It’s Time to Change the Conversation

By Marshall Stowell, PSI

Rhetoric drives funding.

For decades, the development community has focused on developing effective health solutions like anti-retroviral therapy, better treatment for malaria, improved long-acting contraception, mobile technology and other life-improving goods and services.

We’ve made the arguments for an AIDS-free generation, the elimination of malaria and meeting the unmet need for contraception of 220 million women. Each effort has effectively shaped policy, driven government funding decision and moved the public to action.

We’ve made incredible progress. Yet the success bears the risk of being unsustainable.

One reason is that aid programs survive off government donor subsidy, which often has the unintended effect of crippling the market for health products and services. And, programs are funded for relatively short periods of time, mostly from three to five years. Funding gaps, changes in implementing organizations and shifting donor priorities make continuity challenging and efforts are often rewarded based on short-term gains.

The question we need to be asking is how can we better invest in market-shaping so that we’re building a model that is sustainable.

While talk of health system strengthening and integrated delivery is common, funding hasn’t followed suit at the same pace. And, there’s even less talk and less funding for addressing health market failures.

It’s time to change the conversation from touting the development of innovative health solutions to how we build sustainable health markets.

Yes, it’s more esoteric. It’s harder to explain. And it’s not sexy. But it’s the right thing to do.

The graph on page 9 is an obscene reminder of how living in a country with a well-functioning health market allows near instant access to health solutions. The fact that the introduction of oral rehydration salts took less than five years to reach 100 percent coverage in developed countries, while decades later we’re at little more than 50 percent coverage in developing countries, borders on unethical if you believe access to health is a basic human right.

Let’s hit the reset button on how we talk about solving tomorrow’s greatest health challenges by first talking about building tomorrow’s health markets.


Marshall Stowell is the Editor-in-Chief of Impact magazine and Vice President of External Relations & Communications at PSI.

Follow @MarshallPSI on Twitter.




This article is part of an ongoing conversation about #MakingMarketsWork in Impact Magazine No. 22 “Are We Thinking Big Enough” issue. Join in the conversation with @PSIImpact.