The surge in global health organizations has had some interesting effects on the general global health landscape. On one hand, there have been some clear positive changes; because there are many more organizations, a wider swath of healthcare governance issues can be addressed and dealt with. While one organization wouldn’t be able to cover all issues—setting up systems to deal with a variety of communicable and non-communicable diseases, as well as other health issues such as maternal and children’s rights may end up leaving all types of problems being dealt with inadequately—specializing between organizations can lead to greater efficiency.
On the other hand, the huge number of NGOs leads to some major funding issues. Each intergovernmental organization, NGO, and private firm has its own overhead and administrative costs, and the more the organizations are split up, the more inefficient the funding distribution is. That is, because organizations operate under economies of scale, which means that, the larger the organization is, the lower the average cost. With a large number of small organizations, each organization has to cover their own overhead costs before they can begin to do work in the field. Because, for the most part, these organizations are heavily if not entirely reliant on voluntary funding, the funding ends up being split between all of these organizations.
Additionally, at least for organizations such as the World Health Organization, the funding ends up being allocatively inefficient. Devi Sridhar and Lawrence O. Gostin describe how close to 80% of the WHO’s budget depends on voluntary funding, much of which is earmarked towards specific projects. The distribution of this earmarked funding doesn’t match the actual global health problems; only 3.9% of the funding is allocated for non-communicable diseases, which account for 62% of total deaths. These numbers likely illustrate a trend in the greater landscape, indicating that organizations and governments tend to put a priority on problems that may not be what is most important or most pressing globally.
This lack of understanding of the real health issues facing the world currently means that these massive numbers of NGOs may not be contributing as well as they can. Having dozens if not hundreds or organizations focusing on the same issue—for example, malaria—may seem useful on paper, but when each is pulling more funding from larger organizations than it is using in the field, the utility is not necessarily there. Additionally, when the organizations that do exist are focusing all of their efforts on problems that are not the priority, they are also pulling funding from other necessary issues without covering the gap. As such this huge surplus of NGOs, while useful on paper, may actually be pulling away from necessary projects by spreading out funding to cover overhead and setup costs.