BWH researchers discover global healthcare investment leads to state stability

Jennifer Goldsmith, Division of Global Health Equity

How much does the US government spend on foreign aid and what is the impact of that support? This question has taken on new urgency with the current administration’s proposals to dramatically reduce foreign spending. BWH researchers have taken the question of the impact of foreign health aid with results that should inform critical policy decisions around allocation.

BWH researchers, led by Dr. Vinay Gupta, of BWH Division of Pulmonary and Critical Care Medicine,  have studied the impact of US aid in healthcare on stabilizing fragile economies and found that in Sub-Saharan countries US health investments not only improve population health outcomes, but strengthen governance indices contemporaneously.  Dr. Vin Gupta and his colleagues published their findings in Global Public Health on March 14, 2018. Their results demonstrated a novel finding:  US health aid leads to immediate improvements in metrics of state stability across sub-Saharan Africa.

The Council on Foreign Relations, an independent, nonpartisan  think tank, estimates that foreign aid accounted for roughly 1.3 percent of the federal budget in 2015 ($49 billion). Through another lens, the US spends 0.17 percent of GDP, twentieth out of twenty-eight countries measured by the Organization for Economic Cooperation and Development (OECD). Sweden, Norway, Luxembourg, Denmark, the Netherlands, and the United Kingdom all spend more than 0.7 percent of GDP on foreign aid, which is the target set by the United Nations.

Dr. Gupta, of BWH Division of Pulmonary and Critical Care Medicine was lead author on the study. He and colleagues from across Harvard chose to address this question because justifying the broad effectiveness of health aid has become particularly important given contemporary political issues and recent proposed cuts to foreign aid in the federal budget . Dr. Gupta describes his interest and work in global health: “I’ve long been interested in the intersection of global health and international affairs, understanding how novel concepts such as health diplomacy can further the reach of health aid and help make recipients countries not only more healthy, but safer and more secure. The political dimensions of global health are crucially important to understand, as doing so will help ensure that financial commitments remain robust.”

In addition to research Dr. Gupta has worked in global settings across Africa and Asia with institutions such as the China Centers for Disease Control, the Emerging Infections Program of the US CDC, and on humanitarian deployments in his roles as an aerospace medicine physician with the US Air Force.

Dr. Gupta’s co-authors include: Alexandre Mason-Sharma (School of Medicine, Boston University). Zoe Lyon (Harvard Global HEalth Institute and Harvard TH Chan School of Public Health),  Endel John Orva (Harvard TH Chan School of Public Health), Ashish Jha (Harvard TH Chan School of Public Health), and Vanessa B. Kerry (Department of Global Health and Social Medicine, Harvard Medical School, MGH, and Seed Global Health).

The novel nature of these findings comes at a time when the US government has divested from CDC operations in countries around the world. Understanding the value of CDC work is key to making wise foreign policy choices. Dr. Gupta’s research is empirical and addresses questions that are routinely raised in popular media. By demonstrating the impact of global health investment health care leaders have powerful evidence to counter doubts about the remarkable value of this work.

Read the Global Public Health article here.