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Special interests and powerful NGOs are said to be causing a decline in global public health.

A recently published article in the prestigious foreign policy journal Foreign Affairs has touched off a heated debate about the way special interests and powerful NGOs are causing a decline in global public health.

The article also brings to light the silence of women’s rights groups on the issue of basic maternal and child health care.

In her article, “The Challenge of Global Health,” Council on Foreign Relations (CFR) Senior Fellow for Global Health, Laurie Garrett charges big donors like Bill Gates and the Clinton Foundation with flooding developing countries with funding for HIV/AIDS projects that divert attention from basic health problems that face the poor, undermine national public health systems, contribute to a brain drain of qualified health care workers, and fail to achieve results.

She also blames lack of oversight and corruption, saying that in some places “an amazing 80 percent of donor funds get diverted from their intended purposes.”

Garrett says that the surge in spending on such programs as The Global Fund to Fight AIDS, Tuberculosis, and Malaria benefits from high visibility advocacy and means that “the whims of foundations” drive global health.

She says that the funding boom has created more than 60,000 AIDS-related NGOs in the rush for dollars, but that the top three killers in developing countries stem from lack of basic health care at childbirth and for pediatric respiratory and intestinal infections.

In contrast to the aggressive work of AIDS NGOs, she says, “few women’s rights groups put safe pregnancy near the top of their list of priorities, and there is no dysentery lobby or celebrity attention given to coughing babies.”

The result is that in some countries maternal and child health has actually grown worse over the last few years, and that Haiti “actually went backward on every other health indicator.”

While agreeing with Garrett’s basic outline of the problem, various global health experts took issue with her prescriptions.

Roger Bate, from the American Enterprise Institute, challenged Garrett’s characterization of the World Health Organization (WHO) as “the only organization with the political credibility to compel cooperative thinking.”

Bate cited the failure of WHO’s Health for All campaign to improve local health systems due to broad program failures, and called WHO’s “3X5” campaign to bring antiretrovirals to 3 million people by 2005 “ill conceived.”

Bate said, “Garrett wants donor interests coordinated by a body with proven competence and she favors WHO for the job. But it is unclear that the WHO is up to such a task, or can even follow through on its own organizational goals.”

Conservative UN experts also question the WHO’s credibility on maternal and child health issues since the UN organization has long promoted the view that maternal health is linked to abortion rights.

They note that this promotion of the radical women’s rights agenda instead of focusing on basic pre- and post-natal health care is the very problem that Garrett points out is leading to the global health crisis.

[3May07, NY, C-FAM; 3May07,; N Valko RN, 4May07]