Health development agencies are contributing to the status quo of insufficient public health budgets in poor countries, argues Gorick Ooms, Executive Director of the Belgian section of the medical relief agency Mdecins Sans Frontires.

In a provocative Essay in PLoS Medicine, Ooms argues that "development agencies want their interventions to be sustainable." In other words, the country that is receiving health development agency support (the "host country") must have sufficient funding generated from the country's own resources to support these interventions.

But public health budgets in the world's poorest countries, says Ooms, are inadequate and increasing these budgets requires stronger national and international financial commitments. If public health budgets were increased, the level of health care within the capacity of the host countries would be higher.

"Health development advocates assume that public health budgets will not be increased," says Ooms, "and base their sustainability estimations on this assumption. In doing so, they contribute to the status quo of insufficient public health budgets."

Medical relief organizations, on the other hand, are "not driven by health development approaches," he says, but by "a humanitarian impulse; there are overwhelming needs and there is an obligation to respond to those needs."

The "turf battles" between emergency medical relief agencies and health development agencies are senseless, says Ooms. "Health development advocates should not blame medical relief advocates for ignoring concerns about sustainability. The actions of medical relief agencies have nothing to do with ignorance; they are a deliberate choice. The status quo of insufficient public health budgets deserves only a firm rejection."

Citation: Ooms G (2006) Health development versus medical relief: The illusion versus the irrelevance of sustainability. PLoS Med 3(8): e345.