Global health funds have done a lot of good. Is there room for a “global fund” for books?

By Paul Wilson, Assistant Professor of Clinical Population and Family Health at Columbia University.

Books, especially textbooks, are critical to learning, as we have been reading in the latest blog series on this site, but they are in grievously short supply in many developing country classrooms. Results for Development (R4D) recently released a report, on which I advised, exploring the feasibility of a “Global Book Alliance” that would focus attention, expertise and resources on this crucial obstacle to effective education.

Much of our inspiration came from the success of global funds in health, which have transformed donor assistance in many areas. In our Report – and this blog – we carry on the questions explored in the policy paper released by the GEM Report at the start of last year: Could a new alliance do the same for books?

Health funds have raised life-saving resources

Over the last 15 or so years, a series of new international financing mechanisms have been created for health, raising substantial new resources and saving many lives. The largest and best known are the Global Fund to Fight AIDS, Tuberculosis and Malaria (“the Global Fund”) and Gavi, the Vaccine Alliance, but there are a growing number of others.

The Gavi case

Gavi was launched in 2000 to allow poor countries to afford to introduce life-saving vaccines . At its simplest, it would be a vehicle by which donors could band together to purchase these vaccines and provide them to countries. But it was also anticipated that unified (“pooled”) purchase and assured demand would attract new suppliers and drive prices down over time, perhaps eventually allowing countries to purchase these vaccines with their own resources. At the same time, Gavi would provide resources and expertise to help countries strengthen their immunization programs.

Although the decline in prices has not been as rapid as initially hoped, these objectives have been largely achieved. Most of the countries eligible for Gavi support have introduced at least two new vaccines, and Gavi estimates that these immunizations have already contributed to averting 8 million future deaths.

What were the conditions which made Gavi successful? Four stand out:

  1. There was universal consensus that the intervention —vaccines—would have a big health impact if it reached children.
  1. The cost of a commodity — vaccines —was the crucial obstacle to access to the proven intervention.
  1. The needed commodity was the same everywhere and already available in high-income countries — vaccines would save lives in Bangladesh as they had in the US and Europe. These commodities could thus be procured in bulk for all participating countries in international markets, resulting in cost savings over national or donor-specific procurement.
  1. The new global fund brought together in an alliance key international organizations involved in immunization and could therefore serve as forum for agreeing on policy and spending priorities.

The Global Fund case

The Global Fund for health met many of these conditions as well. Antiretroviral and antimalarial drugs could save lives wherever AIDS and malaria raged, but poor countries could not afford to provide them. A vast new subsidized market for these drugs—and coordinated action—might bring down prices. On the other hand, systems for delivering the needed interventions were not in place in many countries, and building these systems country by country has made the task of the Global Fund more complicated than that of Gavi. As a result, bilateral funding channels, with their more hands-on approach to building delivery systems, have continued to complement the Global Fund.

Health fund vs. book fund: similarities and differences

So, what about books? Which of the conditions that made such a strong case for Gavi are in place for a global book alliance? The R4D report confirms that books are important, and that a lack of appropriate (and effectively used) books is impeding progress in education in many countries (condition 1). However, it is less clear that the cost of books is the major impediment to their availability and use (condition 2).

Results for Development found that although there is funding shortfall for books in many countries, this is probably not the most important bottleneck in most places. Inefficiencies in procurement and elsewhere in the supply chain mean that available funds are often poorly used. Moreover, access to books is also hampered by lack of demand from parents, teachers and education policymakers; broken and corrupt distribution systems; and teaching methods that don’t make good use of books when they are available.

The R4D analysis concluded that a Global Book Alliance would have to do much more than channel funding for books and proposed; providing technical assistance should be central to its mission.

In addition, condition 3 listed above is not met because books are needed in hundreds of languages. This leaves little scope for pooled procurement, weakening the argument for a new global funding mechanism, as opposed to country-tailored assistance through traditional bilateral or multilateral channels.

The Global Book Alliance, as envisioned in the R4D report, would be a forum for reaching consensus on policy, priorities, and organizational roles (condition 4). Indeed, the success of the new entity would depend in large part on how successful it was in assuming this role.

In addition, both Gavi and the Global Fund were backed from the start by powerful voices and were thus able to attract substantial new resources. If a new book alliance is able to recruit important backers, it might be able to do something similar for books, although it would face a more challenging environment for new aid initiatives.

This comparison suggests that the case for a Global Book Alliance is not as straightforward as for some of the global health funds, especially Gavi. But there are similarities, and, as the R4D report argues, there could be important benefits from a new mechanism that advocates for schoolbooks, brings expertise and best practices together in one place, coordinates technical assistance, and links this to new funding. And if a Global Book Alliance could bring new focus to previously scattered efforts, it might inspire new funding. If it can do these things well, it could make a big difference even if the analogy with the global health funds is far from perfect.

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