Global health funding slows as deadline for Millennium Development Goals nears

A Ghana News Agency news analysis by Linda Asante Agyei

Accra, Dec. 19,GNA-Stagnating funding from the United States, other funding agencies and shortfalls at the Global Fund to Fight AIDS, Tuberculosis and Malaria, are pointing to a troubled future for development assistance for health.

This is as a result of developed countries and funding agencies putting the brakes on growth in development assistance for health, raising the possibility that developing countries, which will in the end, have an even harder time meeting the Millennium Development Goal deadline looming in 2015.

According to a new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, even as aid continued to grow, reaching 27.73 billion dollars in 2011, significant cutbacks in the United States slowed the growth rate in development assistance to 4% between 2010 and 2011 – the slowest rate in a decade.

Health funding through United Nations agencies plateaued in 2011, and the Global Fund to Fight AIDS, Tuberculosis and Malaria announced in November that it would make no new grants until 2014 due to funding shortfalls. Preliminary estimates indicated that health assistance channeled through the Global Fund declined by 529 million dollars, or 16%, between 2010 and 2011.

The new findings copied to the Ghana News Agency from the IHME, the global financial crisis has led to a slowdown in growth of funding to improve health in many developing countries.

The report, “Financing Global Health 2011: Continued Growth as MDG Deadline Approaches”, detailed the trends in development assistance for health between 1990 and 2009 from aid agencies and governments in 23 developed countries, multilateral institutions such as the World Health Organization, and hundreds of nonprofit groups and charities with preliminary estimates for 2010 and 2011.

It also captured spending by countries from 1995 to 2009. The detailed results of the IHME analysis are being made available in IHME's Global Health Data Exchange (GHDx), along with project-level data that can be used to answer a variety of research questions.

Dr Christopher Murray, IHME Director and one of the report's authors, said “Even though we continue to see growth in global health funding through 2011, it is troubling to see so many funders pulling back. We are just now beginning to see the impact from the extraordinary growth in global health funding over the past decade. If we give up now, we may lose that momentum.”

IHME in September 2011 reported that most of the world's countries are reducing child mortality and maternal mortality more quickly than a decade ago.

The Institute also discovered that an HIV programme in India called Avahan, appears to have prevented 100,000 infections. In August 2011, IHME and collaborators found that in homes that own at least one insecticide-treated bed net, there was a 23% reduction in child mortality.

“The Institute is working on new research examining the relationship between development assistance for health and health outcomes in a broad range of areas”, the report said.

Most of the growth in development assistance for health over the past two years came from the World Bank's International Bank for Reconstruction and Development, which greatly expanded its loans to middle-income countries as the economic crisis worsened in 2009.

Katie Leach-Kemon, IHME's Data Development Manager and a co-author of the Health Affairs article and the Financing Global Health 2011 report, said, “Even with so many economies in turmoil, we are seeing strong commitments to global health from many countries. The UK increased its development assistance for health by double digits in 2011.

Germany has started to increase funding again after cutting back, and Norway has consistently been one of the leaders in donating a substantial portion of its budget every year to global health efforts.”

The report indicated that after a decade of rapid increases in development assistance, the US has greatly slowed the pace of growth to 2% between 2010 and 2011.

It noted development assistance to non-governmental organizations increased by 8% from 2010 to 2011, after two years of drops in funding.

Generally the countries with the most significant disease burdens receive the most aid, but 12 of the countries with the highest disease burdens, including Russia, Sudan, Myanmar, and Egypt, are not among the countries that receive the most development assistance for health.

Again, growth in development assistance for HIV/AIDS, tuberculosis, and health sector support slowed between 2008 and 2009 whilst development assistance for malaria, non-communicable diseases, and maternal, newborn, and child health accelerated over the same period.

The report explained that global financial crisis did not appear to have slowed spending by country governments on health, adding, “Spending accelerated between 2008 and 2009, increasing from 368.46 billion dollars to 410.50 billion dollars, 16 times the total amount spent for development assistance for health”.

Countries in East Asia spent the largest amount of their own resources on health in 2009, followed by the regions North Africa/Middle East and Tropical Latin America.

For every 1 dollar of development assistance for health that governments receive, they redirect 0.56 dollar on average from the health sector to other spending priorities.

Dr. Michael Hanlon, one of the report's co-authors and the head of IHME's Health Financing team said "Ultimately, whether health outcomes improve within a country will be determined by how that country sets priorities,”

“Over time, we are seeing an increase in the amount of health funding shifted to other areas. In the current economic climate, it is critical for policymakers to keep a close eye on these trends and to evaluate the impact that fluctuating spending levels are having on population health.”

GNA