Laney Graduate School and Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
Glob Health Action. 2011 May 9;4:GHA-4-6339. doi: 10.3402/gha.v4i0.6339.
Significant funding of health programs in low-income countries comes from external sources, mainly private donors and national development agencies of high-income countries. How these external funds are allocated remains a subject of ongoing debate, as studies have revealed that external funding may misalign with the underlying disease burden. One determinant of the priorities set by both private donors and development agencies is the perceptions of populations living in high-income countries about which diseases are legitimate for global health intervention. While research has been conducted on the priorities expressed by recipient communities, relatively less has been done to assess those of the donating country. To investigate people's beliefs about the disease burden in high-income countries, we compared publicly available data from U.S. surveys of people's perceptions of the leading causes of death in developing countries against measures of the actual disease burden from the World Health Organization. We found little correlation between the U.S. public's perception and the actual disease burden, measured as either mortality or disability-adjusted life years. While there is potential for reverse causality, so that donor programs drive public perceptions, these findings suggest that increasing the general population's awareness of the true global disease burden could help better align global health funding with population health needs.
大量的卫生项目资金来自外部来源，主要是私人捐助者和高收入国家的国家发展机构。这些外部资金的分配仍然是一个持续争论的问题，因为研究表明外部资金的分配可能与潜在的疾病负担不一致。私人捐助者和发展机构确定优先事项的一个决定因素是高收入国家居民对哪些疾病是合法的全球卫生干预的看法。虽然已经对受援社区表达的优先事项进行了研究，但相对较少评估捐助国的优先事项。为了调查人们对高收入国家疾病负担的看法，我们比较了美国公众对发展中国家主要死亡原因的看法的公开调查数据与世界卫生组织衡量的实际疾病负担的措施。我们发现，美国公众的看法与实际疾病负担之间几乎没有相关性，无论是以死亡率还是残疾调整生命年来衡量。虽然存在反向因果关系的可能性，即捐助计划会影响公众看法，但这些发现表明，提高普通民众对全球真正疾病负担的认识，有助于更好地将全球卫生资金与人口健康需求保持一致。
