Rather than rewarding efficiency or transparency, traditional donor-funded global health programs have tended to focus on “capacity building,” which prioritizes the development of local institutions and workforce.
Capacity building is shorthand for training clinical health workers, supply chain managers, IT specialists, procurement officers, and more; in other words, creating an infrastructure of professionals in local settings to help build or bolster weak institutions.
Unfortunately, this focus on capacity building overlooks a central challenge: Many of the systems these individuals work in do not reward performance. In contexts where loyalty may be prized over skill, or nepotism can trump transparency, even the best-trained professionals can struggle to apply their training effectively. This will only change with the right incentives.
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About the author
Nicolas Boillot
Nicolas Boillot is co-founder and CEO of SystemOne, a global health software company that provides digital infrastructure for diagnostics and disease surveillance in low- and middle-income countries. He is guiding SystemOne through significant shifts in global health — navigating both challenges and opportunities amid major changes in donor priorities and funding landscapes.
