The links between health and poverty are clear: Poverty limits people’s ability to access medical care, safe living environments, and sufficient nutrition, the absence of which can have disastrous consequences. Conversely, good health enables employment and income generation. The pandemic will make it harder to achieve the Sustainable Development Goals (SDGs). While 70 percent of the world’s poor already reside in middle-income countries (MICs), the World Bank projects that more than 100 million more people, most of them in MICs, might have fallen below the international poverty line of $1.90/day in 2020.

Foreign aid for health (e.g., COVID-19 vaccine subsidies through COVAX) prioritizes low-income countries over MICs. Income level reported as a national average, the metric often used to determine health aid eligibility or prioritization, fails to capture substantial subnational poverty and inequality. Thus, millions of poor people in MICs might be left behind as donors focus efforts on the poorest countries. Even in high-income countries such as the United States, 1 percent of the population, or nearly 3 million people, were living below the international poverty line in 2016. In most MICs, meanwhile, the poverty rate is much higher and social welfare systems often are not able to provide commensurate support to poor people. Aggregated indicators of health and poverty are imperfect measures for identifying, targeting, and reaching the poorest people.

We want to highlight five things donors can immediately do to ensure people living in poverty benefit from health aid and are not left behind:

  1. Make poverty elimination a central goal.
  2. Have a clear action plan for vulnerable groups.
  3. Operationalize knowledge of reality.
  4. Adopt a systems approach.
  5. Redress power imbalances in how health aid is imagined and delivered.

Read the full article about using health aid to address poverty by Cordelia Kenney, Kaci Kennedy McDade, Wenhui Mao, and Osondu Ogbuoji at Brookings.