International aid for health in low- and middle-income nations has doubled over the last five years, and much of the cash flow has come from global health initiatives such as the US President's Emergency Plan for AIDS Relief, according to a recent report by the World Health Organization (WHO). But weaknesses in the health systems of countries receiving aid can limit the potential of these programs, acknowledges the WHO, which recently teamed with the World Bank to address this problem.

“You can give as much money as you want, but [...] without strong health systems we would not achieve our results,” says Nicolas Demey of the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria, which has committed $11.4 billion over the last six years in its worldwide programs.

The WHO and the World Bank plan to help governments and agencies develop specially tailored approaches to get the most out of global health initiatives. “We will generate new evidence to inform discussions and choices at the country and global levels,” explains Olusoji Adeyi, coordinator of public health programs at the World Bank.

But not everyone thinks the WHO–World Bank partnership is a match made in heaven. Legal expert Amir Attaran of the University of Ottawa contends that the World Bank is not a sensible partner for the WHO. “Having the World Bank involved in health systems and delivery, where the WHO has expertise, is about as logical as your general practitioner calling your banker for a recommendation on what medicine to prescribe,” he says. “The best possible solution is to get the World Bank out of this.”