Aid is usually assistance voluntarily given by a donor to a willing recipient. Because of the voluntary nature of aid, the donor is usually in a position to specify conditions to which use of the aid is subject. The donor can require that the aid be used to pay for something that the donor feels passionate about (such as the treatment of a particular disease) rather than something that the donor does not feel passionate about (such as the funding of military equipment).
However, there is often a lack of synchronisation between the donor’s intentions and the recipient’s needs. In a recent Harvard Business Review blog post, Ro Wyman and Bill Wyman discussed the problems of niche aid in Africa. Healthcare funding is often focused on “big diseases” such as HIV and TB. However, in northern Rwanda where the authors are working HIV and TB account for only 10% of the health problems.
Many more deaths from disease could be prevented if funding was available for more commonplace low-tech health interventions such as supplying inexpensive antibiotics to treat pneumonia and building community-level primary care delivery systems for the prevention and treatment of everyday illnesses. If a basic healthcare infrastructure could be created, it would save far more lives and it would also reduce the cost of treating the “big diseases”.