Mirko Heinzel, Mathias Koenig-Archibugi

• Governments have increasingly adopted laws restricting the activities of international non-governmental organizations INGOs within their borders. Such laws are often intended to curb the ability of critical INGOs to discover and communicate government failures and abuses to domestic and international audiences. They can also have the unintended effect of reducing the presence and activities of INGOs working on health issues, and depriving local health workers and organizations of access to resources, knowledge and other forms of support. This study assesses whether legislative restrictions on INGOs are associated with fewer health INGOs in a wide range of countries and with the ability of those countries to mitigate disability-adjusted life years lost because of twenty-one disease categories between 1993 and 2017. The findings indicate that restrictive legislation hampered efforts by civil society to lighten the global burden of disease and had adverse side effects on the health of citizens worldwide.