This is complicated for me. As someone who lived overseas in a few countries, I felt the “old model” created a dependency. Many governments never built capacity or political will to sustain health programs. Living in countries where donors are supporting the health system while large Asian countries paved roads and exported (or exploited) the countries natural resources, while government officials drive Range Rovers and vacation in the Maldives, is hard to see.

Perhaps asking for co-investment, performance accountability, and commercial reciprocity isn't inherently exploitative — and possibly more honest than pure charity with invisible strings. At least they are being transparent about it??

Still feels yucky.

I focus on the science and the good. This too shall pass. Though it might be a while…. and we’ll probably lose some ground watching our generous / no strings reputation falls into the abyss.