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A new article in PLOS Medicine says large donors have a major influence on which health issues get funded. The author says it’s an attempt by governments and others to exert more control over international agencies. Oxford University’s Dr. Devi Sridhar says large donors have shifted to a practice called multi-bi financing. “Multi-bi financing is funds that at first glance look multilateral. They’re given to multilateral agencies. You know, the WHO, the World Bank or new initiatives that look multilateral at the surface, but that actually have more characteristics that are bilateral in that they’re often earmarked. They’re often limited in duration. It’s this new area and it’s been growing. It’s been estimated to account for 40 percent of total multilateral funding,” she said. Agencies like the World Health Organization are relying more on this type of funding, rather than on a standard annual budget. In fact, Sridhar said almost 80 percent of the WHO’s budget comes from voluntary contributions, which would be classified as multi-bi financing. “Within the World Health Organization, there have been concerns raised, particularly by developing countries and emerging countries such as Brazil, over how much influence voluntary contributions are having, rather than the assessed budget – what countries are required to pay each year through kind of a U.N. formula,” she said. Sridhar is a university lecturer in Global Health Politics and co-director of the Center for AIDS Interdisciplinary Research. She said the major donors are the U., Britain, Japan, the European Commission and the Bill and Melinda Gates Foundation. | 
