Public goods and donor priorities: The political economy of development aid for infectious disease control

Over the past two decades, development assistance for health (DAH) has reached record levels. Yet, many developing states continue to struggle with diseases easily prevented and treated in industrialized states. Within the aid literature, DAH has historically been viewed as technical rather than political and has been largely disregarded. I argue that, like other forms of foreign aid, DAH may be subject to political influences; and that identifying those interests requires moving beyond dyad-level conceptualizations of political interests. I apply a public goods model to bilateral aid allocations for infectious disease control, using disease characteristics to specify recipients' need and donors' interests. I use an original dataset to model disease-specific aid allocations. The results suggest that, within the public goods setting of global disease control, bilateral donors allocate aid to maximize their own payoff. In addition, this analysis provides a theory-driven explanation for poor health outcomes in many developing countries where aid allocations fail to match need.