Methodology to assess volumes and patterns of official development assistance (ODA) for health and HIV services: the reality of European governments' financial.

Methodology to assess volumes and patterns of official development assistance (ODA) for health and HIV services: the reality of European governments'

financial contributions for the HIV response in developing countries in the period of 2007-2009

Marco Simonelli1, Joachim Rüppel2, Olga Golichenko3, Sieglinde Mauder2

1ActionAid Italy / Action for Global Health, Rome, Italy, 2Medical Mission Institute, Wurzburg, Germany,3International HIV/AIDS Alliance / Action for Global Health, Hove, United Kingdom

ODA Definition and CriteriaOfficial Development Assistance (ODA) is defined as those flows to developing countries and multilateral institutions provided by official agencies, including state and local governments, or by their executive agencies, each transaction of which meets the following tests: • it is administered with the promotion of the

economic development and welfare of developing countries as its main objective;

• it is concessional in character and conveys a grant element of at least 25 per cent.Source: OECD-DAC 2

Aid ActivitiesAid activities include:• projects and programmes• cash transfers• deliveries of goods• training courses• research projects• debt relief operations• contributions to non-governmental

organizations.3

Necessary Dimensions of ODA Analysis

This research attempts to analyse the volume of the Official Development Assistance (ODA) on the part of the 17 European countries belonging to the DAC (Development Assistance Committee / OECD) on the following levels: • Total volume of resources differentiating between official

figures and real resource transfers• ODA contributions for health promotion, and finally• ODA contributions for specific interventions to confront

HIV

A comprehensive and objective assessment of donor contributions for the response to the epidemic cannot focus solely on the aid for specific programmes of HIV prevention, treatment and support

Considering all Relevant Funding Channels or Mechanisms

• Bilateral flows (provided directly by a donor country to an aid recipient country)

• Multilateral flows (channelled via an international organization active in development e.g. World Bank, UN Organizations, Global Fund, etc.)

• Funding channelled via the European Commission represents a special case, but is subsumed by DAC/OECD as multilateral

5

Multilateral Health Financing Organizations

• IDA/World Bank• World Health Organization• UNAIDS (Unified Budget and Work Plan)• UNDP (United Nations Development Programme)• UNFPA (United Nations Population Fund)• UNICEF (United Nations Children's Fund)• Global Fund to Fight AIDS, Tuberculosis and Malaria• UNITAID• GAVI Alliance• International Finance Facility for Immunisation (IFFIm)• Advance Market Commitments (AMC)• African Development Fund• Asian Development Fund

Multilateral Health Financing Organizations, continued

• Drugs for Neglected Diseases initiative (DNDi)• Medicines for Malaria Venture (MMV)• Global TB Alliance • International Partnership for Microbicides (IPM)• International Initiative for AIDS Vaccine (IAVI)• World Food Program (WFP)• International Committee of the Red Cross• International Planned Parenthood Federation (IPPF)• Other…

Classification of Projects according to Needs Assessments developed by Millennium Project

(Health Sector) and UNAIDS (HIV Response)

Health funding needs include:• the cost of running a health system offering essential

medical interventions, such as emergency obstetric care, treatment for the major infectious diseases, and interventions to reduce child mortality.

• interventions primarily provided outside the health system, such as preventing major diseases and mitigating the social impact

8

Relevant Information SourcesSource Purposes and Contents

CRS Aid Activity database of DAC/OECD

Basic data on (sub-)sectors, recipients, policy issues and financial volumes on a disaggregated level, i.e. for individual activities, for bilateral and most multilateral organizations

DAC Statistics database Comprehensive data on the volume, origin andtypes of aid and resource flows on an aggregated level

World Bank Project Database

Data on recipients, sources, amounts of commitments and financial share of up to 5 sectors, as well as other aspects

Global Fund Pledges and Contributions Tables

Pledges made and contributions paid and unpaid for Global Fund

Annual Reports of Inter-national Organizations

Contributions paid to UN organizations, UNITAID, GAVI, etc. by donor; in some cases breakdowns by sector or theme

World Health Assembly Documentation

Status of collection of annual regular budget assessed contributions

National Health Accounts (NHA)

General government expenditure on health as % of total government expenditure

9

Methodological Features• The project-level information system of DAC/OECD

constitutes the most important basis for the analysis• Examination of every single aid activity reported in the

health and population sectors in order to determine the main purposes (linking activities over the years)

• Insufficient or contradictory data are complemented through web-based research and direct communication with implementing agencies

• Health-relevant projects recorded in other sectors are identified via text search and scrutinized accordingly

Result: consolidated and structured list of pertinent projects correcting for misclassifications, reporting errors and double counting

Examples of Reporting Problems

Other flows recorded as Health Projects: Annual Action Programme for the Thematic Programme on Cooperation in the Area of Migration and Asylum for 2009, Commitment: 60.3 million US$Population Census support initiative,Disbursement in 2009: 1 million US$Recherche et analyse démographique Total Disbursements in 2009: 7 million US$Programa de Apoyo a la Política Nacional de Seguridad Alimentaria Nutricional (Food Security)Disbursement in 2009: 12.5 million US$

Examples of Reporting Problems

Other flows recorded as HIV control: Total commitment of 30 million Euros: 24 million

sector budget support, 3 million for technical assistance to the Ministry of Health, and 3 million to help the National AIDS Council (imputed HIV support: 5.7 million Euros or 19%)

Co-Financing Health Sector Budget SupportDisbursement in 2009: 8.4 million US$

General medical and laboratory equipment, laboratory infrastructure and laboratory design componentsDisbursements in 2009: 24.8 million US$

Examples of Reporting Problems

Core contributions to international organizations recorded as bilateral aid (potential double counting):

France for UNITAIDDisbursements in 2008: 207.7 million US$

Germany for UNAIDSDisbursement in 2009: 4.9 million US$

United Kingdom for International Partnership on MicrobicidesDisbursement in 2009: 9.8 million US$

Examples of Reporting Problems

HIV Components not recorded as HIV control:European and Developing Countries Clinical Trials Partnership (EDCTP), to help facilitate and develop clinical trials for new drugs and vaccines against HIV/AIDS, malaria and TBTotal disbursement in 2007: 53.6 million US$, imputable HIV contribution: 32.2 million US$

Higher Education HIV & AIDS (HEAIDS)Disbursement in 2007: 0.7 million US$

Emergency Food Aid for HIV/AIDS-patientsDisbursements in 2009: 1 million US$

General ODA• OECD-accepted ODA includes expenditure items and

accounting entries that do not represent real transfers of financial, technical or personnel resources, namely debt relief, imputed student costs, administrative costs and expenditure for refugees in donor countries

• Some European DAC countries provide a considerable part of their ODA in the form of loans, a practice that contravenes the orientation towards needs.

• Real ODA Grant Transfers after deducting these questionable items show great differences and are in many cases significantly lower than official figures

-860 -979-1,525

-1,034 -993 -900 -847

2,322 2,211 2,544 2,691 3,060 3,421 3,344

188 207151 88

159

666 6511,799 1,758

2,176 2,2322,147

1,722 2,206496 658

764 733

1,329

1,8731,859

1,412

2,706

2,789

1,094

675

1,0091,290

-2,000

-1,000

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

11,000

12,000

2004 2005 2006 2007 2008 2009 2010

Administrative Costs

Refugees in donor countriesImputed student costs

Debt Relief

Bilateral Loans

Bilateral Grants (real Transfers)Multilateral Loans

Multilateral Grants

Repayments (negative amount)

Evolution of France'sODA 2004-2010:

Composition ofGross Disbursementsand Repayments from Recipients

Euro Million

Data for multilateral loans in 2010 arenot available yet and were calculated on the basis of the proportions of loans in the previous year

0.41%

0.47% 0.47%

0.38% 0.39%

0.47% 0.50%

0.24% 0.23% 0.23%0.25%

0.29%0.35% 0.37%

0.20%0.18% 0.18%

0.20% 0.21% 0.22%0.24%

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

2004 2005 2006 2007 2008 2009 2010

DAC standard

Real Transfers

Grants only

Evolution of France'sODA in relation to Gross national Income:

ODA ratios according to different modes of calculation

Collective Intermediate Target of EU: 0.56% of GNI

Minimum Target of EU: 0.51% of GNI

-934 -843 -1,053 -927 -890 -868 -1,011

2,9942,120

2,709 3,171 3,410 3,578 3,556

2,190

2,536

2,7692,849

3,3513,826 4,071583

573

854917

1,145

1,158

1,914

397

2,802

2,1212,066

1,778 61

125

-2,000

-1,000

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000

11,000

12,000

2004 2005 2006 2007 2008 2009 2010

Administrative Costs

Refugees in donor countriesImputed student costs

Debt Relief

Bilateral Loans

Bilateral Grants (real Transfers)Multilateral Loans

Multilateral Grants

Repayments (negative amount)

Evolution of Germany'sODA 2004-2010:

Composition ofGross Disbursementsand Repayments from Recipients

Euro Million

0.28%

0.36% 0.36% 0.37% 0.38%0.35%

0.38%

0.22%0.19%

0.23%0.25%

0.28% 0.31% 0.34%

0.19%0.17%

0.19%0.21%

0.23%0.27% 0.26%

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

2004 2005 2006 2007 2008 2009 2010

DAC standard

Real Transfers

Grants only

Evolution of Germany'sODA in relation to Gross National Income:

ODA ratios according to different modes of calculation

Collective Intermediate Target of EU: 0.56% of GNI

Minimum Target of EU: 0.51% of GNI

0.36%

0.47%0.51%

0.36%

0.43%

0.51%

0.56%

0.30% 0.30%

0.35%0.33%

0.39%

0.49%

0.54%

0.28% 0.29%

0.33%0.30%

0.36%

0.46%

0.51%

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

2004 2005 2006 2007 2008 2009 2010

DAC standard

Real Transfers

Grants only

Evolution ofUnited Kongdom'sODA in relation to Gross National Income:

ODA ratios according to different modes of calculation

Collective Intermediate Target of EU: 0.56% of GNI

Minimum Target: 0.51% of GNI

0.45% 0.44%0.41%

0.44%0.46% 0.48%

0.30% 0.31%0.33%

0.36%0.40%

0.41%

0.28% 0.28% 0.30%0.33%

0.36% 0.36%

0.00%

0.10%

0.20%

0.30%

0.40%

0.50%

0.60%

0.70%

2005 2006 2007 2008 2009 2010

DAC standard

Real Transfers

Grants only

as a % of GNI

Evolution of EuropeanDAC member's ODAin relation to Gross National Income:

ODA ratios according to different

Collective Intermediate Target of EU: 0.56% of GNI

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2005 2006 2007 2008 2009 2010

DAC standard

Real Transfers

Grants only

GNI

Share of EuropeanDAC member's ODAin relation to all DAC Members

0.13%

0.13%

0.17%

0.24%

0.24%

0.26%

0.30%

0.33%

0.46%

0.49%

0.50%

0.51%

0.67%

0.80%

0.85%

0.92%

1.04%

0.13%

0.14%

0.27%

0.24%

0.36%

0.34%

0.38%

0.34%

0.47%

0.50%

0.50%

0.54%

0.67%

0.81%

0.85%

0.94%

1.04%

0.00% 0.10% 0.20% 0.30% 0.40% 0.50% 0.60% 0.70% 0.80% 0.90% 1.00% 1.10%

Greece

Italy

Portugal

Austria

France

Germany

Spain

Switzerland

Belgium

Finland

Ireland

United Kingdom

Netherlands

Denmark

Sweden

Norway

Luxembourg

Official Development Assistance of European DAC Member Countries:Real ODA Transfers and Grants in relation to Gross National Income (GNI)

Real Transfers

Grants only

MinimumRatio of EUfor 2010: 0.51%

UN Targetsince 1970: 0.7%

ODA for Health• Only four out of 17 countries (Luxemburg, Norway,

Sweden and Ireland) reached in 2009 the target level of 0.1% recommended by the Commission on Macroeconomics and Health

• Only the first three countries achieved the target of 0.12% of GNI based on the assumption that European DAC countries cover at least 50% of financing needs

• The main part of the European gap results from the fact that most of the larger economies (Germany, France, Italy, Spain) fall far short of the targets

• The extremely low contributions from some medium-sized economies (Austria, Switzerland) also have a considerable negative impact

2007 2008 2009Share in %

2007 2008 2009 2007 2008 2009 2007 2008 2009

Specific HIV Interventions 59.2 110.0 115.5 100% 59.2 110.0 115.5 57.6 104.6 112.5 1.6 5.4 2.9

Projects of Reproductive Health 15.9 31.6 65.1 25% 4.0 7.9 16.3 15.9 31.4 58.1 0.0 0.1 7.0

Health Sector Programmes 167.8 227.3 221.3 10% 16.8 22.7 22.1 166.9 215.5 218.0 0.9 11.8 3.2

Child health 0.0 0.6 3.5 10% 0.0 0.1 0.3 0.0 0.6 3.4 0.0 0.0 0.1

Immunisation 83.8 66.2 73.9 0% 0.0 0.0 0.0 83.8 66.2 73.9 0.0 0.0 0.0

Other Health Problems 24.4 35.5 40.6 0% 0.0 0.0 0.0 23.8 35.4 40.6 0.6 0.1 0.0

ODA for Specific Health Projects 351.1 471.2 519.9 XXX 79.9 140.7 154.2 348.1 453.7 506.6 3.1 17.5 13.2

General Budget Support 10.8 20.1 19.4 10% 1.1 2.0 1.9

Total Bilateral ODA for Health 361.9 491.3 539.2 XXX 81.0 142.7 156.2

Memo: Emergency Projects 0.0 0.0 0.0 XXX na na na

Memo: Multilateral shown separately 22.6 22.4 7.4 XXX na na na

Memo: Other Sectors recorded as Health 9.4 3.8 4.2 XXX na na na

Share of Bilateral Real ODA 6.8% 6.2% 6.8% XXX 1.5% 1.8% 2.0%

Germany's Bilateral ODA Contributions for Health Promotion and the Response to the HIV Epidemic (US$ millions)

CommitmentsRecorded in Health

SectorsRecorded in Other

Sectors

Category of Aid Activity

Contributions for Health Contributions for HIV Response Total Contributions Total Contributions

2007 2008 2009Share in %

2007 2008 2009 2007 2008 2009 2007 2008 2009

Specific HIV Interventions 75.0 85.2 91.4 100% 75.0 85.2 91.4 73.0 82.3 88.3 2.0 2.8 3.1

Projects of Reproductive Health 40.0 30.1 36.6 25% 10.0 7.5 9.2 38.2 28.2 34.5 1.8 1.9 2.2

Health Sector Programmes 141.6 188.9 218.1 10% 14.2 18.9 21.8 140.3 177.1 212.2 1.2 11.8 5.9

Child health 0.5 2.0 4.2 10% 0.0 0.2 0.4 0.5 2.0 4.2 0.0 0.0 0.0

Immunisation 40.5 65.4 27.1 0% 0.0 0.0 0.0 40.5 65.4 27.1 0.0 0.0 0.0

Other Health Problems 25.7 29.6 30.0 0% 0.0 0.0 0.0 25.7 29.5 30.0 0.0 0.1 0.0

ODA for Specific Health Projects 323.2 401.1 407.3 XXX 99.2 111.8 122.8 318.1 384.5 396.1 5.1 16.7 11.2

General Budget Support 10.5 7.8 19.6 10% 1.0 0.8 2.0

Gross Bilateral ODA for Health, total 333.7 408.9 426.8 XXX 100.2 112.6 124.7

Imputable Repayments -37.5 -38.2 -36.5 XXX -0.1 -0.1 -0.1

Net Bilateral ODA for Health, total 296.2 370.7 390.4 XXX 100.1 112.5 124.6

Memo: Emergency Projects 0.0 0.0 0.0 XXX na na na

Memo: Multilateral shown separately 25.7 13.2 14.3 XXX na na na

Memo: Other Sectors recorded as Health 6.3 7.9 14.3 XXX na na na

Share of Bilateral Real ODA 7.8% 7.3% 7.0% XXX 2.6% 2.2% 2.2%

Category of Aid Activity

Contributions for Health Contributions for HIV Response Total Contributions Total Contributions

DisbursementsRecorded in Health

SectorsRecorded in Other

Sectors

Germany's Bilateral ODA Contributions for Health Promotion and the Response to the HIV Epidemic (US$ millions)

2007 2008 2009 2010 2007 2008 2009 2010 2007 2008 2009 2010 2007 2008 2009 2010 2007 2008 2009 2010

Europ. Union 2,452.3 2,812.6 2,891.0 2,926.0 200.1 224.1 199.2 201.6 60.8 56.3 41.6 42.1 8.2% 8.0% 6.9% 6.9% 2.5% 2.0% 1.4% 1.4%

IDA / World Bank 1,097.1 1,135.8 1,029.7 691.92 116.0 118.2 95.3 56.9 36.5 37.8 23.5 17.7 10.6% 10.4% 9.3% 8.2% 3.3% 3.3% 2.3% 2.6%

WHO core 29.4 30.9 31.1 30.2 29.4 30.9 31.1 30.2 2.7 2.9 3.0 2.9 100.0% 100.0% 100.0% 100.0% 9.1% 9.5% 9.5% 9.5%

UNAIDS 1.6 2.7 5.1 3.6 1.6 2.7 5.1 3.6 1.6 2.7 5.1 3.6 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

UNDP 47.0 40.7 38.4 29.5 1.7 1.4 1.5 1.2 1.6 1.2 1.5 1.1 3.7% 3.3% 4.0% 4.0% 3.5% 3.0% 3.8% 3.8%

UNFPA 25.7 26.0 25.1 19.5 21.5 21.4 18.0 14.0 7.5 8.4 7.7 6.0 83.7% 82.3% 71.7% 71.7% 29.2% 32.3% 30.5% 30.5%

UNICEF 6.1 8.3 9.1 8.2 1.2 1.5 2.1 1.9 0.4 0.5 0.5 0.5 19.4% 17.7% 23.3% 23.3% 6.9% 5.4% 6.0% 6.0%

Global Fund 116.7 312.2 271.4 265.8 116.7 312.2 271.4 265.8 74.3 192.9 127.5 124.8 100.0% 100.0% 100.0% 100.0% 63.7% 61.8% 47.0% 47.0%

UNITAID 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 49.3% 49.3% 49.3% 49.3%

GAVI 5.9 0.0 5.7 5.1 5.9 0.0 5.7 5.1 0.1 0.0 0.1 0.1 100.0% 100.0% 100.0% 100.0% 2.5% 2.7% 1.3% 1.3%

IFFIm 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 2.5% 2.7% 1.3% 1.3%

AMC 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 2.5% 2.7% 1.3% 1.3%

AfDF 125.7 213.3 217.3 222.3 13.0 18.4 11.6 11.8 1.9 3.4 1.7 1.7 10.4% 8.6% 5.3% 5.3% 1.5% 1.6% 0.8% 0.8%

AsDF 50.6 53.3 52.5 53.7 0.8 0.9 1.1 1.1 0.1 0.1 0.1 0.1 1.5% 1.6% 2.1% 2.1% 0.2% 0.2% 0.2% 0.2%

WFP 65.8 100.7 132.1 168.0 1.4 2.4 3.4 4.3 1.4 2.4 3.4 4.3 2.1% 2.4% 2.6% 2.6% 2.1% 2.4% 2.6% 2.6%

DNDi 0.0 0.5 1.0 0.0 0.0 0.5 1.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 0.0% 0.0% 0.0% 0.0%

MMV 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 0.0% 0.0% 0.0% 0.0%

Global TB Alliance 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 0.0% 0.0% 0.0% 0.0%

IPM 1.4 1.4 1.4 1.4 1.4 1.4 0.0 1.4 1.4 1.4 0.0 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

IAVI 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

ICRC 19.8 30.7 28.4 28.6 1.5 2.9 3.6 3.6 0.2 0.3 0.4 0.4 7.8% 9.5% 12.7% 12.7% 0.8% 0.9% 1.3% 1.3%

IPPF 4.9 5.2 8.3 5.9 4.9 5.2 8.3 5.9 1.2 1.3 2.1 1.5 100.0% 100.0% 100.0% 100.0% 25.0% 25.0% 25.0% 25.0%

FIND na 0.0 0.0 na 0.0 0.0 0.0 na 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 0.0% 0.0% 0.0% 0.0%

IUATLD 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0% 100.0% 100.0% 100.0% 0.0% 0.0% 0.0% 0.0%

Other: BACKUP-Initiative (Global Fund) 13.1 5.0 8.0 8.0 13.1 5.0 8.0 8.0 8.3 3.1 3.8 3.8 100.0% 100.0% 100.0% 100.0% 63.7% 61.8% 47.0% 47.0%

Total Multilateral (relevant Org.) 4,063.1 4,779.3 4,755.5 4,466.2 530.2 749.0 667.8 615.1 200.1 314.7 223.1 210.4

Bilateral Health Projects na na na na 323.2 401.1 407.3 447.4 99.2 111.8 122.8 125.0

General Budget Support 72.9 56.5 136.1 136.1 10.5 7.8 19.6 16.8 1.0 0.8 2.0 1.7

Imputable repayments -1,230.3 -1,255.0 -1,196.6 -1,422.2 -37.5 -38.2 -36.5 -43.3 -0.1 -0.1 -0.1 -0.1

Net Bilateral Real Transfers total 3,794.3 5,086.4 5,585.5 6,587.8 296.2 370.7 390.4 420.8 100.1 112.5 124.6 126.5

Net ODA (Real Transfers), total 8,226.7 10,118.6 10,714.5 11,297.3 826.4 1,119.7 1,058.2 1,035.9 300.2 427.1 347.7 337.0

Total Contributions as a % of GNI 0.25% 0.28% 0.31% 0.34% 0.025% 0.031% 0.031% 0.031% 0.009% 0.012% 0.010% 0.010%

Share of Total Real ODA Transfers na na na na 10.0% 11.1% 9.9% 9.2% 3.6% 4.2% 3.2% 3.0%

Net ODA (Real Transfers), total, Euro 6,009.6 7,015.2 7,694.1 8,529.9 603.7 776.3 759.9 782.1 219.3 296.1 249.7 254.4

Net ODA per cap. of devel. regions US$ 1.53 1.86 1.95 2.03 0.15 0.21 0.19 0.19 0.06 0.08 0.06 0.06

Share of Health Pomotion Share of HIV ResponseFinancing Mechanism

Germany's ODA Disbursements for Health Promotion and HIV Response through multilateral Organizations and Total Estimate

Total ODA ContributionsODA Contributions for Health

PomotionODA Contributions for HIV Response

0.013%

0.014%

0.017%

0.017%

0.028%

0.031%

0.041%

0.050%

0.052%

0.056%

0.078%

0.091%

0.098%

0.103%

0.132%

0.149%

0.186%

0.000% 0.100% 0.200%

Portugal

Greece

Austria

Italy

Switzerland

Germany

France

Spain

Finland

Belgium

United Kingdom

Denmark

Netherlands

Ireland

Sweden

Norway

Luxembourg

Official Development Assistance of European DAC Member Countries: Net Disbursements for Health Promotion in relation to Gross National Income (GNI) including Loans

2009

2008

2007

AppropriateContribution Levelfor EuropeanDonors: 0.12%

0.013%

0.014%

0.017%

0.017%

0.028%

0.031%

0.041%

0.050%

0.052%

0.056%

0.078%

0.091%

0.098%

0.103%

0.132%

0.149%

0.186%

0.013%

0.014%

0.017%

0.017%

0.028%

0.029%

0.041%

0.048%

0.052%

0.056%

0.078%

0.091%

0.098%

0.103%

0.132%

0.149%

0.186%

0.000% 0.100% 0.200%

Portugal

Greece

Italy

Austria

Switzerland

Germany

France

Spain

Finland

Belgium

United Kingdom

Denmark

Netherlands

Ireland

Sweden

Norway

Luxembourg

Official Development Assistance of European DAC Member Countries: Net Disbursements for Health Promotion in relation to Gross National Income (GNI) with and without Loans

Grants only

All Transfers

AppropriateContribution Levelfor EuropeanDonors: 0.12%

-200

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Volumes and Composition of European's DAC Members ODA for Health in 2009Ranked by GNI, Lending includes ODA Loans and Equity Investments

Bilateral Lending

Bilateral Grants

Multilateral Grants

Imputable Repayments

US$ million

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

ODA Transfers and Grants of European's DAC Members for Health in 2009Ranked by GNI, Lending includes ODA Loans and Equity Investments

Target Volume 0.12% of GNI

Target Volume 0.1% of GNI

Net ODA Transfers for Health

Net ODA Grants for Health

US$ million

ODA for HIV Response• The analysis was completed for 11 countries with higher

GNI representing 92% of total GNI of European DAC members

• We observe abysmal differences regarding financial efforts: Whereas few countries contributed their fair share others paid less than a tenth of what they should pay

• Again, the backlog of the majority of larger economies (Germany, France, Spain and especially Italy) is responsible for the main part of the gap

• The effect of the correction through project-by-project review is even larger than in the case of ODA for health

Health sector

Other sectors 1) Total

Officially reported 126.7 2.4 129.1 100%

Excluded after revision 40.4 0.1 40.5 31%

Correctly reported 86.3 2.3 88.5 69%

Identified in other (sub)-sectors 2.0 0.8 2.8 2%

Total revised 88.3 3.1 91.4 71%

8.6 0.5 9.2 7%

21.6 0.6 22.2 17%

118.5 4.3 122.8 95%

Category

Results of the Review Project by Project in the case of Germany's ODA for the HIV Response in the year 2009

1) Including purpose of social mitigation of HIV

Amounts disbursed in US$ million Share of official

reported

Specific HIV interventions

Imputed HIV components in reproductive health

Imputed HIV components in sector-wide approaches

Total revised estimate of HIV projects and components

0.003%

0.004%

0.007%

0.010%

0.014%

0.015%

0.015%

0.024%

0.039%

0.046%

0.057%

0.000% 0.010% 0.020% 0.030% 0.040% 0.050% 0.060% 0.070% 0.080% 0.090% 0.100%

Italy

Austria

Switzerland

Germany

France

Belgium

Spain

United Kingdom

Netherlands

Norway

Sweden

Official Development Assistance of European DAC Member Countries:Net Disbursements for the HIV Response in relation to Gross National Income (GNI)

2009

2008

2007

AppropriateContribution Levelfor EuropeanDonors: 0,05%

Geographic Distribution

• Analysis of Health ODA per capita made available by 5 larger economies and the European Union casts doubt on coordination and orientation towards countries with highest needs

• Final appraisal will take into account ODA for Health promotion and HIV response by all donors

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2007 2008 2009 2007 2008 2009

Share of Sub-Saharan Africa in ODA for Health and for HIV Response by European Donors

France Germany Italy Spain United Kingdom European Union

ODA for Health ODA for HIV Response

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

11.00

12.00

13.00

14.00

Equa

toria

l Gui

nea

Djib

outi

Gren

ada

Mol

dova

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bwe

Pales

tinian

Adm

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Leon

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St. L

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ea-B

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Jam

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Ethi

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Guin

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and

Herz

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dor

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Turk

ey

ODA for Health from Five European DAC Members per Capita in 2009, all Recipients

European Union

United Kingdom

Spain

Italy

Germany

France

US$

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

11.00

12.00

13.00

14.00

Equa

toria

l Gui

nea

Djib

outi

Gre

nada

Mol

dova

Zim

babw

ePa

lesti

nian

Adm

. Are

asSi

erra

Leon

eM

alaw

iZa

mbi

aLi

beria

Moz

ambi

que

Rwan

daCo

mor

osN

amib

iaSe

rbia

St. L

ucia

Gui

nea-

Biss

auM

aurit

ania

Liby

aCa

pe V

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Cam

bodi

aSa

o To

me

& P

rinci

peBu

rkin

a Fa

soSe

nega

lN

icar

agua

Guy

ana

Kyrg

yz R

ep.

Buru

ndi

Mor

occo

Gha

naBe

nin

Keny

aPe

ruG

abon

Tanz

ania

Afgh

anis

tan

Cent

ral A

fric

an R

ep.

Barb

ados

Togo

Alba

nia

Nig

erAn

gola

Surin

ame

Cong

o, D

em. R

ep.

Mal

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bano

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Nep

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Sal

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gand

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negr

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jikis

tan

Geo

rgia

Jam

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Cam

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Rep

ublic

Chad

ODA for Health from Five European DAC Members per Capita in 2009, Recipients > 1€

European Union

United Kingdom

Spain

Italy

Germany

France

US$

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

11.00

12.00

13.00

14.00

Equa

toria

l Gui

nea

Djib

outi

Zim

babw

e

Mau

ritius

Sier

ra Le

one

Mal

awi

Zam

bia

Libe

ria

Moz

ambi

que

Rwan

da

Com

oros

Nam

ibia

Gui

nea-

Biss

au

Mau

ritan

ia

Cape

Ver

de

Sao

Tom

e &

Prin

cipe

Burk

ina

Faso

Sene

gal

Buru

ndi

Gha

na

Beni

n

Keny

a

Gab

on

Tanz

ania

Cent

ral A

fric

an R

ep.

Togo

Nig

er

Ango

la

Cong

o, D

em. R

ep.

Mal

i

Swaz

iland

Leso

tho

Sout

h Af

rica

Uga

nda

Cam

eroo

n

Chad

Nig

eria

Som

alia

Ethi

opia

Gui

nea

Gam

bia

Cong

o, R

ep.

Côte

d'Iv

oire

Suda

n

Bots

wan

a

Mad

agas

car

Eritr

ea

ODA for Health from Five European DAC Members per Capita in 2009, Sub-Saharan Africa

European Union

United Kingdom

Spain

Italy

Germany

France

US$

Next steps• Action for Global Health plans to develop partnerships with

local organisations from civil society in order to track the internal ODA flows in a sample of African countries including the allocation by sub-regions, delivery channels, target populations and programmatic orientations. This in-depth analysis will consider the interplay with other funding sources, mainly the resources raised domestically by the general government and households. Thereby we expect to produce reliable results and to contribute, simultaneously, to strengthening the capacity of democratic control in the field of development and health financing

More information see: www.actionforglobalhealth.eu

www.medmissio.de