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Jimmy Carter describes his dream for the last guinea worm to die before he does.


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Who Should Be Responsible for Funding Global Health Initiatives? #DoNowUHealth


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Since 1986, Jimmy Carter has worked to eradicate the guinea worm. From an initial 3.5 million cases to only 126 in 2014, the Carter Center has nearly succeeded in making guinea worm the second disease in human history, after smallpox, to be eradicated. However, Carter has been the only one pushing for the eradication of this disease. Organizations such as UNICEF and the World Health Organization (WHO) have aided in approving measures, but have not monetarily contributed to the program. For decades, philanthropic health intervention has supported governments in areas struggling to cope with diseased populations. Global health initiatives have largely become reliant on a handful of well-wishers like Jimmy Carter because of how difficult it is for governments and international organizations alike to raise funds for humanitarian ventures. The weighing of economic burdens against health burdens has raised an important question: who should be fiscally responsible for maintaining the health of humanity?

With campaigns such as the Carter Center’s guinea worm eradication plan and the Bill & Melinda Gates Foundation’s tuberculosis incidence reduction program, efforts made by philanthropic organizations are playing a major role in solving the world’s health issues. By focusing on and devoting large sums of money to specific projects, these organizations have been effective in many respects. However, those who are responsible for deciding which health programs should receive funding and which ones have to wait are faced with overwhelming ethical questions, and are often themselves unaffected by the health issues at hand. Moreover, philanthropic organizations operate out of their own good will. Because of this, it might not be feasible to rely on them to continue paying for the world’s health without an effective and reliable system in place.

A Cambodian boy receives the measles vaccine.CDC
A Cambodian boy receives the measles vaccine.

International humanitarian organizations, most notably WHO, work side-by-side with philanthropic organizations. WHO supports countries to improve health technologies, strengthen health information systems and assure that all people have access to health services at an affordable price. The World Bank, a similar United Nations institution, provides policy advice to help countries expand access to affordable health care, protect people from poverty caused by illness and promote investments that support humanitarian advancement. Although these entities provide coordinating authority in health and set global agendas for achieving universal wellness, they are severely underfunded and often rely on private philanthropic organizations to initiate global health projects. This situation raises the question of whether or not international humanitarian organizations like WHO should receive more funding from Western nations. Even so, there are many concerns surrounding a single international organization having the power to set and police the global health agenda for the entire world. There are also ethical concerns regarding the potential for Western countries with greater monetary influence to manipulate an international organization into a surrogate for their own health ventures.

On a national level, governments are important in global health because they have direct influence over their populations and are directly impacted by the health of their people. Every nation desires a healthier population, but some countries cannot provide adequate health care to their citizens because of their limited resources and debilitated economies. Consequently, when local governments have to direct more money to health, they contribute less to other public necessities like sanitation, education, and infrastructure. This makes aid from developed countries the backbone of health-care sectors in developing countries. The United States, for example, has led successful efforts in combatting the AIDS virus on a global scale through a government-sponsored program known as PEPFAR. However, in the developed world, political controversy stems from the idea that local governments will eventually enjoy the benefits of a healthier population and should therefore handle their own health care regardless of limitations on resources. Additionally, party polarization over foreign aid as a component of the U.S. budget has the potential to cut western aid to the developing world, thus threatening the reliability of American dollars for health measures whenever political leadership changes.

As Carter’s guinea worm eradication project nears completion, other health-care issues around the world continue to pose major economic, biological, and ethical dilemmas for many developing nations. What do you think? Who should be responsible for funding global health initiatives?


More Resources

MAP: World Health Organization
External Resources for Health as a Percentage of Total Expenditure on Health (%), 2013

This map shows the reliance of developing countries on external resources to support their health systems.

WEBSITE: Centers for Disease Control and Prevention (CDC)
Global Health Funding

This site shows how $1.73 billion in United States Government financial investments is managed by the CDC to improve global health (2013).

WEBSITE: World Health Organization
Global Health Expenditure Database

This interactive website provides many different metrics for public and external funding for health initiatives in developing countries.

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This post was written by the following students at Duke University: Ajay Desai, Kerry Mallinson, Shivani Purohit, Murotiwamambo Mudziviri and Victoria Coaxum.

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Who Should Be Responsible for Funding Global Health Initiatives? 14 July,2017SENCER

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