24 October 2012

Harmful effects of global health initiatives are exaggerated

An evaluation of the scientific evidence on the effects of global health initiatives on the health systems of developing countries concludes that the harmful effects have been exaggerated. The systematic review found that much of the research literature did not fulfil the requirements of rigorous scientific evidence. Published today by JRSM Short Reports, the review focused on negative health system effects because these have been a source of criticism for global health initiatives and if true, have important implications for policy-makers. Billions of pounds of taxpayers’ money are channelled as aid through these initiatives.

The systematic review identified 24 studies published in peer-reviewed scientific journals between 2002 and 2009 that have commented on adverse effects on health systems arising from investments by the Global Fund. The Global Fund is one of the largest international financing institutions distributing almost £15 billion of taxpayers’ money in developing countries. All the studies evaluated contained only seemingly anecdotal evidence or authors’ perceptions or interpretations of circumstances.

Senior author Professor Rifat Atun, Professor of International Health Management at Imperial College London, said: “Ever since the emergence of the major global health initiatives, there has been an assertion that they undermine the performance of already weak national health systems by bypassing them. Yet these assertions are based on opinion and not fact.”

Professor Atun, explaining the significance of the systematic review, said: “Uncritical repetition of anecdotal evidence carries the risk that unsubstantiated claims and perceptions are eventually accepted as a valid representation of the objective reality.” None of the studies were originally designed to capture or assess health system effects, positive or negative. The evidence extracted from the studies often repeated commonly expressed concerns over potential negative health system effects of disease-specific programmes.


Professor Atun added: “The current evidence on potentially negative health system effects of global health initiatives used in scientific literature seems to rely on personal views and anecdotal evidence. Institutions that invest taxpayers’ money must be accountable for demonstrating results or any negative effects through independent and objective evaluations of their work.”

Notes for editors:

Negative health system effects of Global Fund’s investments in AIDS, tuberculosis and malaria from 2002 to 2009: systematic review will be published online at 00.01 hrs on Wednesday 24th October  by JRSM Short Reports.  Please make sure you mention or link to the journal in your piece.

For further information or a copy of the paper please contact:

Rosalind Dewar, Media Office
Royal Society of Medicine
DL +44 (0) 1580 764713
M +44 (0) 7785 182732

JRSM Short Reports is an online-only, open access offshoot to JRSM, the flagship journal of the Royal Society of Medicine. Its Editor is Dr Kamran Abbasi.

Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.

In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.

Website: www.imperial.ac.uk

Further information

For further information contact:
Media Office
Tel: + 44 (0) 20 7290 2904
Mobile +44 (0) 7785 182 732
Email: media@rsm.ac.uk