May 14, 2019

New research shows effects of international health aid beyond fighting disease, challenges “dead aid” critique

CONTACT: Johan Marulanda /


WASHINGTON D.C. (May 14, 2019) | International aid from the Global Fund to Fight AIDS, Tuberculosis, and Malaria is linked to better governance in low- and middle-income countries, including improved control of corruption, rule of law, and overall development. A study published by Georgetown University researchers challenges critiques of international aid as “dead” and claim short term benefits are outweighed by harm to governance.

The study “Governance and Health Aid from the Global Fund: Effects Beyond Fighting Disease” shows countries receiving more aid from the Global Fund displayed better governance, even after controlling for other factors. The research, published in the Annals of Global Health, was based on data from 112 countries over 15 years and was co-authored by Dr. Matthew M. Kavanagh and Lixue Chen of the O’Neill Institute for National and Global Health Law at Georgetown Law.

This new research comes as the Global Fund prepares for a global donor conference this fall to replenish its financing, which will be hosted by the President of France, Emanuel Macron.

The article shows that “increased Global Fund financing is associated with better control of corruption, regulatory quality, voice and accountability, and rule of law,” key World Bank indicators of good governance. Financing was also linked to improved adult mortality and overall development.

The authors highlight key aspects of the Global Fund’s structure that ensure financing flows through participatory processes that engage multiple stakeholders at global and national level and have high levels of transparency and accountability, including independent audits. While further research is needed, the authors suggest their findings are likely linked to these “innovative structures, unique to the architecture of aid, explicitly designed to improve governance and negate the distortions of aid financing.”

The article was published along with a commentary from Ambassador Eric Goosby, MD, U.N. Special Envoy on Tuberculosis and former head of U.S. global AIDS programs.

The O’Neill Institute for National and Global Health Law at Georgetown University is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.