It does seem necessary to get governments to spend more of their own money on health, indeed. Do you think it would make sense to fund charities to try to convince governments to invest more in health (perhaps by also helping them increase their tax revenues, via increasing tax collection efficiency)?
I think the solution in this case is make clear plans with government then slowly defund the activity. Poor governments that weren’t going to find something of their own accord anyway, usually won’t front up until the external funding actually reduces.
“working with government” has been the vogue thing for charities, and especially national government aid orgs (like USAID) for decades. There have been endless attempts in the vein you suggest both to support governments to spend more on health, and to allocate money better within the health budget—with no clear evidence that it works. Although shifting government spending from low impact to high impact areas seems attractive, i don’t see any reason that it would work well in future when so many have failed in the past.
GiveWell recently gave a big grant along the lines you are thinking, which i largely disagree with (although I’ve softened a little on it)
On the taxes front it’s a big debate. Personally i think there’s very little correlation between increased tax take persay and increased spending on health. if you look at African countries that are spending more and doing better in health like Liberia and Rwanda, they are spending higher percentages of their GDP on health and smarter, not taking more tax than other similar countries.
Then there are cases like Botswana where they spent their diamond money well on healthcare, but that’s not from taxes.
Obviously when a country develops, then health care gets better but that’s another story. The ” growth people” will tell us to focus on growth and not sweat things like tax take and health allocation, but the jury is out as to how much charities / external actors can influence that either.
It does seem necessary to get governments to spend more of their own money on health, indeed. Do you think it would make sense to fund charities to try to convince governments to invest more in health (perhaps by also helping them increase their tax revenues, via increasing tax collection efficiency)?
I think the solution in this case is make clear plans with government then slowly defund the activity. Poor governments that weren’t going to find something of their own accord anyway, usually won’t front up until the external funding actually reduces.
“working with government” has been the vogue thing for charities, and especially national government aid orgs (like USAID) for decades. There have been endless attempts in the vein you suggest both to support governments to spend more on health, and to allocate money better within the health budget—with no clear evidence that it works. Although shifting government spending from low impact to high impact areas seems attractive, i don’t see any reason that it would work well in future when so many have failed in the past.
GiveWell recently gave a big grant along the lines you are thinking, which i largely disagree with (although I’ve softened a little on it)
https://forum.effectivealtruism.org/posts/t8QRuMfetCbeAkyFu/technical-support-units-a-dubious-givewell-grant
On the taxes front it’s a big debate. Personally i think there’s very little correlation between increased tax take persay and increased spending on health. if you look at African countries that are spending more and doing better in health like Liberia and Rwanda, they are spending higher percentages of their GDP on health and smarter, not taking more tax than other similar countries.
Then there are cases like Botswana where they spent their diamond money well on healthcare, but that’s not from taxes.
Obviously when a country develops, then health care gets better but that’s another story. The ” growth people” will tell us to focus on growth and not sweat things like tax take and health allocation, but the jury is out as to how much charities / external actors can influence that either.