Needless External Funding Dependency: A Death Warrant for Public Health

While global development assistance for health (DAH) is frequently framed as an indispensable humanitarian imperative, heavy institutional reliance on external funding structural mechanisms often compromises state capacity in lowand middle-income countries (LMICs). This paper demonstrates that the prevailing donor-driven, vertical financial model severely disrupts local health ecosystems by diverting critical human resources, institutionalizing structural subordination, and rendering domestic public health systems highly vulnerable to the political, fiscal, and ideological volatility of donor nations. Utilizing a qualitative, case-grounded methodology, this paper applies the sovereign governance and aid-dependency models advanced by Adeyi (2021, 2023) to an illustrative, institutional case study of policy retention and infrastructure stagnation at the Komfo Anokye Teaching Hospital (KATH). By pairing macro-level policy analysis with micro-level institutional outcomes, we analyze how unchecked external funding dependency actively undermines sovereign health governance. The paper concludes by presenting a strategic roadmap for health security rooted in domestic resource mobilization and the enforcement of mandatory donor sunset clauses.