Global Health Update 2: Narrowing Down My Topic

Since my initial update about my exploration of medical volunteering, I have shifted my broader focus to include sustainability of actors besides NGOs and medical schools, which are the primary providers of medical volunteers. Now, I have overviewed and mapped out the key players in global health, which my research has revealed to be:

  • Multilateral institutions (WHO, World Bank, etc)
  • Bilateral/national aid agencies
  • NGOs
  • Private foundations
  • Private sector
  • Global public-private partnerships
  • Medical schools
  • Low & middle income country (LMIC) recipients

Mapping out the players involved in providing, managing, and spending on global health has helped me look at the different roles that each actor assumes. I am inserting a useful chart I found that organizes global health actors by role. As you can note, actors typically assume multiple roles.

Screen Shot 2017-06-12 at 7.52.38 PM


[Mccoy, David, Sudeep Chand, and Devi Sridhar. “Global Health Funding: How Much, Where It Comes from and Where It Goes.” Health Policy and Planning 24.6 (2009): 407-17.]

I am investigating sustainability in global health with regard to Gavi, The Vaccine Alliance (formerly known as the Global Alliance for Vaccines and Immunization).

The narrowing down of my topic went something like this:

Investigating volunteer tourism as a broad concept → Focusing on medical volunteering → Noticing that sustainability consistently showed up as a theme and deciding to look at sustainability in global health more broadly than in just volunteer programs → Gavi, The Vaccine Alliance has consistently been lauded for implementing sustainable vaccination programs that require governments to co-finance vaccine programs until their economy can support financial autonomy. Also, I noticed that Gavi is working in a new phase during the period 2016-2020, which is very recent and relevant. 

During each new phase, Gavi reevaluates goals, policies, and priorities. During this phase, 22 countries are looking to “graduate” from Gavi funding and assume financial autonomy of vaccine programs. For my Monroe project, I am considering tracking the progress of the countries that are attempting to graduate from Gavi. So far, I have read a lot of literature on Gavi’s creation and history, promotion of sustainability through co-financing and health systems strengthening, and challenges in addressing within-country equity (inequalities based on gender, land area, and linguistic fractionalization hamper access to vaccination programs).

I am not sure what data I will look at to evaluate the 22 countries that are trying to graduate from Gavi funding, so that is my biggest challenge so far. Just before writing this post, I organized all of my notes on key players in global health, challenges in global health, sustainability, and Gavi. For my next step, I intend to look at Gavi’s 2016 report (and perhaps other Gavi publications – so far I have only looked at published literature from outside sources) to understand exactly what challenges Gavi most recently is facing. Then, perhaps, I will figure out what data to look at to evaluate how the 2016-2020 transition is going so far.

Thanks for reading my post!


  1. Hello Nada, this project sounds very interesting! I was wondering for your evaluation of the countries what sort of factors will you be looking at to compare them? I’ve always found the variations in nations interesting and how they affect different aspects of their progression, government, and in this case health care. Will you have any cultural factors, or primarily economic or geographic? Although including several correlations between specific indicators such as GDP per capita or IMF may be interesting, are you considering more qualitative factors that may have a more complex causation? Overall, it seems like a really intriguing topic! Good luck!