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Rx for Survival

Ask the Experts

Allan Rosenfield

Dr. Allan Rosenfield

Dean, Columbia University Mailman School of Public Health


Foreign aid for international health is responsible for many dramatic successes that have improved life expectancies and living standards. While some aid has been wasted, many of the public health victories of the past 50 years would not have been possible without aid funds. One prominent example is the eradication of smallpox, which involved substantial efforts to vaccinate populations in resource-poor countries. Similarly, the ongoing effort to eradicate polio has reduced the incidence of polio by more than 99 percent since 1988. Donations have funded polio vaccinations that have protected millions of children from the crippling disease. Another life-saving intervention is oral rehydration therapy, which reduces diarrhea-related deaths in children. In many Asian and Latin American countries, increasing access to family planning has enabled women to prevent unplanned pregnancies.

Today, HIV presents a new challenge to the global health community. While much more needs to be done, aid efforts are providing HIV prevention, care and treatment programs to some residents in resource-poor countries. Early results of those efforts are promising and the U.S. should continue to fund these programs.

While aid that provides direct and immediate access to care and treatment is critical (i.e. providing necessary drugs and the tools to administer them), we must also think long term. Many countries, especially in sub-Saharan Africa and parts of Asia, have little or no public health infrastructure due to decades of political and economic upheaval. What this means is that without significant assistance from donor countries and NGOs, they have no effective way to distribute and administer treatment or preventive services to their populations. In addition, many of these countries are experiencing critical shortages of clinical professionals.

This does not mean that we should abandon life-saving aid, but rather we must think creatively and work together with the health and finance ministers of these countries so that we are also dedicating resources to help build the health infrastructure and train and retain health professionals within each country

Dr. Allan Rosenfield, is dean of Columbia University's Mailman School of Public Health and has first-hand knowledge of international health issues through his past work as an obstetrician in Nigeria and as an MCH/family planning advisor to Thailand's Ministry of Public Health. He has written extensively on domestic and international health issues, with a focus on population, women's reproductive health, maternal mortality, HIV/AIDS, human rights and health policy. He was a coordinator for the U.N. Millennium Project's Task Force on Child Health and Maternal Health and has played a leadership role in the Mailman School's groundbreaking maternal mortality and HIV/AIDS care and treatment programs in resource-limited settings.


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