Most industrialized nations have government agencies that provide aid directly to less developed countries, sidestepping multilateral aid organizations entirely. In fact, most international development aid is given this way. The multilateral-bilateral aid ratio has hovered around 30:70 for many years.
The motives for establishing these agencies are often mixed: to further national interests, to achieve certain foreign policy objectives, and to be good global citizens. Whatever the mix of motives, such programs do often accomplish humanitarian aims and foster economic development, even though political and historical circumstances tend to determine which countries receive aid. France, for example, tends to concentrate on its former colonies and Britain on the countries of the British Commonwealth, while Japan gives mostly to developing countries in Asia.
In the United States, the U.S. Agency for International Development (USAID) has been the primary channel for bilateral aid since the John F. Kennedy era, but President Bush's Emergency Fund for AIDS Relief (PEPFAR) has also established an alternative infrastructure to administer its grants.
The U.S. Centers for Disease Control and Prevention (CDC), another agency of the federal government, combines the national interest and the global interest in a different way. The CDC's mission is to safeguard the nation's health through research (especially into infectious diseases) and to support worldwide public health surveillance to help quell epidemics before they can cross international borders.
Elsewhere, the Japan Bank for International Cooperation (JBIC), the United Kingdom's Department for International Development (DFID), and the Danish International Development Agency (DANIDA) all undertake development aid programs, many of which include health-related initiatives. These agencies may give aid directly to the government of the recipient country or channel it via contracts with NGOs who can work effectively in partnership with local communities.