte, and Richard E. and Charlene O. Zalesky. To apply for a scholarship for the 2017 program,  apply online here (CHHS is accepting scholarship applications beyond the 2/17 deadline, although priority will be assigned in the order they were received). If you would like to apply after the deadline, availability is not guaranteed, but you may email msmithgall@isye.gatech.edu to inquire.

To register:

Click Pre-Planning Strategy course and then add each of the other two courses in the certificate program (found on webpage at left side)to your virtual cart before payment. Please email msmithgall@isye.gatech.edu with any questions about registration. The full program is $6,000 ($2,000 per course) whereas each individual course fee is $2400 if taken separately outside of the 6-day certificate program. The program is offered once a year in May.  To sign up for all three courses and receive the discounted $6,000 rate for the full certificate program, please use this code at check-out: SCL-HHS.

Climate Justice Changes Health: Live Webinar on February 27th

The following message is from APHA’s environmental health team.

Climate Justice Changes Health

APHA has declared 2017 as the Year of Climate Change and Health. This very special kick-off webinar is being hosted by APHA, the Public Health Institute Center for Climate Change and Health, Island Press and Security & Sustainability Forum. During the webinar, you’ll hear from speakers who are engaged in the fight for climate justice and healthy communities, to explore how climate justice is the best strategy to address both climate change and health inequities here in the U.S. and around the world.

Date: February 27th, 2017, 1:00 PM – 2:30 PM EST

Linda Rudolph, MD, MPH
Director, Center for Climate Change and Health, Public Health Institute

Surili Patel, MS
Senior Program Manager, Environmental Health APHA

Jacqui Patterson, MSW, MPH
Director, Environmental and Climate Justice Program, NAACP

Patricia Cochran
Executive Director, Alaska Native Science Center

Renzo Guinto, MD
Healthy Energy Initiative, Health Care Without Harm, SE Asia

Lisa Hoyos
Director, Climate Parents

Amy Vanderwarker
Co-Director, California Environmental Justice Alliance

Please Register here!

Stay involved! Follow the conversation on social media using the hashtags #APHAwebinar and #ClimateChangesHealth. For more information on how climate change impacts health, please visit www.apha.org/climate.

Questions? Contact environment@apha.org.

Fellowship Opportunity: UCL Marmot Prince Mahidol Fellowships

The UCL Marmot Prince Mahidol Fellowships are available to researchers committed to reducing inequalities in health within their countries. Applicants are likely to have completed doctoral training by the time of entry into the program in one of a variety of fields including, but not limited to: behavioural and social sciences, biomedical sciences, health professions, and public policy.  The Fellowships are designed to help develop the next cadre of researchers working in the area of inequalities in health, whilst building strategic global links between UCL and other institutions worldwide.

Fellowships will last for up to one year, with fellows being required to use the residency at UCL within the Institute of Health Equity (IHE).  Up to three awards for fellowships are available for 2017/18.  The deadline for applications is May 31, 2017.  For more information about the selection criteria and process, please visit: https://www.ucl.ac.uk/iehc/iehc-news/ucl-marmot-prince-mahidol-fellowships.  Applicants are welcome to discuss their research questions and potential costs by correspondence prior to submitting their application. Please email correspondence to: contact@iheucl.org.

Video @CGD: Why Forests? Why Now?

Global warming and climate change are real and pressing issues for today’s world that cannot continue to grow without any action. Both natural events as well has human activity have led to an increase in average global temperatures. Shifts in climate, extreme weather events, and rising temperatures affect each and every one of us, but more importantly, disproportionately affect our most poor and vulnerable populations.

The impoverished not only face more difficulty obtaining medical care, food, and proper shelter, but also lack the resources to recover from natural disasters quickly. Homes and livelihoods are often lost or significantly damaged because of floods or droughts never seen in this magnitude before. Because of this, we cannot even begin to think about ending poverty without first addressing the issue of climate change.

One proposed solution is to reduce deforestation, and keep tropical forests standing to keep carbon sinks intact. These intact forests not only store large quantities of carbon, but also absorb about one-fifth of carbon dioxide emissions each year. These forests are so vital that they were recognized in the Paris agreement, calling for countries to conserve these forests along with other carbon reservoirs in order to mitigate the effects of climate change.

Not only do tropical forests help mitigate the impacts of global warming, but can also contribute towards the achievement of 4 of the Sustainable Development Goals (SDGs). The SDGs revolving around food, water, health, energy, and human safety are all impacted by the success of maintaining these critical forests.

Maintaining tropical forests make sense economically. Carbon pricing, which is putting a price on carbon pollution based on its wide-ranging effects, has been implemented among 40 countries already, with many seeing success. One of these countries is Brazil, who has already seen a reduction in its deforestation rate of 80% since 2004. Brazil has been utilizing satellite-based technologies to track illegal deforestation and alert environmental police to these areas quickly, with other countries hoping to follow similar models.

Other economic incentives include performance-based payments (PBMs) between high and low-income countries. One such partnership between Guyana and Norway, has seen success in 6 areas, including for example broad buy-in throughout Guyana and strengthening its institutions of forest governance. However, this has not been without difficulties as well, including increasing commercial pressures from logging markets, and long-term uncertainty about the success of these partnerships.

While these initiatives have shown initial success, more impactful solutions such as a reduction in energy subsidies worldwide could free up government spending. This spending in turn, could be targeted towards poor populations in a variety of ways, such as strengthening social protection systems.

So why now? As the impacts of global warming and climate change increase, so too do their effects on poverty. Unless we decide to act now, our ability to target extreme poverty will become even more difficult. In order to reach our SDG of ending all poverty by 2030, we must act now and we must act quickly. Protecting and restoring tropical forests, establishing more global partnerships between low and high income countries, and improving other incentives are critical for the future our Earth as well as its inhabitants.

Global News Round Up

Politics & Policies

Business prides itself on solutions that generate a significant return on investment. As a rule, U.S. global health programs follow this principle. For less than 1 percent of the federal budget, global health investments have yielded impressive results above and beyond their original price tag, and are poised for even greater returns in the future.

Harvard Global Health Institute and the London School of Hygiene & Tropical Medicine formed an Independent panel to analyze the global response to Ebola. Their work resulted in a report in the Lancet which identifies 10 important recommendations for reform.

While children in the U.S. are often required to be current on their vaccinations or receive a special waiver in order to attend public school, there is no requirement for adult vaccinations.

In this era of deep political divides and polarized opinions, we should let evidence – not politics – direct actions to benefit everyone in our country.

No More Epidemics is calling on all countries to publish their completed assessments of national capacities to prevent, detect and respond to epidemic threats, known as the Joint External Evaluation (JEE).

According to Robert Gebelhoff of the Washington Post, resistant malaria needs to be a high priority for the new administration and governments in the developing world.

Federal health officials may be about to get greatly enhanced powers to quarantine people, as part of an ongoing effort to stop outbreaks of dangerous contagious diseases.

The Indian government has cut ties with Bill and Melinda Gates Foundation and has decided to fund and manage the immunization programs on its own.

In response to Greenpeace’s study that estimated that nearly 1.2 million people die each year due to high concentrations of air pollutants, India’s Environment Minister said that “there is no conclusive data available in the country to establish direct correlation-ship of death exclusively with air pollution.”

Margaret Chan, outgoing director of the World Health Organization, is urging greater collaboration among global health organizations in the face of a challenging political environment in the United States.

Programs, Grants & Awards

Former U.S. Vice President Al Gore, the American Public Health Association (APHA), The Climate Reality Project, Harvard Global Health Institute, the University of Washington Center for Health and the Global Environment and Dr. Howard Frumkin, former director of the CDC’s National Center for Environmental Health, announced a Climate & Health Meeting that will take place on February 16, 2017 at The Carter Center in Atlanta, Georgia.

On Feb. 14, women’s-rights activists around the world are commemorating V-Day, hoping to raise awareness of violence against women worldwide. The campaign, One Billion Rising, refers to the U.N. projections that 1 in 3 women will be raped or beaten in her lifetime, or 1 billion in the world.

The Aid & Development Africa Summit 2017 is an exclusive platform uniting regional and global expertise and offering a unique opportunity for cross-sector engagement between UN and government agencies, NGOs, donors and the private sector.

In advance of the upcoming 7th Annual Global Health Conference taking place at FIU this March, FIU’s Global Health Consortium brought representatives from around the world to Washington, D.C. to evaluate the strategies for monitoring and decreasing the impact of antimicrobial resistance.

With funding from The Rockefeller Foundation, Columbia University’s Mailman School of Public Health, home to the nation’s first academic program in climate and health, today announces a Global Consortium on Climate and Health Education to share best scientific and educational practices and design model curricula on the health impacts of climate change for academic and non-academic audiences.


A new study projects that by 2035, cardiovascular disease, the most costly and prevalent killer, if left unchecked, will place a crushing economic and health burden on the nation’s financial and health care systems.  According to the study, in the next two decades, the number of Americans with cardiovascular disease will rise to 131.2 million (45 percent of the total US population) with costs expected to reach $1.1 trillion.

A new study found that nearly all of about 400,000 employees at large companies nationwide in the US face increased risk of heart disease and stroke from obesity, high blood pressure, poor diet and and other risk factors.  The findings, published Tuesday in the journal Health Affairs, illustrate the need for more workplace health initiatives grounded in science and evidence to inspire employee health and reduce employer costs, study authors said.

People who are overweight in their 20s and then become obese later in life may be three times more likely to develop esophageal or stomach cancer, according to new research.

CD8 T cells protect adult naive mice from JEV-induced morbidity via lytic function.

A study recently published in Virus Research took a look into the presence of Zika virus in human breast milk.

Diseases & Disasters

Early cancer diagnosis saves lives and cuts treatment costs, the United Nations health agency today said, particularly in developing countries where the majority of cancer cases are diagnosed too late.

The Zika infection has prompted the World Health Organization to declare a global health emergency due to the link to thousands of suspected cases of babies born with small brains – or microcephaly – in Brazil.  But there are still many, crucial, unanswered questions.


Philanthropist and former Microsoft exec Melinda Gates said this week that the data we have on global health is improving – in part because of projects undertaken by the Gates Foundation and other philanthropic organizations — but there’s still a long way to go.

Environmental Health

On Feb 5th, Dubai residents ditched their cars to participate in the country’s 8th year car-free day initiative.

Human activity is changing the climate 170 times faster than natural forces.” In the last 45 years, temperatures have increased by the equivalent of 1.7C per century and the warmest years on record have occurred since 1998.

New research shows that air pollution has become such a danger that now the ill-effects of breathing in fine particulates outweighs the usual health benefits of 30 minutes of cycling each way.

Equity & Disparities

A model for fighting against hunger and malnutrition with a global reach which has been successful within and outside the region has spread worldwide, first from Brazil and then from Latin America, notes a distinction given to the current Director-General of FAO (United Nations Food and Agriculture Organisation), José Graziano da Silva.

Violence toward women does not, at first sight, appear to be a problem in Hong Kong, Japan or South Korea. Overall homicide rates are among the lowest in the world — below 1 per 100,000 people — and street crime is rare. Harassment is also uncommon: women generally feel safe when going out alone at night.  But despite the veneer of safety, the three jurisdictions actually have the highest rate of female homicide victims in the world.

Maternal, Neonatal & Children’s Health

Nine countries have committed to halve preventable deaths among pregnant women and newborns in the next five years.

A study in the International Journal of Epidemiology found problems in the methodology and analysis in the three widely cited studies on the impact of mass deworming in Africa.


Climate & Health Meeting: Live Webcast on February 16th

The following message is from APHA’s environmental health team.

The science on climate change and health is under attack. And we risk seeing the clock turned back decades.

That’s why APHA stepped up and joined forces with former Vice President Al Gore and others to host a meeting on Thursday Feb. 16 focused on climate change and health. We believe it is critical that climate change and other important public health issues receive the attention they deserve and that the drive toward solutions continues. Don’t miss your chance for a front row seat to the meeting via a live webcast!

The Climate & Health Meeting will bring together public health professionals, the climate community and others who are key to confronting and managing climate-related public health challenges.

View the live webcast

We hope to see you there! A recording will be available for any sessions you cannot view live.


Surili Patel
Senior Program Manager – Environmental Health

Surili Sutaria Patel

Questions? Please contact our environmental health team or tweet us @EH_4_All.