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11. Global Health and the New Bottom Billion: What Do Shifts in Global Poverty and the Global Disease Burden Mean for GAVI and the Global Fund?

Author:
Amanda Glassman, Andy Sumner, and Denizhan Duran
Publication Date:
10-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
After a decade of rapid growth in average incomes, many countries have attained middle-income country (MIC) status. At the same time, the total number of poor people hasn't fallen as much as one might expect and, as a result, most of the world's poor now live in MICs. In fact, there are up to a billion poor people or a 'new bottom billion' living not in the world's poorest countries but in MICs. Not only has the global distribution of poverty shifted to MICs, so has the global disease burden. This paper examines the implications of this 'new bottom billion' for global health efforts and recommends a tailored middle-income strategy for the Global Fund and GAVI. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date; revisits the rationale for health aid through agencies like GAVI and the Global Fund; and proposes a new MIC strategy and components, concluding with recommendations.
Topic:
Development, Globalization, Health, and Poverty

12. More Money or More Development: What Have the MDGs Achieved?

Author:
Charles Kenny and Andy Sumner
Publication Date:
12-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
What have the MDGs achieved? And what might their achievements mean for any second generation of MDGs or MDGs 2.0? We argue that the MDGs may have played a role in increasing aid and that development policies beyond aid quantity have seen some limited improvement in rich countries (the evidence on policy change in poor countries is weaker). Further, there is some evidence of faster-than-expected progress improving quality of life in developing countries since the Millennium Declaration, but the contribution of the MDGs themselves in speeding that progress is—of course—difficult to demonstrate even assuming the MDGs induced policy changes after 2002. The paper concludes with reflections on what the experience of MDGs in terms of global goal setting has taught us and how things might be done differently if there were to be a new set of MDGs after 2015. Any MDGs 2.0 need targets that are set realistically and directly link aid flows to social policy change and to results.
Topic:
Development, Economics, Humanitarian Aid, Poverty, and Foreign Aid

13. The New Bottom Billion: What If Most of the World's Poor Live in Middle-Income Countries?

Author:
Andy Sumner
Publication Date:
03-2011
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Most of the world's poor no longer live in low-income countries. An estimated 960 million poor people—a new bottom billion—live in middle-income countries, a result of the graduation of several populous countries from low-income status. That is good news, but it has repercussions. Donors will have to change the way they think about poverty alleviation. They should design development aid to benefit poor people, not just poor countries, keep supporting middle-income countries, think beyond traditional aid to craft coherent development policies, and work to help create space for more inclusive policy processes in new and old MICs.
Topic:
Development, Poverty, and Foreign Aid