Posted by: afedorova | 01/31/2011

Development assistance for health: Is the glass half full or half empty?

No one is safe in the global recession, not even the “darlings of the donors,” as Dr. Chris Murray of the Institute for Health Metrics and Evaluations (IHME) describes them.

As seen in IHME’s latest report: Financing Global Health 2010: Development Assistance and Country Spending in Economic Uncertainty these are the countries that rank high on the list of development assistance for health but at the same time rank lower on the comparison list of countries with the highest disease burden.

At an event today hosted by the Global Health Council, IFC, USAID, the World Bank and the EU Dr. Murray framed the discussion of global health funding around three issues: the main health problems in developing countries, how these societies meet health challenges and policies to maximize the impact of health interventions.

The U.S. is clearly the main donor of health development assistance (public and private funds combined)  and private spending, remittances and contributions from philanthropic organizations such as the Bill & Melinda Gates Foundation now play a key role as well. But as Dr. Jeremiah Norris, a senior fellow at the Hudson Institute, pointed out Official Development Assistance represented 20 percent of total spending (private, public, remittances) in 2004; however by 2008 it dropped to 14 percent.

The Good News For Now:

  • The U.K. preserved its expansion for ODA and the health share of ODA should also stay fairly constant. The Global Fund to Fight AIDS, TB and Malaria (GFATM) replenishment came in with positive pledges of about $11.7 billion dollars, which is an increase compared to the 2009/2010 cycle. The U.S. also disbursed more to the fund as compared to last year.

The Not So Good News

  • Donors are spending less in 2008-2010 than they were in 2007 and the prognosis is that they will cut back even more in the future. The U.S. budget debates also mean it’s unlikely there will be an expansion in spending for ODA. The report from the GFATM auditors on mismanaged funds has already led to Germany, Sweden and Ireland to consider freezing their contributions so the replenishment pledges might not actually translate to money coming in.

What Does It All Mean?

The cuts will be felt the most in the global institutions which act as the channels for disbursing global health assistance (such as GAVI and the GFATM). This will lead to intensified competition between organizations and a move toward multi-sectoral strategies to improving health —taking into account education, infrastructure, water and energy issues— and moving away from the siloed approaches for specific diseases only.

The panelists also pointed out the need for a more coherent approach to funding for key diseases such as HIV/AIDS and malaria, which are very donor dependent and are therefore going to be affected the most.

Three Key Things Which Need To Happen This Year:

  • Proactive response to any accusations of money laundering and funds misallocation
  • Efficient use of investors’ money – greater pressure to demonstrate clear evidence that promises have been met, goals delivered and targets achieved in a strong and convincing way
  • More health for the money – an increase in the efficient use of current funds

Do you agree with the panelists that the glass is actually half full, and the recession will allow us to focus on evidence-driven best practices that make a difference?


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