Old and new powers in development assistance in health

Development Assistance in Health (DAH) has always been an important component of Official Development Aid (ODA) and has also been considered the “tracing sector” for innovation in the aid system (for example for innovative financing and the establishment of Global Public Private Partnerships). Over the last two decades both the number of actors and their influence in determining the profile and nature of development cooperation policy changed substantially. The emergence of new donors and influencers among both emerging economy countries (both OECD and non-OECD members) and Non State Actors (NSA) substantially contributed to the change of scenario. Multi-stakeholder initiatives and organizations are another spectacular example of the remarkable shift from the traditional international bilateral and multilateral development cooperation system, to an extremely complex global cloud of transnational actors. The chapter uses the health domain to describe the evolution of global aid policies and actors; it analyzes DAH on trends in predominant ideas, resources and their sources, leadership, institutions, DAH channels, and policy networks.