Global and Donor Financing. (MDS-3: Managing Access to Medicines and Health Technologies, Chapter 14)
(2012; 21 pages)


The international community’s commitment to global health and access to pharmaceuticals has been increasing; in addition to traditional sources of funding from bilateral and multilateral institutions, such as development banks and United Nations (UN) agencies, private foundations and public-private partnerships are playing much larger roles as resources to improve health in developing countries. The types of assistance available include -

  • Financial assistance (loans or grants)
  • Commodities
  • Technical expertise
  • Training, study tours, and fellowships
  • Research funding

Some donor funding is being directed toward the entire health sector as part of a sector-wide approach (SWAp) to aid or toward the national government budget instead of to specific programs or interventions, which means that health program managers must take additional steps to get access to funding for specific health programs.

Ministries of health need to collaborate with other government ministries, which are likely to carry out negotiations with donor agencies. Ministries of health must be able to justify the demand for additional funding for pharmaceutical management activities.

Challenges associated with donor assistance include a country’s inability to use donor funds effectively because of limited infrastructure, the unpredictability of donor assistance from year to year, and the complex monitoring and evaluating requirements that vary by donor. In recognition of some of these challenges, donors and recipient countries have been working together to improve collaboration and harmonize funding requirements. Performance-based funding is another trend being used to improve the effectiveness of development aid.

With heavy demand for assistance funds, proposals must satisfy donors’ concerns about consistency with government policies, government commitment, health care reform, project impact, and sustainability. Many donors follow a two-stage proposal process, requiring the submission and approval of a project profile or letter of intent, followed by a more detailed project proposal.

Project documents often include -

  • Project goals (development objectives)
  • Project purpose (immediate objectives)
  • Outputs
  • Activities
  • Inputs and resources

Private foundations tend to follow more flexible procedures for reviewing grant proposals and overseeing grant-funded projects, but most donors require periodic progress reports and evaluation.

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