The role of international health NGOs in international development
Health-related NGOs also provide capacity development in areas of need; that is, helping nations develop sustainable domestic health solutions through training programs. An example of this type of aid is the Center for International Rehabilitation, which has provided rehabilitation training for Iraqi physical therapists, physicians, and rehabilitation clinic managers in Tuzla, Bosnia and Amman, Jordan. These trainees then care for amputees, spinal and head injury patients in their home country.
Many international health NGOs operate in consultative status with the United Nations, allowing them to collaborate directly with UN bodies and the World Health Organization (WHO) to address global health challenges. [6] For example, the International Federation of Red Cross and Red Crescent Societies (IFRC) partners with the UN to provide emergency health services, especially during crises such as the COVID-19 pandemic. [7] The pandemic highlighted the critical role of international health organizations, with entities like the WHO coordinating global responses, including vaccine distribution through the COVAX initiative. [8] In addition, prominent organizations like the Bill & Melinda Gates Foundation work closely with UN-affiliated agencies, focusing on health innovation, such as developing affordable vaccines and strengthening healthcare systems. [9] The Gates Foundation has also partnered with U.S.-based institutions like the Centers for Disease Control and Prevention (CDC) to tackle diseases like malaria and HIV/AIDS, demonstrating a strong connection between international health efforts and U.S. policy priorities. [10] These partnerships underscore the importance of a coordinated global response in achieving sustainable health outcomes, particularly in times of crisis.
Medical NGOs vs. other national health systems
NGOs often complement national healthcare systems by addressing gaps that government-run programs cannot adequately fill, particularly in low-resource settings. National systems, constrained by budget limitations, bureaucratic inefficiencies, or geographic inaccessibility, may fail to provide equitable healthcare access to marginalized populations. NGOs, operating with more flexibility, can bridge these gaps by delivering targeted services in areas of critical need, such as rural regions or underserved urban communities. [11] For example, NGOs frequently focus on areas like maternal health, infectious disease prevention, and emergency response where national systems may be lacking. [12]
Unlike national systems, which are often subject to political priorities or limited by systemic inefficiencies, NGOs can mobilize international funding, deploy innovative solutions, and adapt their approaches to the specific needs of local populations. This role became especially evident during the COVID-19 pandemic, where NGOs partnered with governments to distribute vaccines, provide community education, and support overwhelmed healthcare facilities. However, while NGOs play a vital role in strengthening healthcare systems, their efforts are not a replacement for sustainable government action. Excessive reliance on NGOs can sometimes undermine national systems by creating parallel structures that draw resources and skilled personnel away from the public sector. A cooperation between sectors is vital to the continuing effort of achieving health equity.
NGOs vs. missionaries
One important characteristic of NGO work is that, in the "pure" sense, they provide services based solely upon need, without political, ethnic, religious, or other considerations. Thus, strictly speaking, religious missionary organizations that perform services as part of a proselytizing or evangelical campaign should be separated from the NGO category and simply be referred to as religious missionary organizations. Some religious relief organizations do provide services more as a duty or "charity", however, without requirements for the recipients to attend any preaching, prayer or other religious preconditions.
American efforts in international health
The U.S. Department of Defense
In another teamwork effort, the Assistant Secretary of Defense (Health Affairs) of the United States Department of Defense, as the DoD's senior medical officer, established the International Health Division in late 2007 to help coordinate military health doctrine and practices in international development. The International Health Division places great emphasis upon working with NGOs to provide sustainable, culturally-appropriate development activities around the world. While critics maintain that DoD does not provide aid equitably and without regard to political influence, the Asian tsunami of December, 2004 (due to the 2004 Indian Ocean earthquake) demonstrated that DoD was capable of working in a supporting role without regard to geopolitical gain. Indeed, the DoD was surprised at the unexpected degree of improvement in American prestige as a result of its role in Southeast Asia and months later, in the Pakistan earthquake. A similar event resulted in rapid mobilization of DoD resources in response to the 2007 Peru earthquake, Bangladeshi Typhoon Sidr [15] and Tropical Storm Nero in the Dominican Republic, all in the last half of 2007, with no reasonable expectation of material gain for America.
In 2005, then-Secretary of Defense Donald Rumsfeld signed DoD Directive 3000.05, "Stability, Security, Transition and Reconstruction Operations". [16] This document requires the DoD to assign Stability, Security, Transition and Reconstruction (SSTR) the same importance in planning and preparation as it gives to war.
The rationale for SSTR is intuitive: stability promotes rule of law and economic development. These provide the base for essential services such as education, public health and sanitation, law enforcement and fire suppression. Essential services, in turn, lead to increased stability and economic opportunity. Health in the general population, and in particular the labor force, is essential to productivity and consequent stability. [17]
Although these relationships are not necessarily linear, and there is no inherent guarantee of equitable distribution of wealth in a developing society, full employment and hope for the future may be powerful disincentives to conflict. In this way, the DoD, through SSTR operations, expects to prevent some potential conflicts and criminal activities.
The International Health Division, charged with policy implications of DoDD 3000.05, is located within the Office of the ASD(HA), reporting through Force Health Protection & Readiness. International Health develops DoD's policy on medical ethics and the practice of medicine in international health and development settings. International Health also identifies needs in developing nations and looks for non-governmental organizations (NGOs), intergovernmental organizations, and private voluntary organizations (PVOs) such as professional societies, that have the ability and expertise to address these problems. In this way, the NGOs develop helping relationships with the nations or regions they work in, fostering stability and sustainability.
Other DoD international health activities occurring on a regular basis include medical civic action projects (MEDCAPs), in which Army, Navy or Air Force medical assets provide direct care, sanitation, and other public health services to host nation (HN) locals. Such MEDCAPs are generally traced to the Vietnam War, when medical units and medical personnel assigned to combat units would organize field medical care to Vietnamese, Hmong and others. There is a growing realization among the military that MEDCAP care may not be the best model, if the result is merely handing out antibiotics for upper respiratory infections and anti-inflammatories for aches and pains. However, projects such as de-worming, dentistry, prenatal education and care, and veterinary care, when performed in conjunction with HN health authorities and the local health infrastructure, have indisputable and long-lasting benefits to the recipients.
Similar to MEDCAPs, the military performs Medical Readiness Training Exercises (MEDRETEs), Joint Combined Exchange Training (JCET), and Humanitarian-Civic Action (HCA) exercises, all of which may have direct and indirect services as a feature of the training.
Finally, the military has unparalleled logistical and lift capabilities to respond to humanitarian assistance/disaster response(HADR) needs.
In conjunction with the Uniformed Services University of the Health Sciences (USUHS), the Center for Disaster and Humanitarian Medicine (CDHAM) develops curriculum, teaches disaster and humanitarian assistance principles to graduate, medical, and post-doctoral students and publishes courses on incident command and other related topics. The handbook on military-NGO relations, "A Guide to Non-Governmental Organizations for the Military" is available free on-line.
A non-governmental organization (NGO) is an independent, typically nonprofit organization that operates outside government control. NGOs often focus on humanitarian or social issues but can also include clubs and associations offering services to members. Some NGOs, like the World Economic Forum, may also act as lobby groups for corporations. Unlike international organizations (IOs), which directly interact with sovereign states and governments, NGOs are independent from them.
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.
Humanitarian aid is material and logistic assistance, usually in the short-term, to people in need. Among the people in need are the homeless, refugees, and victims of natural disasters, wars, and famines. The primary objective of humanitarian aid is to save lives, alleviate suffering, and maintain human dignity.
Medical Aid for Palestinians (MAP) is a British charity that offers medical services in the West Bank, Gaza and Lebanon, and advocates for Palestinians' rights to health and dignity. It is in special consultative status with ECOSOC since 2002.
A humanitarian crisis is defined as a singular event or a series of events that are threatening in terms of health, safety or well-being of a community or large group of people. It may be an internal or external conflict and usually occurs throughout a large land area. Local, national and international responses are necessary in such events.
Humanitarian assistance is aid and action designed to save lives, alleviate suffering, and maintain human dignity during and after man-made crises and disasters. It encompasses a wide range of activities, including providing food, water, shelter, medical care, and protection. Humanitarian assistance is grounded in the principles of humanity, impartiality, neutrality, and independence.
Disaster response refers to the actions taken directly before, during, or immediately after a disaster. The objective is to save lives, ensure health and safety, and meet the subsistence needs of the people affected. It includes warning and evacuation, search and rescue, providing immediate assistance, assessing damage, continuing assistance, and the immediate restoration or construction of infrastructure. An example of this would be building provisional storm drains or diversion dams. Emergency response aims to provide immediate help to keep people alive, improve their health and support their morale. It can involve specific but limited aid, such as helping refugees with transport, temporary shelter, and food. Or it can involve establishing semi-permanent settlements in camps and other locations. It may also involve initial repairs to damage to infrastructure, or diverting it.
The right to health is the economic, social, and cultural right to a universal minimum standard of health to which all individuals are entitled. The concept of a right to health has been enumerated in international agreements which include the Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, and the Convention on the Rights of Persons with Disabilities. There is debate on the interpretation and application of the right to health due to considerations such as how health is defined, what minimum entitlements are encompassed in a right to health, and which institutions are responsible for ensuring a right to health.
An international non-governmental organization (INGO) is an organization which is independent of government involvement and extends the concept of a non-governmental organization (NGO) to an international scope. INGOs can admit members affiliated to government authorities as long as it does not interfere with their freedom to express themselves. INGOs operate under the principles of neutrality, humanity, impartiality, and independence. Around the world, there are about 75,000 international organizations and about 42,000 of them are active.
The Malaysian Red Crescent (MRC) is a voluntary humanitarian organization that seeks to promote humanitarian values, as well as provide service and public education in disaster management, as well as healthcare in the community. It is part of the International Red Cross and Red Crescent Movement.
Heart to Heart International is a global humanitarian organization based in Lenexa, Kansas with a mission of seeking to improve healthcare access around the world by ensuring quality care is provided equitably in medically under-resourced communities and in disaster situations.
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.
Due to the near-universal desire for safe, effective, and high quality healthcare, there is a growing interest in international healthcare accreditation. Providing healthcare, especially of an adequate standard, is a complex and challenging process. Healthcare is a vital and pervasive issue; it influences all aspects of societies. It has medical, social, political, ethical, business, and financial ramifications. In any part of the world healthcare services can be provided either by the public sector or by the private sector, or by a combination of the two. Healthcare can be provided in hospitals or be accessed through practitioners working in the community, such as general medical practitioners and dental surgeons.
IsraAID is an Israel-based non-governmental organization that responds to emergencies all over the world with targeted humanitarian help. IsraAID was founded by Shachar Zahavi and Mully Dor. This includes disaster relief, from search and rescue to rebuilding communities and schools, to providing aid packages, medical assistance, and post-psychotrauma care. IsraAID has also been involved in emergency response and international development projects in more than 60 countries, with focuses on Water, Sanitation & Hygiene, public health and medical care education, and mental health and protection.
Healthcare in Malawi and its limited resources are inadequate to fully address factors plaguing the population, including infant mortality and the very high burden of diseases, especially HIV/AIDS, malaria and tuberculosis.
Healthcare in the State of Palestine refers to the governmental and private healthcare providers to which residents in the claimed territory have access. Since 1967, there have been improvements in the access to healthcare and the overall general health conditions for residents. Advances in training, increased access to state-of-the-art medical technology, and various governmental provisions have allowed per-capita funding to increase, and therefore the overall health of residents in the region to increase. Additionally, the enhanced access to and funding from international organizations like the World Health Organization, the United Nations, the Palestinian Ministry of Health, and the World Bank Education and Health Rehabilitation Project have contributed to the current state of affairs within the healthcare segment of the Palestinian territories.
The International Hospital Federation (IHF) is an independent, not-for-profit, non-governmental organization based in Bernex, Switzerland. The IHF is a global membership association for hospital management that assists leaders of healthcare organizations and facilities in improving the standard, quality, and level of service delivery to improve the healthcare outcomes of people all over the world. The IHF provides a platform for the global healthcare community to share knowledge, ideas, and experiences, as well as identify international partnerships and collaboration opportunities. The IHF also represents the voice of hospitals and health systems on the global stage in initiatives, research, and joint statements with other global institutions and NGOs. Furthermore, the IHF established the Geneva Sustainability Centre in 2022 in response to the need for hospitals and healthcare services to address climate change.
Organizations from around the world responded to the West African Ebola virus epidemic. In July 2014, the World Health Organization (WHO) convened an emergency meeting with health ministers from eleven countries and announced collaboration on a strategy to co-ordinate technical support to combat the epidemic. In August, they declared the outbreak an international public health emergency and published a roadmap to guide and coordinate the international response to the outbreak, aiming to stop ongoing Ebola transmission worldwide within 6–9 months. In September, the United Nations Security Council declared the Ebola virus outbreak in the West Africa subregion a "threat to international peace and security" and unanimously adopted a resolution urging UN member states to provide more resources to fight the outbreak; the WHO stated that the cost for combating the epidemic will be a minimum of $1 billion.
Evidence Aid is an international platform that was formed out of the need to deliver time sensitive access to systematic reviews for use in the event of disasters and other humanitarian emergencies. The method of using systematic reviews is to provide evidence for use by policy makers, clinicians, regulators, and even the general public who benefit when these materials are easy to understand and are accessible. The vision of Evidence Aid is to create and satisfy an increasing demand for evidence to improve the impact of humanitarian aid by stimulating the use of an evidence-based approach. Evidence Aid was founded in 2004. It is currently a project that is housed by the Cochrane Collaboration and Queen's University Belfast. Evidence Aid was established by several members of the international Cochrane Collaboration following the 2004 Indian Ocean earthquake and tsunami. Evidence Aid was formed to provide systematic reviews on the effects of interventions and actions of relevance prior to, in the course of and during the aftermath of disasters or other humanitarian emergencies, in order to improve health-related outcomes; their aim is to work with those who need and use this evidence, as well as working with researchers and publishers to facilitate freely accessible materials to meet the information needs for those facing humanitarian emergencies and disasters. Evidence Aid works in collaboration with other organizations including Public Health England; Red Cross Flanders, International Rescue Committee; Centers for Disease Control; Centre for Evidence-Based Medicine; and the University of Oxford.
