Country Contributions to Global Public Goods for Health

The document analyzes the systemic underfunding of Global Public Goods for Health (GPGHs), identifying a 'participation trilemma' where traditional donors fear losing authority, non-traditional donors demand more authority before contributing, and recipient countries lack both. It categorizes funding into four pathways: Treaty-based Multilateral Contributions (TMCs), Voluntary Multilateral Contributions (VMCs), Bilateral Contributions (BCs), and Domestic Contributions (DCs). The authors find that VMCs are the most unequal pathway, heavily reliant on a few G7 nations, and propose shifting the narrative from 'development aid' to 'Global Public Investment' (GPI) to engage a broader base of contributors, including Upper Middle-Income Countries (UMICs) and China.

• The authors identify a 'participation trilemma' that locks the status quo of under-provision for GPGHs: traditional donors want to share the fiscal burden without ceding authority, non-traditional donors want authority before increasing contributions, and recipient countries have neither authority nor an exit from the system.
• Country contributions to GPGHs flow through four distinct pathways: Treaty-based Multilateral Contributions (TMCs), which are reliable but small; Voluntary Multilateral Contributions (VMCs), which can be large but are unreliable and unequal; Bilateral Contributions (BCs), which offer high donor control; and Domestic Contributions (DCs), which provide indirect global spillover benefits.
• Voluntary Multilateral Contributions (VMCs) are characterized by extreme inequality in participation. High-income countries, particularly the G7, provide a disproportionate share of funding compared to their economic capacity, while Upper Middle-Income Countries (UMICs) and Low-Income Countries (LICs) contribute negligibly.
• Analysis of the Access to COVID-19 Tools Accelerator (ACT-A) and the Global Fund shows a strong positive correlation between a country's Gross National Income (GNI) and its contribution size, though significant outliers exist. For ACT-A, GNI explained approximately 79% of the variation in contributions.
• Country willingness to contribute to VMCs is shaped by 'latent factors' (long-term dispositions like efficiency, obligation, political brand, and path dependency) and 'political factors' (short-term considerations such as civil servant trust, civil society support, parliamentary approval, peer pressure, and geopolitical opportunism).
• The authors propose ten non-traditional country groupings to replace income-based categories (HIC, MIC, LIC) for more effective advocacy. These include 'The Multilateralists', 'The Weakly Free-riding HICs', 'The Strongly Free-riding HICs', 'The Oil States', and 'The Regional Powers'.
• The paper argues that the current 'development aid' (ODA) narrative is outdated and fails to engage non-traditional donors. It recommends a shift toward a 'Global Public Investment' (GPI) framework where all countries contribute on a fair-share basis and share in decision-making.
• To increase GPGH funding, the authors suggest five strategic objectives: increasing quantity by targeting 'free-riding' countries, increasing quality through inclusive governance for UMICs, raising contributions from core donors via 'investment' arguments, coordinating the financing landscape, and co-creating a new set of principles based on GPI.

APA

Reid-Henry, S., Dwyer, S., Benn, C., & Rødningen, I. (2023). Country Contributions to Global Public Goods for Health. Peace Research Institute Oslo. https://cdn.cloud.prio.org/files/98504530-f909-4bbd-8472-79cb04df2359/Simon Reid-Henry et al - Country Contributions to Global Public Goods for Health PRIO Paper 2023.pdf?inline=true

Chicago

Reid-Henry, Simon, Sinead Dwyer, Christoph Benn, and Ida Rødningen. Country Contributions to Global Public Goods for Health. Peace Research Institute Oslo, 2023. https://cdn.cloud.prio.org/files/98504530-f909-4bbd-8472-79cb04df2359/Simon Reid-Henry et al - Country Contributions to Global Public Goods for Health PRIO Paper 2023.pdf?inline=true.

Wikipedia

{{cite report |last1=Reid-Henry |first1=Simon |last2=Dwyer |first2=Sinead |last3=Benn |first3=Christoph |last4=Rødningen |first4=Ida |title=Country Contributions to Global Public Goods for Health |publisher=Peace Research Institute Oslo |date=2023 |url=https://cdn.cloud.prio.org/files/98504530-f909-4bbd-8472-79cb04df2359/Simon Reid-Henry et al - Country Contributions to Global Public Goods for Health PRIO Paper 2023.pdf?inline=true |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{reidhenry2023country, author = {Reid-Henry, Simon and Dwyer, Sinead and Benn, Christoph and Rødningen, Ida}, title = {{Country Contributions to Global Public Goods for Health}}, institution = {Peace Research Institute Oslo}, year = {2023}, url = {https://cdn.cloud.prio.org/files/98504530-f909-4bbd-8472-79cb04df2359/Simon Reid-Henry et al - Country Contributions to Global Public Goods for Health PRIO Paper 2023.pdf?inline=true}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }