No Time to Fight, People Are Dying Out There: The Impact of Elite Polarization on Developmental Assistance for Health Available to Purchase

The factors influencing donor countries’ overall contributions to developmental assistance for health (DAH) are little known, despite the importance of DAH in improving health conditions in low- and middle-income countries. This study examines how political elite polarization in legislative branches affects DAH commitments and disbursements from country-members of the OECD’s Development Assistance Committee. From a world-society perspective, political polarization may decouple DAH contributions from global health funding norms and values. I test the impact of polarization on DAH commitments and disbursements using two-way fixed-effects regression analyses on multiple data sets and a new index of right–left elite polarization. I find that polarization is negatively associated with DAH disbursements but shows no significant relationship with DAH commitments. This suggests that elite polarization in donor countries impedes legislative efficiency, potentially increasing DAH disbursement volatility, and (more broadly) that political dynamics in donor countries can significantly impact the stability of global health financing. These findings have important implications for understanding the challenges in sustaining consistent DAH funding, especially from Development Assistance Committee members.