View
17
Download
0
Category
Tags:
Preview:
DESCRIPTION
Action For Global Health Health as a Tracer Sector Berlin 8 April 2008 Elisabeth SANDOR OECD DCD. Content. 1. Background on Health as a tracer sector 2. The challenges and progress in Aid Effectiveness in Health 3.Health as a Tracer Sector in Accra. Better results are needed !. - PowerPoint PPT Presentation
Citation preview
Action For Global HealthHealth as a Tracer Sector
Berlin 8 April 2008Elisabeth SANDOR
OECD DCD
Content
1. Background on Health as a tracer sector
2. The challenges and progress
in Aid Effectiveness in Health
3. Health as a Tracer Sector in Accra
Better results are needed !Tracking Health MDGs in SSA:
– HIV prevalence among pregnant women aged 15-24: only 8 out of 36 countries on target
– TB prevalence only 4 countries on target, 27 with worsening trend
– Under-5 Mortality Rate: 2 countries on target, 25 making progress but behind time-bound target, 9 with worsening trend
Source: Global Fund, 2007
Background
• High-Level Fora on Aid Effectiveness and Scaling up for Better Health (2004-2006) focused on AE: lack of aid predictability, alignment and C&H, insufficient ownership and use of country systems + produced best practice for GHPs’ interventions in countries
• Dec.2006: WHO/WB/OECD meeting on “Aid Effectiveness and health”: participants endorsed “Health as a tracer sector”
• Health as a tracer sector to feed the broader agenda on AE (best practice, lessons, keeping public support to financing for development)
Background (2)
• OECD work on AE in health : DCR 2007, DCD EFF coordinates with IHP and other health-related initiatives (HMN, IHME, Global Innovative financing), preparation of HLF3 in Accra
• One Task Team on HaTS to pilot and guide the work up to Accra and beyond (links with IHP and UNSG’ Steering Committee on MDGs in Africa)
• So objective: not only for Accra…but keep Health as a source of lessons for better AE/results and development impact
The challenges in AE in Health: more aid is needed
• Health captured a large part of the ODA increase but more aid is still needed to reach common agreed objectives (also DAH increase brings greater need for accountability)
• The current uncertainties about future increase of aid
• The bulk of the increase in DAH has been going to specific initiatives and few bilateral programs
0.33
0.22
0.26
0.35
0
20
40
60
80
100
120
140
0.00
0.05
0.10
0.15
0.20
0.25
0.30
0.35
0.40
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
ODA
(200
6US
D bi
llion)
% o
f GN
I
ODA as a % of GNI (left scale)
Total ODA(right scale)
0.33
Total ODA (right scale) - excluding debt relief for Iraq and Nigeria
The path to delivering the 2010 promises is getting steeper and what will there be for health ?
DAH has significantly increased and changed
Source: Michaud 2006
Most of the
recent increase:
• focused on Africa
• focused on specific diseases
• was channeled through bilateral (US) and new multilateral agencies (GAVI A, GFTAM)
0
2
4
6
8
10
12
14
16
2000 2005
year
US$ b
illion
s
Private non-profit
Other multilaterals
Development banks
UN agencies
Bilateral agencies
Bilateral ODAH (in constant USD millions)
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,0001
99
7
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
Axis Title
Bilateral ODA in Health, USD millions
France
Germany
United Kingdom
EC
EU - countries
DAC countries (hors EC)
Bilateral ODAH (in constant USD Millions)
0
100
200
300
400
500
600
700
800
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Bilateral ODA in Health, USD millions
France
Germany
United Kingdom
EC
The challenges in AE in HealthBetter aid is needed
Implementing the 2005 Paris Declaration
Aligning with
partners’ agenda
Using partners’ systems
Alignment(Donors - Partner)
2
Mu
tual a
ccou
nta
bility
Ownership(Partner countries)
Partners set the agenda
1
Harmonisation(Donors - Donors)
Establishing common
arrangements
Simplifying procedures
Sharing information3
Managing for Results 45
The challenges in AE in health: better aid is needed
Improve AE is key in a sector which is:
- complex (large number of actors, multi-sectoral nature of the determinants of health and multiple financing streams, health results require long-term and sustained investments)
- heavily fragmented at global and country levels
Fragmentation in international effort ….
Source; Don De Savigny & COHRED
0.01.02.03.04.05.06.07.08.09.0
10.0
2001 2002 2003 2004 2005
Benin
0.0
2.0
4.0
6.0
8.0
10.0
12.0
2001 2002 2003 2004 2005
Guinea
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
2001 2002 2003 2004 2005
Liberia
0.0
5.0
10.0
15.0
20.0
25.0
2001 2002 2003 2004 2005
Mali
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
2001 2002 2003 2004 2005
Mauritania
0
10
20
30
40
50
60
70
80
2001 2002 2003 2004 2005
Tanzania
Health aid can be very volatile and unpredictableDisbursements from DAC members 2001- 2005
Source: OCDE, 2007
The challenges in AE in Health: Donor aid can be poorly aligned within country systems and priorities
Example from Rwanda (Scaling up for Better Health, 2005): – Donor preference to disburse via NGOs/manage
funds themselves/send them directly to local-level projects . Central Government manages only 14% of donor support to the health sector.
– Inequalities in the distribution of donor funding by strategic objective: $18mn earmarked for malaria (the biggest cause of mortality and morbidity), $1mn for the integrated management of childhood illnesses and $47mn for HIV/AIDS.
MOH MOEC
MOFPMO
PRIVATE SECTORCIVIL SOCIETYLOCAL GVT
NACP
CTUCCAIDS
INT NGO
PEPFAR
Norad
CIDA
RNE
GTZ
Sida WBUNICEF
UNAIDSWHO
CF
GFATM
USAID
NCTP
NCTP
HSSP
HSSP
GFCCP
GFCCP
DAC
CCM
T-MAP
3/5
SWAP
SWAP
UNTG
PRSP
PRSP
Donor collaboration is a challengeDonor collaboration is a challenge
Source: Mbewe, WHO
The progress and remaining challengesin AE in health:
• The current renewed interest for Health Systems has generated a set of interventions which need to be coordinated/harmonised
• Changes in aid modality can have unintended consequences for health
• It’s important to report on progress about the different ongoing initiatives and innovative financing for development
The progress and remaining challenges in AE in Health
• Division of labour and coordination at the global level: informal group of the H8 and IHP
• Global Programs continuous effort to implement the Paris agenda
• Harmonise M&E
• Change behaviour remains key
What is Accra ?• High Level political event on aid, a few months
before Financing for Development in Doha• Mid-term Stock-taking of the Paris Declaration mutual
commitments• Forward looking event : road to 2011.• 100 partner countries, most donors, most international
aid agencies, • 800 to 1000 participants• Strong civil society engagement (consultations +
Advisory Group-CSO contribution + pre Accra meeting)
List of Roundtables• RT 1 : Country ownership• RT 2 : Alignment : country syst, predictability• RT 3 : Harmonisation- complementarity• RT 4 : Results & impacts• RT 5 : Mutual accountability• RT 6 : Civil society & aid effectiveness• RT 7 : Situations of fragility & conflicts• RT 8 : Sector applications (health, education, infrastructure…)
• RT 9 : Aid architecture (incl. Global Health Partnerships)
Core Issues (Partner Countries) for the RTs and the Accra Agenda for
Action• Untying• Conditionality• Predictability• Division of Labour• Incentives• Capacity Development
+ «cross cutting» issues: human rights, environment, gender
Health as a Tracer Sector in Accra• A contribution to the Roundtable on sector
application of the PD (will look at lessons – Sector Wide Approaches and Programme-Based Approaches - across 4 sectors + priority areas and cross-cutting issues)
• One Report on Health and Aid Effectiveness to take stock of progress and remaining challenges
• Other inputs: to other RTs and to the Market place• Concrete recommendations for the Accra Action
Agenda= all prepared by the Task Team on HaTS
Examples of inputs on HaTS in Accra
• Compacts for mutual accountability in a set of partner countries
• Study on donors constraints to provide long-term health aid
• Best practice and lessons from GHPs• Study on Human Rights and AE in health• Monitoring progress in AE in health (country
and global levels)
Thank You !
www.accrahlf.net
Recommended