OneWorld.net (U.S.)

The almost immediate outpouring of donations by the U.S. public to relief organizations following news of the tsunami in South Asia demonstrates the desire of many in wealthy nations to assist those in countries with fewer resources.

After the disaster passes and the media moves on to the next story, however, most Americans do not get to hear how the money they sent was spent, and there’s a nagging perception among much of the U.S. public that foreign aid is money wasted. While donor-funded health interventions have successfully changed health behaviors and saved millions of lives over the last 50 years--even in some of the poorest places in the world--these stories are rarely widely reported.

For example, in the late 1970’s at least half of all infant deaths in Egypt were caused by dehydration due to diarrheal disease. A program initiated by the Egyptian Ministry of Health and funded by the U.S. government distributed locally manufactured oral rehydration salts to rural communities and taught mothers how to correctly mix and administer the salts to their children.

According to a new book from the Washington D.C.-based think tank Center for Global Development, at the peak of this program in the mid-to-late 1980s, "mortality attributed to diarrhea fell 82 percent among infants and 62 percent among children." Currently in Egypt, only one out of every 200 children who contract diarrhea will die of its consequences.

Egypt’s prevention of diarrheal deaths is but one of the 17 cases of successful health campaigns to be found in the book, Millions Saved: Proven Successes in Global Health. From the elimination of measles in southern Africa to curbing tobacco use in Poland, the 167-page volume provides a compact and detailed history of donor-funded programs that have worked on a large scale in developing countries.

Millions Saved co-authors Ruth Levine and Molly Kinder had been working for over two years with a network funded by the Bill and Melinda Gates Foundation to explore policy and finance challenges in global health. When they went to find examples of successful health projects to present to policy makers on Capitol Hill, they realized that solid research demonstrating the vast quantity of successes did not exist.

Knowing that donor-funded projects had worked, Levine and Kinder conceived the idea to document a range of the successful cases in one publication.

“These stories are a reminder of what can be done. The right amount of money in the right place at the right time is very relevant,” said Jim Sherry, Vice President of the Global Health Council, an alliance of health-care professionals and organizations working to improve health standards worldwide.

In collaboration with 15 international public health experts, Levine and Kinder came up with benchmarks by which to judge a "successful" program. Every example in the book was considered on the basis of five criteria--scale, importance, impact, duration and cost-effectiveness. In addition, the impact of the health intervention had to have been documented in peer-reviewed journal articles or official project evaluations. And prior to publication, each write-up was reexamined by technical experts knowledgeable about the case.

Having tough and thorough standards makes Millions Saved more than just a book of 17 inspirational stories but an invaluable resource for global health professionals.

"By putting them all together and putting them side by side...it’s a surprise to some people," said Kinder. "I don’t think everyone knew all of these successes existed."

Indeed, many global health advocates admit having to knock down walls of skepticism when speaking to policymakers about the need for donor funding for developing countries.

"It counters the view that development assistance cannot work and provides inspiration in the face of daunting global health challenges," said Levine at a press conference in Washington, D.C. in early March.

One very important lesson revealed by the book reverses the widely-held notion that funding projects in developing countries is like throwing money down the drain, as corrupt government officials will squander the funds.

"Governments can do the job," said Levine. And the book illustrates that without co-operation from government officials, these programs would have been virtually impossible to carry out on such a large scale.

More success however, is assured where there is predictable, adequate funding both from local and international sources.

Eight of the 17 case studies succeeded because of help from the U.S. in one form or another. In Morocco, cases of blinding trachoma have fallen by 75 percent since 1999 due in part to the use of $500 million worth of antibiotics donated by the New York.-based Pfizer pharmaceutical company. A loan from the World Bank--in which the United States government is the largest investor--financed China’s tuberculosis project preventing 30,000 cases a year.

"Your money as a taxpayer is saving lives and there is room to do even more," said Kinder.