Governance and Health Aid from the Global Fund: Effects Beyond Fighting Disease

Governance (Source: Worldwide Governance Indicators, 2018)
Voice and accountability	The extent to which a country’s citizens are able to participate in selecting their government, as well as freedom of expression, freedom of association, and a free media.
Government effectiveness	The quality of public services, the civil service and the degree of its independence from political pressures, the quality of policy formulation and implementation, and the credibility of the government’s commitment to such policies.
Regulatory quality	The ability of the government to formulate and implement sound policies and regulations that permit and promote private sector development.
Rule of law	The extent to which agents have confidence in and abide by the rules of society, and in particular the quality of contract enforcement, property rights, the police, and the courts, as well as the likelihood of crime and violence.
Control of corruption	The extent to which public power is exercised for private gain, including both petty and grand forms of corruption, as well as “capture” of the state by elites and private interests.
Development & Health
The Human Development Index (HDI)	Summary measure of average achievement in key dimensions of human development: a long and healthy life, being knowledgeable and have a decent standard of living. Source: UNDP, 2018
Adult Mortality Rate (per 1,000)	The probability of dying between the ages of 15 and 60—that is, the probability of a 15-year-old dying before reaching age 60, if subject to age-specific mortality rates of the specified year between those ages. Source: World Bank, 2018

Table 2

Effect of Global Fund Spending on Governance & Development.

Statistical Models	Control of Corruption	Regulatory Quality	Voice & Accountability	Gov’t Effectiveness	Rule of law	Human Development Index	Total Adult Mortality
Statistical Models	• = Significant & Beneficial Effect (e.g. better governance, lower mortality)
Model 1: GF Spending, total Effect of Global Fund spending controlling for national income, political stability and violence, and time	•	•	•		•	•	•
Model 2: Controlling for Other Aid All controls from model 1 & controlling for other aid	•	•	•		•	•	•
Model 3: GF Spending, per capita simple No controls	•	•	•	•	•	•	•
Model 4: GF Spending, per capita + Aid All controls from model 1 using per capita global fund spending & controlling for other aid	•	•			•	•	•
Model 5: Full model Controlling for Baseline Corruption All controls from model 1 using per capita global fund spending & controlling for other aid	•	•	•		•	•	•

Table 3

Global Fund Expenditure Effects on Governance & Development Indicators 2003–2017.

	(1)	(2)	(3)	(4)	(5)	(6)	(7)
Model 5: Total + Controlling for Corruption in 2003
VARIABLES	Control of Corruption	Regulatory Quality	Voice & Accountability	Gov’t Effectiveness	Rule of law	Human Development Index	Total Adult Mortality
Global Fund Expenditure, total	0.0016*** (0.0002)	0.0014*** (0.0002)	0.0019*** (0.0004)	0.0002 (0.0002)	0.0023*** (0.0003)	0.00014*** (0.00001)	–0.321*** (0.036)
National Income	0.0396*** (0.0034)	0.1925*** (0.0081)	0.1126*** (0.0113)	0.2356*** (0.0115)	0.0712*** (0.0062)	0.119*** (0.008)	–60.838*** (9.397)
Political Stability & Absence of Violence	0.1010*** (0.0115)	0.1008*** (0.0088)	0.1468*** (0.0120)	0.0743*** (0.0135)	0.1649*** (0.0073)	0.1188*** (0.0084)	–60.838*** (9.39734)
Bilateral Aid	0.0007*** (0.0002)	–0.0005*** (0.0001)	0.0018*** (0.0003)	–0.0010*** (0.0002)	–0.0001 (0.0002)	0.0084*** (0.0010)	–7.7467*** (2.5293)
Corruption 2003	0.7625*** (0.0129)	0.4688*** (0.0132)	0.4910*** (0.0205)	0.6068*** (0.0105)	0.6360*** (0.0109)	–0.00001 (0.00001)	–0.05552* (0.02931)
Observations	1,368	1,368	1,368	1,368	1,368	1,341	1,268
Number of Countries	112	112	112	112	112	110	112
Year Controls	YES	YES	YES	YES	YES	YES	YES
R2	0.781	0.405	0.313	0.669	0.690	0.696	0.249