Though vertical aids programs directly assist groups in dire need, such as individuals with Cholera as discussed in the case study, these programs don’t aid in global health as effectively as alternative programs. Instead of providing funding to provide better hospitals and better training of health care professionals in order to develop an overall more supportive health care system in these impoverished areas, organizations create programs to only address one issue or ailment. Vertical aid programs essentially make these needy areas continuously dependent on outside help, rather than establishing better systems to address as many needs of the community as possible.
The issue lies in supporters of vertical aid programs. Rather than sacrificing some of the praise they will receive for providing financial aid that directly aids in a global health issue, supporters would rather maintain their image and support vertical aid programs despite a great amount of evidence indicating that these programs are not as effective as other options. I would compare vertical aid programs to putting a Band-Aid on a deep wound, without properly stitching the injury. Instead of exploring the root problem of the situation, which often implies a vast socio-economic inequality, proponents of vertical aid programs would rather throw money and resources at an issue with a clear ‘solution’ so they can claim to eradicate some issue. In order for there to be real change in the world, financial supporters will need to swallow their pride and contribute aid in order to help improve global health, instead of contributing aid in order to make a name for oneself or claim to be an advocate for a disease.
Despite the fact that I think resources can be better allocated than in the use of vertical aid programs, vertical aid programs are a necessity of our world. Even though, ideally, people should contribute aid for the benefit of society, I fear this is not human nature and not the reality we live. The human race is a selfish one and because of this we strive to benefit ourselves before others, especially when the benefit is for a group that is vague and distant from our lives. If contributing financial aid doesn’t directly have a benefit that one can visualize, “the money might well dry up” (Levine). Like the infamous Nigerian prince email, I think the reasoning behind this is that people want to see their money put to use so they know its not being abused and wasted. Additionally, living in a first world country, its difficult to imagine living somewhere where basic health care isn’t accessible, and death is around the corner for most. As we live in our little bubble of a world, we need “advocates” to raise awareness of global health issues so that we can help—global health advocacy is “active[ly] support[ed by] organizations and individuals who are associated with particular health causes” (Levine). Without these vertical aid programs, our global health initiatives would not have nearly as much support, and might not even be in existence.
Works Cited
Elzinga, Gijs. “Vertical–Horizontal Synergy of the Health Workforce.” World Health Organization, Apr. 2005, www.who.int/bulletin/volumes/83/4/editorial10405/en/. Accessed 14 Apr. 2017.
Levine, Ruth. “Should All Vertical Programs Just Lie Down?” Center for Global Development, 5 Oct. 2007, www.cgdev.org/blog/should-all-vertical-programs-just-lie-down. Accessed 14 Apr. 2017.
Thomas, John, et al. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed., Broadview Press, 2014. “Case 8.2 Ethics and Humanitarian Aid: Vertical Aid Programs.” 267-268
Hi Tori,
I really enjoyed reading your blog post and agree with your stance regarding vertical aid programs. As you mentioned, a major problem with the vertical aid programs is their supporters who want to establish their names through funding for programs that will attack individual medical problems and diseases instead of focusing on global health. With this in mind, my question is what are the possible ways to go about raising awareness for this problem as well as getting more people to fund what is necessary to improve global health? Additionally, perhaps a minor solution to this problem would be a more integrated vertical/horizontal program which is discussed in the World Health Organization’s article “Vertical-Horizontal Synergy of the Health Workforce.”
http://www.who.int/bulletin/volumes/83/4/editorial10405/en/
In a response to another vertical aid post, I mentioned that using vertical aid is ideal for preventing dependence on outside help because it focuses only on systemic health shocks or other issues that cannot be managed by the afflicted country. While I still think that is the case, I will concede that unless a country develops its healthcare infrastructure, it will remain reliant on foreign aid. However, I believe that a country should develop its healthcare system through investment rather than aid, and must do so with the intention of operating their system autonomously. Vertical aid does not attempt to fix structural issues — nor should it attempt to, as those problems ought to be fixed domestically. Should the United States provide permanent infrastructure and medical professional or training for these countries? I do not see this as a role the United States should undertake, as efforts to modernizing and expand a healthcare systems should be focused on domestic programs. Turning inwards and prioritizing American healthcare isn’t a selfish act, just one that is in our best interest.
Hi Tori,
I like your analogy of putting a Band-Aid on a deep wound, without stitching it first. I find a strong parallel between vertical aid systems and our own healthcare system in the US. We prescribe to a reactive system that places the emphasis on addressing the issue after it’s happened and when our insurance coverage kicks in. Reactive healthcare involves reacting to an injury, disease, symptom or condition. If you wake up one morning with a fever and headache, you will probably react by popping a few Tylenol and maybe a call to the doctor. Based on what the doctor says, you may be put on antibiotics to help fight the infection. Both you and your doctor are working in response to the event that has already taken place. Proactive healthcare differs in that actions are taken before symptoms manifest. By boosting your immune system with vitamin C, consuming antioxidants, and maintaining a balanced diet, you may never get those symptoms. Another thing to note is that similarly to the money-eating vertical aid system, our own healthcare system is the most expensive in the world but doesn’t even crack top ten in terms of quality. Proactive medicine has proven to be more cost efficient while decreasing the amount of time spent sick and increasing life expectancy.
Sources:
http://www.hullfinancialplanning.com/preventive-medicine-costs-less-than-reactive-medicine/
Dear Tori:
I agree with your opinion that although resource might be better allocated without the usage of the vertical aid program. Considering the legal goal for vertical aid program would be to complete the concrete goal which was funded by the funders. However, if consider the problem from an ethical angle, the dilemma fight between the humanitarian mission statement of NGO which is to offer help and not to “waste” the resource which was designated for specific goal on other patient.