Public health ethics for donor and aid agencies

Anant Kumar, Xavier Institute of Social Service

In developing, and low and middle income countries, International donor and aid organisations are funding and supporting public health projects and programmes since decades. These organisations have also documented and justified their investments in their evaluations, presentations and reports but “do these investments have made difference to people life and health”. Most government and people in developing world believe that international aid and NGOs projects and programmes will bring economic and social benefits to their country and people. To some extent, it is true. But these funded projects and programmes have also adversely affected the public health in developing countries by shifting focus from real public health issues and challenges. People are dying from communicable disease like, malaria and diarrhoea but donors are promoting and investing more and more in technology oriented health services and intervention programmes. The donors and aid agencies are also generating evidence base to support and justify their interventions and programmes through funded research. These research findings influence and promote policies, which are more in favour of market forces like pharmaceutical companies rather than favouring and improving the health of poor people. Are these grant-in-aid support, funded research to generate evidence base, and policy influence in favour of pharmaceutical companies and other multi-national companies are ethically right? Scholars, donors and public health professionals across the world have different opinion and views on ethics recommendation for donor and aid agencies, particularly public health ethics but most of them agree that ethics should be guided by motivation based on the principles of right and wrong in favour of poor and marginalised. The paper brings up and critically examines these questions and emphasises the need of developing ethics applicable to funding and donor agencies to safeguard the rights and health of poor people in developing world.