Achieving the health-related Millennium Development Goals

www.actionforglobalhealth.eu

Achieving the health-related Millennium

Development GoalsSimon Wright


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.


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.


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.


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.


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


Health ODA risingCountry 2005 2006 Change

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


Aid effectiveness

• Paris Declaration 2005

• 5 Paris Principles of aid effectiveness:– Ownership– Alignment– Harmonisation– Mutual accountability– Managing for results


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.


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.

Documents

Achieving the health-related Millennium Development Goals