Ex­cerpts from ‘Fi­nanc­ing Global Health 2013’


It is im­por­tant for us in the de­vel­op­ment cir­cle to keep tabs of what is hap­pen­ing on fi­nan­cial re­sources and its sources and how it is dis­trib­uted and/or ne­go­ti­ated es­pe­cially for de­vel­op­ing coun­tries. Many of African coun­tries with­out the in­ter­na­tional fi­nanc­ing mech­a­nism re­gret­tably their health sec­tor will col­lapse as do­mes­tic health fi­nanc­ing is dwin­dling day by day. Only one African coun­try in 2013 achieved the Abuja dec­la­ra­tion of al­lo­cat­ing 15% of its budget to health. Many are still com­mit­ting funds of be­low 10%.

‘Fi­nanc­ing Global Health 2013; Tran­si­tion in an Age of Aus­ter­ity’ is a re­port that was pre­pared by the In­sti­tute for Health Met­rics and Eval­u­a­tion (IHME), The IHME is an in­de­pen­dent global health re­search cen­ter at the Univer­sity of Wash­ing­ton. IHME pro­vides rig­or­ous and com­pa­ra­ble mea­sure­ment of the world’s most im­por­tant health prob­lems and eval­u­ates the strate­gies used to ad­dress them.

The 2013 re­port is the fifth edi­tion of this an­nu­ally pro­duced re­port on global health fi­nanc­ing. As in pre­vi­ous years, this re­port cap­tures trends in de­vel­op­ment as­sis­tance for health (DAH) and govern­ment health ex­pen­di­ture as source (GHE-s).

The re­port ob­served that the global health fi­nanc­ing trends de­picted in Fi­nanc­ing Global Health 2013: Tran­si­tion in an Age of Aus­ter­ity un­der­line the re­silience of de­vel­op­ment as­sis­tance for health (DAH). It also un­veils new per­spec­tives on the data that em­pha­size shifts in the promi­nence of DAH part­ners. Bi­lat­eral aid agencies on the whole have re­duced their DAH con­tri­bu­tions, and their share of DAH has di­min­ished since 2011. In ad­di­tion, con­tri­bu­tions from the World Bank’s In­ter­na­tional Bank for Re­con­struc­tion and De­vel­op­ment peaked in 2010. Over the same pe­riod, the ma­jor pub­lic pri­vate part­ner­ships, no­tably the GAVI Al­liance (GAVI) and the Global Fund to Fight AIDS, Tu­ber­cu­lo­sis and Malaria (GFATM), con­tin­ued to ex­pand, sus­tain­ing health as­sis­tance at cur­rent lev­els.

It also re­ported that “Epi­demi­o­log­i­cal data also en­hance up­dated es­ti­mates of DAH. Pair­ing DAH with dis­abil­ityad­justed life years (DALYs) re­veals im­bal­ances be­tween dis­ease bur­den and in­ter­na­tional in­vest­ments. Non­com­mu­ni­ca­ble dis­eases (NCDs), while a prom­i­nent and ris­ing por­tion of dis­ease bur­den in the de­vel­op­ing world, are not a pri­mary fo­cus of DAH. How­ever, DAH for non-com­mu­ni­ca­ble dis­eases did ex­pand from 2010 to 2011. The DAH al­lo­cated to ma­ter­nal, new­born, and child health (MNCH) also grew sub­stan­tially, re­flect­ing donors’ con­tin­ued sup­port for the un­fin­ished agenda of MDGs 4 and 5, which aim to re­duce child and ma­ter­nal mor­tal­ity.”

Key find­ings of Fi­nanc­ing Global Health 2013 are;

De­vel­op­ment as­sis­tance (DAH):

1. Ac­cord­ing to IHME’s pre­lim­i­nary es­ti­mates, to­tal DAH in 2013 amounted to $31.3 bil­lion. The year-over-year in­crease in DAH was 3.9%.

2. While the United States con­tin­ued

for health to be the sin­gle largest chan­nel of DAH, at $7.4 bil­lion, 2013 marks the sec­ond con­sec­u­tive year of re­duc­tion in DAH from the US. US DAH peaked in 2011 at $8.3 bil­lion.

3. Al­though the United King­dom is re­cal­i­brat­ing the coun­tries and health ar­eas it tar­gets, the DAH dis­bursed by the UK con­tin­ued to rise in 2013. DAH from the UK amounted to $1.2 bil­lion in 2013, a 24.7% in­crease over 2012 dis­burse­ments.

4. The spend­ing of pub­lic-pri­vate part­ner­ships also grew sub­stan­tially in 2013. GAVI’s dis­burse­ments reached an es­ti­mated $1.5 bil­lion in 2013, a 32% in­crease rel­a­tive to 2012 lev­els. GFATM grew 16.8%, with 2013 DAH ex­pen­di­ture of $4 bil­lion.

5. DAH from NGOs in­creased by 2.4% be­tween 2011 and 2013. Of the NGOs IHME can track, those based in the US spent $4 bil­lion in 2013, while NGOs based out­side the US spent $895 mil­lion that same year.

6. Across re­gional group­ings, subSa­ha­ran Africa re­ceived the largest por­tion of DAH. In 2011 (the most re­cent year for which re­cip­i­ent-level es­ti­mates are avail­able), sub-Sa­ha­ran Africa’s share was $8.8 bil­lion, or 28.6% of to­tal DAH.

7. The share of DAH tar­get­ing ma­ter­nal, new­born, and child health con­tin­ued to grow. In 2011, MNCH re­ceived $6.1 bil­lion, a 17.7% in­crease from 2010.

Govern­ment health ex­pen­di­ture as a source:

1. Spend­ing by gov­ern­ments on health as sourced do­mes­ti­cally (GHE-S) was $613.5 bil­lion in 2011. This means that, on aver­age, coun­tries spent 20 times more of their own re­sources on health than they re­ceived in as­sis­tance. Fur­ther­more, govern­ment health spend­ing grew at a faster pace than as­sis­tance. This spend­ing grew 7.2% from 2010 to 2011 (the most re­cent year for which es­ti­mates are avail­able).

2. The amount of to­tal health spend­ing rep­re­sented by DAH var­ied widely by coun­try. The share of DAH fun­nelled to gov­ern­ments (DAH-G) as a part of to­tal spend­ing by gov­ern­ments on health was typ­i­cally less than 10%. How­ever, in cer­tain coun­tries in Asia and Western and South­ern Africa, DAH chan­nelled to gov­ern­ments amounted to more than half of to­tal govern­ment health ex­pen­di­ture.

I will con­clude this ar­ti­cle by quot­ing Dr. Flavia Bus­treo As­sis­tant Di­rec­tor Gen­eral in World Health Or­ga­ni­za­tion in a re­view of the re­port posted at the Global Pol­icy Jour­nal “de­spite gloomy pre­dic­tions and a pe­riod of global donor “belt tight­en­ing”, the lat­est In­sti­tute for Health Met­rics and Eval­u­a­tion IHME re­port, ‘Fi­nanc­ing Global Health 2013: Tran­si­tion in an Age of Aus­ter­ity’ brings bet­ter news than many ex­pected. De­vel­op­ment As­sis­tance for Health (DAH) re­mained steady, with a 3.9% growth from 2012 to 2013…….. Ma­ter­nal Neona­tal and Child Health (MNCH) has been a big win­ner in the 2013 re­port. DAH for MNCH grew sub­stan­tially by 17.7% from 2010 to 2011, reach­ing $6.1 bil­lion in 2011. This is good news, how­ever, there is no time for com­pla­cency.”

All com­ments to Dr Aminu Ma­gashi at health­weekly@ya­hoo.com

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