In recent years, donors such as the Bill and Melinda Gates Foundation have made an
enormous contribution to the reduction of the global burden of disease. It has been argued
that such donors should prioritise interventions based on their cost-effectiveness, that is to
say, the ratio of costs to benefits. Against this, we argue that the donor should fund not the
most cost-effective interventions, but rather interventions which are just cost-ineffective for
the country, thus encouraging the country to contribute its own domestic resources to the …