In years past, the face of the global burden of disease was a rural child suffering undernutrition and infections in a low-income country. The case for donor intervention—both bilateral and philanthropic—was morally, technically and economically clear. Today, however, it is more commonly an urban adult suffering multiple chronic diseases in a middle-income country. How could donors provide universal health coverage (UHC) or meet such an expansive need for healthcare services? Would they invest in adults who have already had a shot at life and whose lifestyle choices are supposedly to blame? What role could they have in a country with resources? These questions need answers.
In 2013, the Lancet Commission on Investing in Health (CIH) grouped the global health agenda into three categories: the unfinished agenda to reduce disparities in key infectious diseases and reproductive, maternal and child health; the emerging agenda to curb non-communicable diseases (NCDs) and injuries; and the…