www.actionforglobalhealth.eu Achieving the health-related Millennium Development Goals Simon Wright
Jan 13, 2016
www.actionforglobalhealth.eu
Achieving the health-related Millennium
Development GoalsSimon Wright
www.actionforglobalhealth.eu
Action for Global Health
• 15 NGOs in Brussels, France, Germany, Italy, Spain and UK
• Diverse organisations working together for common goals: funding, prioritising of health systems, equitable access especially gender
• “Health Warning” looked at quantity EU ODA for health
• Next report will look at harmonisation of health ODA for health systems.
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Health MDGs• MDG 4: Reduce child mortality by two-thirds. Progress in
all regions except sub-Saharan Africa where rate estimated at 160 per 1000 live births. Just four of 46 sub-Saharan African countries are on track.
• MDG 5: Reduce maternal mortality by three-quarters. Slowest progress: rates in sub-Saharan Africa are 920 per 100,000 live births (compared with 8 per 100,000 in industrialised countries). In Africa, risk of maternal death 1:22.
• MDG 6: Combat HIV, AIDS, malaria and tuberculosis. HIV infection rates rising, not reversed, but some places show hope. One quarter of people who need antiretrovirals are receiving them. Bednet coverage increasing fast from low base.
• MDG 8: Develop a global partnership for development. Access to medicines remains a major obstacle to healthcare.
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Influencing from Europe
• Trade and patent laws for medicines
• Brain-drain of health workers
• Macro-economic policies imposed by IMF and World Bank
• Technical assistance if not imposed
• Pilots and projects
• Research and development
• Official Development Assistance.
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Financing for MDGs• WHO Commission on Macroeconomics and
Health (2001): $27 billion ODA for health in 2007, rising to $38bn by 2015
• Equivalent of 0.1 % of donor GNI to ODA for health, within the 0.7% commitment
• Assumes aid is provided efficiently and used effectively
• Estimates for available ODA for health in 2007 were maximum of $6-12bn in 2004, noting that much of increase was for HIV.
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ODA fallingCountry 2007/US$m 2007/%GNI 2006/%GNI % Change
France 9.940 0.39 0.47 -15.9
Italy 3.929 0.19 0.2 -3.6
Spain 5.744 0.41 0.32 33.8
Germany 12.267 0.37 0.36 5.9
United Kingdom
9.921 0.36 0.51 -29.1
DAC-EU 62.095 0.4 0.43 -5.8
EC 11.771 - - 3
Total DAC 103.655 0.28 0.31 -8.4
OECD DAC Preliminary figures for 2007
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Health ODA risingCountry 2005 2006 Change
Health (General + Basic)
Population Pol/Programme & Reproductive Health
Health (General + Basic)
Population Pol/Programme & Reproductive Health
Health (General + Basic)
Population Pol/Programme & Reproductive Health
France 278.87 7.54 270.26 2.39 ▼ 8.61 ▼ 5.15
Italy 101.77 10.46 94.49 3.91 ▼ 7.28 ▼ 6.55
Spain 116.64 28.94 105.17 40.9 ▼ 11.47 ▲11.96
Germany 123.5 74.58 247.4 226.75 ▲123.9 ▲152.17
United Kingdom
283.08 304.76 394.42 283.66 ▲111.34 ▼21.1
DAC-EU 1543.08 699.31 2239.17 1004.78 ▲696.09 ▲305.47
EC 613.98 55.44 469.54 110.63 ▼144.44 ▲55.19
Total DAC 3448.05 3175.38 4532.82 4011.15 ▲1084.77 ▲835,77
OECD DAC 2006 figures
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Aid effectiveness
• Paris Declaration 2005
• 5 Paris Principles of aid effectiveness:– Ownership– Alignment– Harmonisation– Mutual accountability– Managing for results
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Harmonisation of health ODA
• Donors prefer bilateral relationships, citizens need to educate politicians
• Aid “darlings” and “orphans”• Confusion of mechanisms; donors promote
their own, not recipient’s choice• Duplication and monitoring burden• New initiatives – International Health
Partnership, MDG Contracting, Providing for Health Initiative.
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Our concerns• Aid effectiveness agenda must not allow
donors to escape their commitments• ODA target needs greater action especially
if economic growth slowing• Long-term predicable aid for health systems• No competition between horizontal and
vertical • Donor governments must stop launching
and start harmonising new initiatives• Civil society key to effectiveness of aid.