Global Health Care Matters: Broadening The Focus

Ina n ag e o f m at e r i a l p l e n t yand technologic marvels, it seems inconceivable that millions of poor people in the developing world should die every year from diseases that could be treated with inexpensive and effective interventions. This unending tragedy is repeated every day in low-income countries because their resources are limited, their systems for delivering treatments are inadequate, and efforts of the industrialized world to come to their rescue fall short. Health spending per person in high-income countries is more than 150 times what it is in lowincome countries, as George Schieber and colleagues note in their lead paper. But as this thematic issue on the health financing challenges facing low- and middle-income countries underscores, while spending on health has recently increased dramatically, money alone will not fix the problem. Management systems must be in place to administer the scarce resources and apply them effectively, and international institutions and donor countries are questioning which strategies would most quickly reduce this scourge. One result is the creation of new institutions and mechanisms for external assistance; another is the growing emphasis on the need to provide financial protection as well as better health. This thematic issue represents a marked departure from much of the content that Health Affairs has published over its twenty-five-year history: focusing more of our energies and space on low- and middle-income countries. Although we remain committed to devoting much of our space to material aimed at improving the troubled U.S. health care system, this broadening of our focus will better align our interests with those of our publisher—Project HOPE—which sponsors health education and related projects in thirty countries around the globe. In 2005 and again in 2006, Project HOPE provided volunteer American physicians and nurses on a humanitarian mission that took the U.S.S. Mercy—a vast teaching hos