How health aid should evolve to tackle the “middle-income dilemma”​

In our previous work, we explained that the “middle-income dilemma” in global health is that “although most of the poor now live in pockets of poverty in middle-income countries (MICs) and face high mortality rates, these countries are regarded as too rich to qualify for aid.” A crucial question facing donors is what role they can still play in supporting MICs after these countries have transitioned away from receiving external assistance. One way that donor support could be used to tackle the health challenges facing poor populations in these countries after graduation is through channeling this support to “global functions” (activities with transnational benefits), such as product development for diseases of poverty or market shaping to bring down prices of medicines and vaccines. In this project, we are examining how aid for health should evolve in ways that could benefit poor populations in MICs, especially through support for global functions. This work includes a partnership with AidData to use spatial methods to gain an understanding of the sub-national flows of health aid in transitioning MICs.

Ipchita Bharali, Center for Policy Impact in Global Health
Hanna Huffstetler, Center for Policy Impact in Global Health
Kaci Kennedy McDade, Center for Policy Impact in Global Health
Osondu Ogbuoji, Center for Policy Impact in Global Health
Gavin Yamey, Center for Policy Impact in Global Health

Donor transitions from HIV programs: what is the impact on vulnerable populations?
Authors: Kelly Flanagan, Hannah Rees, Hanna Huffstetler, Kaci Kennedy McDade, Gavin Yamey, Diana Gonzalez, and Robert Hecht

Transitioning from foreign aid: is the next cohort of graduating countries ready?
Authors: Gavin Yamey, Diana Gonzalez, Ipchita Bharali, Kelly Flanagan, Robert Hecht

Health Affairs Blog: Donor Transitions From HIV Programs: What Is The Impact On Vulnerable Populations?

This focus area is part of a larger project, Designing innovative policy solutions to close global health financing gaps that was funded by the Bill & Melinda Gates Foundation.