Subadditionality in Global Health Financing

March 12, 2012 § 1 Comment

In a recent post, Amanda Makulec references the IHME Financing Global Health 2011 report (and Michael Herman) to highlight what researchers are referring to as subadditionality. Over the past 30 years, economic literature has found that financial assistance from one government to another (tied to a specific sector, such as health) can cause the recipient country to decrease its own investment in that sector.1 This phenomenon is what researchers are calling subadditionality. The research is discussed in more detail here.

Thanks to Makulec for this infographic to help us understand subadditionality a bit better:


As Makulec points out, the research findings suggest not only that assistance to governments may create a negative response (less government spending on health), but also that assistance to NGOs may actually do the opposite (that is, it may incite more government spending on healh). However, before we go chastising government aid and pushing for NGO dominance, it’s important to note that researchers from the IHME are open about the nescient nature of their findings– reminding us that the current stats  do not mean that it’s necessarily better to give money to NGOs than to governments. There are still tough questions to be asked and further investigation to be conducted before a nuanced understanding will unfold on the subject. Read the report and stay up-to-date on further research to better understand.

1 IHME’s summary of subadditionality: We found that for every $1 of DAH channeled through government (DAH-G) that flowed to a country, governments on average took $0.43 to $1.14 of their own money away from the health sector. W


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