Health has long been a gift that we have attempted to give to the rest of the world. Disease eradication programs, vaccination outreach campaigns, and the Western biomedical system have all been spread to countries near and far. These gifts were often colonialist in design, given without community consent, and without regard to culture or custom. Contrary to Thomas Friedman‘s thoughts, the world is not flat. Rather we live in a world that is increasingly connected by technology, but still remains sharply separated by those who have and those who don’t.

When it comes to global health, we no longer have the luxury of saying, “those people over there have health issues.” There is no simple separation between “us” and “them.” Health problems aren’t over there any more than they are right here. In the US, lifestyle choices contribute to heart disease, diabetes, obesity, and lung cancer. When we talk of disparities in access health in other parts of the world, we cannot forget the glaring health disparities in US inner cities and across communities of color.

The curtain has been lifted and hopefully we have looked in the mirror to see that we too have health issues in our country. While the ideas to make health better have long come from the West and developed countries, that paradigm is no longer applicable to global health today. Our world is still expansive, but we are more connected than ever before. With the internet at our finger tips and friends across the ocean only a skype call away, solutions in global health come from around the world. The past demonstrated that “developed” countries believed they were giving something valuable to those who didn’t have what they had. The result was a plethora of failed aid goals, missing life-saving medications, and decrepit health care systems.

Innovations for better health come from all around the world. It is no longer the “developed” giving ideas to the “developing.” The increasing use of mobile phones have inspired some exciting programs for health records management while SMS and texting have led to revolutions in access to health knowledge and care. However, it isn’t always technology ideas that are most effective. Developing countries have reminded us how important and critical health insurance can be, while at the same time demonstrating the severe need for more trained health care workers. Models that train community health workers, access micro-health insurance on your mobile phone, and social enterprises that provide ambulance emergency services have all been launched in “developing” countries. I can only hope that our health care system can take the time to look around the world for ways to improve.

For many years, complex issues in international development and global health have been tackled by simplified single-issue campaigns that have created short-term “band-aid” solutions. This can be attributed to the limited view most Americans have of the world. For many, issues of global health remain remote and abstract. We, young people, have grown up with the internet in our laps, basic knowledge of different cultures around the world in our classrooms, access to easier communications and travel, and more opportunities to study abroad and participate in global exchanges. These factors have made the world seem more connected, and have bestowed upon us the capability to serve as the key drivers of social change.

We must bridge the divide between rich and poor, privileged and oppressed, developed and developing. We, as privileged young people, can be the voice that changes the actions of our largest institutions to focus on programs that work, projects that benefit people in need, and efforts to build healthier communities.

Reposted from the Blog of Americans for Informed Democracy, where I am writing as a Global Health Issue Analyst.

“Giving in its purest form expects nothing in return.” – Anonymous

There are a lot of confusing buzzwords being thrown around these days: ending charity, dead aid, patient capitalism, impatient optimists, and investment over aid. What does it all mean?

My initial thoughts on this subject were spurred by zyOyz founder Steve Jennings’ repost of an article titled: “Charity alone not the answer to tackling poverty”. Well I agreed with the article’s basic premise that just giving money is not the only solution or the best, I was troubled by the article’s absolute statements that business models and capitalism will save the world.

The article, reposted from the Financial Times, notes the work of the Acumen Fund founded by Jacqueline Novogratz, which invests in small businesses with a social impact termed as “patient capital.” It has become a highly successful model, however Novogratz is quoted as saying: “We need creative approaches to reinvigorate capitalism and make it more inclusive.” The most inclusive business model that I know, with high degrees of success, is the cooperative model based on needs of those involved, inclusion, and participation. Looking at history, capitalism has generated exclusion: great amounts of wealth for many people, but it has also perpetuated extremely flawed systems that create great degrees of poverty for many people. The evidence is in any major city where the consequences of capitalism lay bare the desperation of good people who are left with nothing.

At the root of the article, “Charity alone not the answer to tackling poverty,” is the long-running debate on whether investment is more effective than aid. Professor Bill Easterly made popular the fact (through his book, “White Man’s Burden”) that over $1 trillion in aid has been given to Africa over the last 50 years with limited positive results, Dambisa Moyo has termed this “dead aid” and calls for a complete end of aid to Africa. Others like Bill and Melinda Gates, who have given vast amounts of aid (which they often call “investment”) to Africa with their foundation, label themselves as “impatient optimists.” They are hopeful for the future and want more done at the present time.

However, there is a problem with their impatience that many have critiqued. Impatience tends to push solutions that are ineffective. Ian Wilhelm gets further into this topic in a blog about “irrational aid.” In the post he writes about Alanna Shaikh’s critique of ineffective aid, such as outdated pharmaceuticals and medical equipment that has no use in the field. This argument is countered by Isaac Holeman’s disagreement that well that aid may be irrational, it provides immediate personal stories of need to bring in more donors. I have to agree with Alanna in saying that this irrational, possibly impatient, aid does more harm and basically no good.

How have we now moved from decrying the failures of charity and aid to highlighting the benefits of business models and the capitalist system back again to smiling about greater benefits of monetary investment in people and ideas? Where is the line drawn between investment and aid? As far as I can tell it is mostly semantic. Isn’t aid when transparent, effective, and driven by best practices an investment? Giving an investment is essentially the same as giving aid or charity.

Investment is the buzzword used by social enterprises, microfinance, and has become the new fad in international development organizations. I think that it is important to make a distinction between what is effective and what is not. Aid can be very effective and investment can be very ineffective. The reverse is also true. Where does effective aid change from being a type of investment? When experts talk about the broken aid system do they forget that the broken aid system is merely a reflection of the broken financial system. The same interests and individuals who have run financial systems have run foreign aid systems.

The real issue in this debate need not be if businesses are better than charities or who’s money is better spent. What is most important needs to be the question of, “How?” The systems, structures, and practices that implement aid and drive investment need to be cooperative, inclusive, needs based, and people-centered – in one word: effective. If you are looking for a return on investment (ROI) or accolades for your donated or invested dollars, then maybe you should reconsider why you give?