Thank you for taking the time to reply! I'm curious what your prompt was? Before posting here I asked claude the same question and got something that was more confusing to me than your answer.
I'm curious how the Effective Altruism community addresses fiscal substitution in the "global health and development" cause area? Do any of the top GiveWell recommended charities find ways to track how their impact applies to government spending in their host countries?
I found this via Tyler Cowen's Marginalrevolution.com -
"While donor-driven programs undoubtedly saved millions of lives, they also created unintended distortions in national health priorities.
Many governments in sub-Saharan Africa and parts of Asia actually scaled back domestic health investments, as donor program filled key gaps in HIV/AIDS, maternal and child health, and infectious disease control.
In some cases, domestic health budgets shrank in real terms, even as external funding increased. This phenomenon, often referred to as “fiscal substitution,” led to national health systems that were heavily donor-dependent, externally managed, and vulnerable to funding shocks.
Notably, this reliance emerged despite countries pledged to allocate at least 15% of their national budgets to health.
More than two decades later, only a handful has met this target." (this is from Redefining Global Health in the 21st Century by Michael John Alastair Reid and Eric Paul Goosby).
Thank you for taking the time to reply! I'm curious what your prompt was? Before posting here I asked claude the same question and got something that was more confusing to me than your answer.
I'm curious how the Effective Altruism community addresses fiscal substitution in the "global health and development" cause area? Do any of the top GiveWell recommended charities find ways to track how their impact applies to government spending in their host countries?
I found this via Tyler Cowen's Marginalrevolution.com -
"While donor-driven programs undoubtedly saved millions of lives, they also created unintended distortions in national health priorities.
Many governments in sub-Saharan Africa and parts of Asia actually scaled back domestic health investments, as donor program filled key gaps in HIV/AIDS, maternal and child health, and infectious disease control.
In some cases, domestic health budgets shrank in real terms, even as external funding increased. This phenomenon, often referred to as “fiscal substitution,” led to national health systems that were heavily donor-dependent, externally managed, and vulnerable to funding shocks.
Notably, this reliance emerged despite countries pledged to allocate at least 15% of their national budgets to health.
More than two decades later, only a handful has met this target." (this is from Redefining Global Health in the 21st Century by Michael John Alastair Reid and Eric Paul Goosby).