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  3. The money is there. So why is it not being spent? That is the big puzzle about the rich world’s efforts to improve health in poo

The money is there. So why is it not being spent? That is the big puzzle about the rich world’s efforts to improve health in poo

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问题     The money is there. So why is it not being spent? That is the big puzzle about the rich world’s efforts to improve health in poor countries. In June the leaders of the G8 promised up to $8 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria, an umbrella group coordinating health aid. The Global Fund closed its latest round of funding applications this week but much of the money committed remains unused. Officials at the fund insist that all is fine: disbursements always lag commitments and money can be released only if it will be spent effectively. But experts such as Joseph Dwyer of Management Sciences for Health say that the pitiful state of poor countries’ health services is the main reason for the gap between what is promised and what is spent. Julian Schweitzer of the World Bank says that physical and human shortages in local health services represent "a huge bottleneck to aid".
    Now the aid efforts may be making things worse. Jordan Kassalow of the Scojo Foundation, an American charity, observes that rich single-issue outfits tend to divert the best medical talent to trendy causes and away from basic medicine against diarrhoea and respiratory infections—the chief killers of children.
    Laurie Garrett of the Council on Foreign Relations has a different worry: those anti-corruption efforts have pushed donors into an obsession with often meaningless short-term targets. The result is a never-ending stream of documents and meetings. A sharp focus on process and targets ordained from on high makes it harder to be flexible and innovative or to take advantage of enterprising locals. In poor countries, laments Ms Garrett, "we almost spit on the private sector."
    But it is the private sector that may offer the most practical chance of progress. Fed up with the costs of an unhealthy workforce, many big local and multinational firms in Africa and Asia are now offering their own innovative health schemes. These started as simple anti-AIDS efforts at mining firms such as Anglo American. Now they have spread. HSBC, a London-based international bank, recently started a scheme to improve its suppliers’ and customers’ health.
    In training, too, private-sector and voluntary efforts may work better than official programmes. The International Centre for Equal Healthcare Access has trained thousands of local health-care workers in South-East Asia. Kenya’s HealthStore Foundation has helped nurses and community health workers set up dozens of for-profit clinics that reach patients government clinics don’t. Such ideas may yet transform the world’s most dilapidated health systems into better and more far-reaching ones—if only the current wave of top-down spending does not drown them out.
According to some experts, Global Fund delays the disbursements because
选项 A、there remains a huge gap between what is promised and what is spent.
B、the $8 billion can’t be released until it will be spent effectively.
C、the situation of health-care in poor countries presents a tough barrier.
D、the physical condition of local people imposes a bottleneck to aid.
答案C
解析 事实细节题，考查因果细节。根据Global Fund定位到第一段。题干中because是因果标志性词汇，解题关键是找到相应词汇main reason，该句提到：“穷国糟糕的医疗卫生状况是导致承诺援助金额与实际拨款金额之间巨大差距的主要原因”，故选C项。
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