In 2011, donors provided $27.73 billion for development assistance for health – a marginal increase over 2010. Nevertheless the current growth trajectory over the last three years is more akin to the growth of health assistance in the 1990s than the dramatic upswing in aid seen in the first decade of the 21st century. Christopher Murray and Michael Hanlon from the Institute for Health Metrics and Evaluation offered these details in a presentation on the subject at the University of Washington Thursday, an event hosted by the Global Health Council.
Declines in funding from the Global Fund to Fight AIDS, TB and Malaria are largely responsible for the slowing trend, the presenters said. The Global Fund, The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and the Global AIDS Vaccine Initiative (GAVI) represent the biggest global health assistance programs. Funding for global AIDS has significantly flattened, while funding for malaria and tuberculosis have increased. Maternal and Child Health (MCH) funding is up- largely attributable to GAVI.
Despite the economic downturn, Great Britain and Australia have both increased funding for development, demonstrating that budgets for development assistance are not a simple function of the state of public finances and indicating that advocacy can make a difference.
Murray and Hanlon also noted that there remains an unfortunate correlation between donors providing health funding to governments with concurrent reductions in the government’s own financial contributions to the health of its people. There is not a lot of data or evidence about the actual impact on health outcomes although there is some data that suggests that reductions in government health spending trigger increases in child mortality. Interestingly, the reverse seems to happen when donors provide assistance to non-governmental organizations (NGOs) in a given country; government financing tends to increase. The reasons for these phenomena are not completely clear.
Ongoing donor commitments to development assistance for health, according to the presenters, will require evidence that aid is making real contributions to improved health outcomes and the ability to assure donors of transparency, accountability and impact evaluation.