How do major health donors prepare for country exits?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors, Kaci Kennedy McDade, Osondu Ogbuoji, Marco Schäferhoff, and Gavin Yamey have authored a review “Health aid in transition: a review of the Global Fund to Fight AIDS, Tuberculosis, and Malaria." Many development donors use country income levels—typically gross national income per capita—to ensure that their support for health systems in the developing world goes to countries with the greatest need. As a result, donors often reduce support when countries graduate from low- to middle-income status. While this graduation reflects advancement in economic development and is cause for celebration, transitions away from donor assistance for health typically bring significant challenges for middle-income countries. The evidence also appears to indicate that countries that are expected to graduate from multilateral health assistance…
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The “4 Ds” that Threaten Middle-Income Countries

Policy Blog
This blog was first published in Global Health NOW June 26, 2019. The authors, Shashika Bandara, Kaci Kennedy McDade, Hanna Huffstetler, and Wenhui Mao are major contributors to the 4Ds project at the Center.   In the last 2 decades, more than 30 countries moved from low-income to middle-income status, a billion people were lifted out of poverty, and there were major reductions in maternal and child mortality globally. Despite this progress, middle-income countries, where over 70% of the world’s population now live, are facing unprecedented challenges. The progress they’ve made is threatened. In particular, 4 key phenomena—which we call the 4Ds of global health transition—are rapidly reshaping the nature of health in MICs: Disease: The global burden of disease is shifting away from infections toward non-communicable diseases and injuries. In many…
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