Donor funding priorities for communicable disease control in the developing world.

Prior research has considered donor funding for developing world health by recipient and donor country but not by disease. Examining funding by disease is critical since diseases may be in competition with one another for priority and donors may be making allocation decisions in ways that do not correspond to developing world need. In this study I calculate donor funding for 20 historically high-burden communicable diseases for the years 1996 to 2003 and examine factors that may explain variance in priority levels among diseases. I consider funding for developing world health from 42 major donors, classifying grants according to the communicable disease targeted. Data show that funding does not correspond closely with burden. Acute respiratory infections comprise more than a quarter of the burden among these diseases but receive less than 3% of direct aid. Malaria also stands out as a high-burden neglected disease. The evidence indicates that neither developing world need nor industrialized world interests explain all funding patterns, and that donors may be imitating one another in ways that do not take into account problems in the developing world. There is an urgent need for a major increase in funding for communicable disease control in the developing world, and for more balanced allocation of the resources already provided.