In a Lancet opinion piece, Richard Horton, the journal’s editor, writes, “The indifference of all of us — The Lancet too — to those who actually ‘do’ global health in countries raises questions about just what our efforts really achieve. How can global health succeed if it doesn’t listen to those on the front lines of policymaking in countries we profess to care about?” He describes the experiences of an unnamed policy director in an African ministry of health as she attempts to negotiate the challenges of global health funding and development aid.

Horton notes no one responded to World Bank President Jim Yong Kim when he “asked his audience at a [World Health Assembly] technical briefing on the [International Health Partnership (IHP+)] to tell him bad things about the bank.” Horton continues, “But if President Kim had visited a small room in an African ministry of health instead of the Palais des Nations in Geneva, if he had spoken with someone who never speaks to a president or a director general or an executive director of a global agency, and if he had heard one woman’s bitter passion instead of obsequious trivialities at the World Health Assembly, he would have seen a different world from the one his advisers and the international bureaucracy would have him see.” Horton concludes, “It is the same for [WHO Director-General] Margaret Chan, [UNICEF Executive Director] Anthony Lake, and even [U.N. Secretary-General] Ban Ki-moon. Who really tells these people the truth? Do they sit down and really listen to those who know what is happening in countries? And if they do, does anything change as a result of their listening? 15 minutes with the woman from this African country would tell our global health panjandrums a great deal about the world they preside over. And the problems they choose to ignore” (7/13).