Global Health and the New Bottom Billion: What do Shifts in Global Poverty and Disease Burden Mean for Donor Agencies?
| DOI | http://doi.org/10.1111/j.1758-5899.2012.00176.x |
| Author | Andy Sumner,Denizhan Duran,Amanda Glassman |
| Date | 01 February 2013 |
| Published date | 01 February 2013 |
Global Health and the New Bottom
Billion: What do Shifts in Global
Poverty and Disease Burden Mean
for Donor Agencies?
Amanda Glassman
Center for Global Development
Denizhan Duran
Center for Global Development
Andy Sumner
Institute of Development Studies at the University of Sussex
Abstract
After a decade of rapid growth in average incomes, many countries have attained middle income country (MIC)
status. At the same time, poverty has not fallen as much as one might expect and as a result most of the world’s
poor now live in MICs. In fact, there are up to a billion poor people or a ‘new bottom billion’ living not in the world’s
poorest countries but in MICs. Not only has the global distribution of poverty shifted to MICs, so has the global
disease burden. This article examines the implications of this ‘new bottom billion’ – the fact that up to a billion of the
world’s poorest people now live in MICs – for global health efforts, and recommends a tailored middle income
strategy for the Global Fund and GAVI. The article describes trends in the global distribution of poverty, preventable
infectious diseases, and health aid response to date; revisits the rationale for health aid through agencies like GAVI
and the Global Fund; and proposes a new MICs strategy and components, concluding with recommendations.
Policy Implications
•Eliminating the country income threshold as an across-the-board criterion for allocating global health funding.
•Setting up regional pooled procurement or pricing mechanisms.
•Building evidence based, priority setting institutions in MICs.
•Establishing increased accountability mechanisms and providing technical support for MICs.
•Increasing the allocative efficiency of health aid while ensuring equity.
After a decade of rapid growth in average incomes,
many countries have attained middle income country
(MIC) status. At the same time, poverty has not fallen as
much as one might expect and as a result most of the
world’s poor now live in MICs. In fact, there are up to a
billion poor people or a ‘new bottom billion’ living not
in the world’s poorest countries but in MICs.
Not only has the global distribution of poverty shifted
to MICs, so has the global disease burden.
This article examines the implications of this ‘new bot-
tom billion’ – the fact that up to a billion of the world’s
poorest people now live in MICs – for global health
efforts and recommends a tailored middle income strat-
egy for the Global Fund and GAVI.
The article is structured as follows: Section 1 describes
trends in the global distribution of poverty, preventable
infectious diseases, and health aid response to date. Sec-
tion 2 revisits the rationale for health aid through agencies
Global Policy Volume 4 . Issue 1 . February 2013
Global Policy (2013) 4:1 doi: 10.1111/j.1758-5899.2012.00176.x ª2012 London School of Economics and Political Science and John Wiley & Sons Ltd.
Research Article
1
To continue reading
Request your trial