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Pulling it Together: What We Know about Making the Case to the Public for Global Health

Former Senate Majority Leader Bill Frist, who is a member of our Board, recently published a column making the case very effectively for continued investments in global health.  Today we released our latest national survey on attitudes towards global health, which uncovered important nuances about the argument for foreign aid and global health.

When it comes to helping other countries with health, younger people are much more likely to be supportive than older people.  Perhaps that is not surprising but it says something about how globalization has touched younger people, as well as who the most receptive audience is for the global health message.  We can see this in the intense interest in global health in schools of public health and in the interest in global health of the many students I hear from at the Foundation.

One of the strongest predictors of support for global health spending was the belief that aid would make a difference.  This means that documenting the impact of assistance and then communicating that to opinion leaders and the public is absolutely critical for advocates of foreign aid and global health.  We found that the public believes that almost half of every dollar we spend to help other countries is lost through corruption, so this is a formidable challenge.  Based on the evidence I have seen, the public’s perception is a gross over estimate, but perhaps surprisingly, this is not a subject that has been extensively and rigorously studied, especially with regard to U.S. aid.

Another really strong predictor of support for global health spending was knowledge (or misperception).  People who understood that foreign aid represented just a small share of the federal budget — it does actually represent just one percent of the budget — were more likely to support more spending on global health.  The misperception has been documented in our survey and others many times.  What’s more important is the finding that, controlling for other variables, knowledge seems to influence, or at least be closely associated with attitudes.  That is sometimes but not always the case on policy issues.

Those who had travelled to a developing country were also somewhat more likely to support increased U.S. spending, though the effect was smaller.  Combined with the stronger support from young people, this finding suggests that the many college semester and year abroad programs in developing countries could have an impact on attitudes towards global health and foreign aid beyond the personal impact we have all seen them have on young people’s lives.

We also found in the survey, as we have in previous ones, that specifying that the purpose of foreign aid is for health matters.  Fifty four percent of the American people say we are spending “too much” on “foreign aid” whereas only 21% say we are spending too much “to improve health for people in developing countries” (32% said not enough).

pitMARCH_1.gifEducating people about the extent of U.S. foreign aid currently, in addition to its purpose, also has the potential to change opinions.  After we asked people’s initial opinion on the amount of foreign aid spending, we told them that foreign aid represents about one percent of the budget, and found that the share saying we spend too much was cut in half (from 54% to 24%).  The share saying we spend too little more than doubled (from 17% to 36%).The message here is threefold.  First, global health aid has the potential to be relatively popular even if foreign aid is not.  It may not move votes in an election as issues like jobs and the economy can, but it could be a plus instead of a minus for elected officials.  Second, information and public education — to counter misperception — can matter to the level of public support.  But third, whether for foreign aid generally or global health more specifically, the ultimate obstacle to greater public support is the need to make the case effectively that aid is not ripped off and makes a difference.