global philanthropy and health disparities research: the opportunities and challenges of approaches...
TRANSCRIPT
Global Philanthropy and Health Disparities Research: The
Opportunities and Challenges of Approaches and Results
Anne C Petersen, PhDResearch Professor, CHGD, UM
Founder & President, Global Philanthropy Alliance
Presentation for UM MHIRTMarch 22, 2011
Outline of Presentation
Brief review of global philanthropy
Brief review of health disparities, especially global
Using philanthropy to address global health disparities
Conclusions
Global Philanthropy Foundation growth in global giving
outstripped domestic giving over last two decades; now 24% of $ given
Background:• Foundation assets increased four-fold since
1990• Foundation giving increased more than
five-fold over same period• Number of foundations more than doubled
over same period; new foundations more likely to give internationally
Global Philanthropy (cont)
Half of international giving consistent with Millennium Development Goals
Health received the largest share of foundation funding with intended beneficiaries outside the US (43% in 2006, 39% in 2008)
Gates gave almost all the global health funding
Recession Effects
Foundation Center estimates that • US Foundations lost 17% of assets in
2008• Giving down 8% in 2009• International giving down only 4% in
2009• Without Gates in data, both domestic
and international giving down 9% in 2009
Broader Global Philanthropy
Foundation giving only a small part of global giving (but are good data for US, not for rest)
Other donors include:• Individuals• NGOs• Religious organizations – by far the
largest generally; globally too?• Corporations
Individual Giving Internationally Data from PSID 2007 (2006 giving) 6.3% giving rate $100/272 median/average giving per
donor household Factors influencing giving:
• Age (rate linear, highest gifts 10-64 yr)• Income/Wealth (linear for rate, amount)• Education (rate linear, $ lowest some coll)• Region (NE highest rate, Mtn highest $)• Marital Status (married highest rate, $)
Impact of Global Philanthropy
Foreign aid not so effective Is philanthropy better? Few good studies yet despite greater
impact orientation of global donors Critique (Garrett)
• donors too narrow • no one looking at the whole system• doing as much damage as good?
Health Disparities
Dramatic differences among countries in health indicators
Maps that follow show death and disability-adjusted life year (DALY) rates by WHO regions
HIV/AIDS is the leading cause of adult mortality in Africa
Two leading causes of DALY rates: lower respiratory infections and diarrheal diseases
Health-related MDGs Fewer children dying – deaths of
children <5 down 30% since 1990 Fewer children < 5 years
underweight - % underweight-25% More skilled help during childbirth
but <50% births in Africa & SE Asia New HIV infections -16% from 01-08 TB Rx more effective More safe drinking water but not safe
toilets
Laurie Garrett Critique
The Challenge of Global Health (Foreign Affairs, 2007)
More money for global health but significant problems• Narrowly focused on single problems• Must refocus on public health• Brain drain of health workers getting
worse
Need Systemic Approach
Recent report from FSG (Kania & Kramer, 2010) on Collective Impact found that 90% of non-profit efforts are suboptimal
Efforts that are effective engage all stakeholders over multiple years
Is this possible in global arena? Or even focusing on country health?
Current scattershot efforts unlikely to have sustainable effectiveness
L Garrett (cont) Situation since 2007? Talk on 2/7/11 Currently at plateau Most of global funding from the US –
“two Washingtons” Huge funding risk now with budget
cuts in the US (as in Western Europe) No likely support for global health in
Congress
Will US Philanthropy Fill the Gap Left by US Funds
Recent report (KFF 2010) shows global health funding flat in 2009
Funders Concerned about AIDS reported that funding for that disease was down in 2009 compared with 2008
US foundations not known for collaboration
But Gates together with partners could make a difference
Future of Global Health
Could current efforts be sustained – possible IF Gates + UN + key countries partner
Will current efforts be sustained – unlikely• Regions of significant instability• Most “developed” countries focused on
cutting budgets not increasing or even sustaining commitments
BUT
Being an eternal optimist I believe that leadership could
emerge to lead the world through our current crises
Stranger things have happened