PLoS Medicine
(Accessed 29 September 2012)
http://www.plosmedicine.org/article/browse.action?field=date

Who Sets the Global Health Research Agenda? The Challenge of Multi-Bi Financing
Devi Sridhar Essay, published 25 Sep 2012
doi:10.1371/journal.pmed.1001312

Summary Points
– A major challenge in the governance of research funding is agenda-setting, given that the priorities of funding bodies largely dictate what health issues and diseases are studied.

– The challenge of agenda-setting is a consequence of a larger phenomenon in global health—“multi-bi financing.”

– Multi-bi financing refers to the practice of donors choosing to route non-core funding—earmarked for specific sectors, themes, countries, or regions—through multilateral agencies such as the World Health Organization (WHO) and the World Bank and to the emergence of new multistakeholder initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance.

– These new multistakeholder initiatives have five distinct characteristics: a wider set of stakeholders that include non-state institutions, narrower problem-based mandates, financing based on voluntary contributions, no country presence, and legitimacy based on effectiveness, not process.

– The shift to multi-bi financing likely reflects a desire by participating governments, and others, to control international agencies more tightly.