By: Alanna Shaikh

I’ve gotten a lot of push-back on my post a few weeks ago about the increasing role of corporations in global health. I didn’t mean to imply that’s there is no downside. Corporations do bring new money and new approaches to global health, but they also bring new challenges. Some of these challenges are huge. Here are a few of them:

Corporations are businesses. Their ultimate goal is profit, for owners or shareholders. Their ultimate goal is not, as a rule, making the world a better place. That means, for one thing, that they’re picky about where they will support global health. They want to work in emerging and current markets, where they can gain new customers by publicizing their good deeds.

The need to promote their own role, and get credit for charitable work, has implications beyond where they choose to work. It means substantial budgets being spent on publicizing and discussing global health work rather than doing it. We already see a huge conference-to-work-done ratio in global health efforts. The corporate need for publicity may well make that worse.

This also makes me wonder about long-term, slow-acting development programs. It’s easy to publicize drug donations or hospital building. It’s a lot harder to publicize support to community empowerment programs (and badly done publicity will actually damage a community’s sense of self-reliance, thus negating the effects of any empowerment program) or health sector strengthening efforts.

A lot of the global health programs that matter most aren’t photogenic. They are slow – agonizingly slow – and they show success in tiny stages. They may be about building capacity in the governments of developing countries so they can better support health. They may about changing rules and regulations that govern health care, or about supporting the public – or private – sector to take a larger role in health care provision and expand people’s options for health care. How do you take a picture of that? Who can summarize it in a press release or glossy brochure? Corporate support is likely to go disproportionately to the kind of programs that do fit well in a three-fold-full-color pamphlet.

In the same vein of self-interest, corporations want to work where a healthy population will be to their benefit. That’s why nobody is trying to support global health in Somalia or Chad. There is no percentage there. The percentage is in the countries which are on the rise: Kenya, say, or Ethiopia or Chile. That means that countries which need help the most may not get the attention of business support to global health.

Corporate support to global health also depends on corporate profits. When those profits shrink, support to global health efforts is likely to shrink proportionately. So when the world sees recession, when the poor are hit hardest – will the private sector abandon the cause?

All that being said, I stand by my argument that corporations have made major contributions to global health. There is a substantial list of successes that we’d never have seen without them. No donor is perfect. We can work around the flaws of corporate donors, just as we work around the flaws of all the others.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not neccesarily the views and opinions of the Global Network.