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Health Data Administration is the data useful resource that medical and IT professionals are leveraging to shape healthcare’s future. The 80-plus international health leaders and staff, current and former consultants at a number of companies, researchers, health care professionals, and NGO staff we spoke to for this story described the consultants as pervasive” and ubiquitous.” And plenty of have become wary of consultants’ involvement within the sector.

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The growing reliance on what are often US consulting corporations, Vox learned, is a symptom of a larger problem at international health organizations: The work is still finished by people in wealthy nations for people in creating countries, too often without their participation.