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• W2221729012 abstract "In my World Report,1Usher AD Key donors to reinstate health funding to Zambia.Lancet. 2015; 386: 519-520Summary Full Text Full Text PDF PubMed Scopus (6) Google Scholar I pointed out that a range of indicators that had been improving—child mortality, access to drugs, antenatal care, and maternal and newborn health—suddenly declined as a result of what the Zambian Ministry of Health called a “dramatic and acute resource reduction”. As far as I have been able to find out, no one knows exactly what the human costs of this abrupt withdrawal of donor funding from the Zambian health sector were. The Zambian Government's own annual reviews suggest that the costs were heavy, with disbursements to health-care providers dropping by 40% in 2009–10. The director of the Zambian Anti-Corruption Commission, who investigated the fraud, says there were negative effects on health delivery. The Swedish aid agency Sida, the lead donor in the Zambian health sector before the corruption scandal, also acknowledges the negative effects. Sida never investigated how Sweden's reaction to the corruption in Zambia affected the life and health of people for whom the assistance had been intended. Given donors' preoccupation with measuring results, one could well ask why not. Collins Chansa and Joel Negin remarked that government expenditure on health increased during a period stretching from 2 years before the corruption scandal to 4 years afterwards. Although an increase in domestic spending on health is undoubtedly a good thing, the point of my article was to underline that donors' zero-tolerance-on-corruption policies can have tragic consequences for beneficiaries. If the corruption occurs in the transport sector and donors freeze their funding, a bridge could go unbuilt or a road left unpaved. In the health sector, it can mean that patients with AIDS do not receive their drugs and babies go without health care. My article was about the dilemma that donors face when they choose to adopt a hard line on corruption. This is not to say that they should not do so. But when they do, they need to be upfront about the fact that their actions have consequences. I declare no competing interests. Key donors to reinstate health funding to Zambia6 years after a corruption scandal damaged donor confidence in Zambia, funders are preparing to enter into new health agreements with the government. Ann Danaiya Usher reports. Full-Text PDF Key donors to reinstate health funding to ZambiaIn her World Report (Aug 8, p 519),1 Ann Danaiya Usher noted that key donors intend to reinstate health funding to Zambia 6 years after a corruption scandal that led them to withdraw funding. It is true that an immediate decline in health indicators—such as antenatal coverage, tuberculosis, malaria, and diarrhoeal and respiratory infections—was seen after the loss of funding. However, between 2007 and 2013, Zambia recorded huge reductions in maternal and child mortality—with under-5 mortality declining by 37% and maternal mortality by 33%—and improvements in several other service delivery indicators and health outcomes (eg, family planning, deliveries by skilled providers, treatment of fevers and acute respiratory infections in under-5 children, use of insecticide-treated bednets, total fertility rate, and prevalence of chronic malnutrition among children younger than 5 years). Full-Text PDF" @default.
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• W2221729012 date "2015-11-01" @default.
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• W2221729012 title "Key donors to reinstate health funding to Zambia – Author's reply" @default.
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• W2221729012 doi "https://doi.org/10.1016/s0140-6736(15)00968-x" @default.
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