Responding to the Organization for Economic Co-operation and Development’s (OECD) predictions that 2010 will see overseas aid stand at $21bn lower than promised, Head of Oxfam Campaign, Emma Seery observed that the missing $21 billion could pay for every child to go to school, and could save the lives of 2 million of the poorest mothers and children, "making this failure of the richest countries nothing short of a scandal". Oxfam estimates it would cost $16bn each year to ensure that every child gets the chance to go to school and $5bn would provide improved medical care that would save the lives of about 2 million mothers and children. ‘Rich countries have no excuse for failing to deliver the aid increases they promised’, she added. Collectively the EU-15 who are members of the OECD will miss their 0.51% aid target they committed to in 2005, with OECD projections putting them at just 0.48% average in 2010. Nine out of ten Europeans believe strongly that their leaders must meet their aid promises, despite the economic downturn, according to a recent Eurobarometer study.
Resource allocation and health financing
Some 300 participants gathered in Bogota, Colombia, from the 24-26 March, for an intermediate international meeting to discuss and agree on policy recommendations ahead of a 2011 High Level Forum on aid effectiveness in South Korea. Capacity development (CD) is strongly embedded in the agenda of the South. This agenda aims to harness broad political leadership, get beyond fragmented and piecemeal approaches, address systemic issues related to state reform and incentives, and make increased use of South-South co-operation and regional/local resources.
Several themes emerged from initial discussions in this consultation, which was convened by the World Health Organization (WHO): determining to what extent, and how, WHO should address the broader social and economic determinants of health; deciding what constitutes good partnership behaviour at global and country level; determining how WHO can match the support it provides more closely and flexibly to the needs of different countries; and improving WHO’s involvement in the field of technical collaboration. Participants agreed that improving performance is intimately linked to the way WHO is financed and this warrants further consideration. They indicated a need to seek the views of all member states on the wider issues raised at this meeting. Questions raised in this report will be used as the basis for a web-based consultation, to which all countries will be invited to contribute their views.
The Global Fund 2010 results report has projected that the virtual elimination of mother-to-child HIV transmission by 2015 is within reach, that malaria may be eliminated as a public health problem within a decade, and that the international target of halving tuberculosis prevalence could be met by 2015. According to the report, Fund-supported programmes saved at least 3,600 lives per day in 2009 and an estimated total of 4.9 million since the creation of the Fund in 2002. By the end of 2009, Fund-supported programmes provided antiretroviral treatment to 2.5 million people with HIV and AIDS, treatment to 6 million people who had active TB, and had distributed 104 million insecticide-treated nets to prevent malaria.
According to this policy brief, European aid donors are taking steps to meet promises to deliver a higher share of development aid directly to governments in the form of budget support. The brief points to positive and negative consequences of budget support. While budget support is argued to enhance local accountability, it may not succeed unless government recipients are accountable to their populations for how the funds are used. A more self-serving reason is argued for donors to turn to budget support – it enables the donor to increase aid delivery, thus meeting disbursement rates, without requiring an enlargement of their own administrative operations, thereby keeping costs down. This motivation has more to do with donors’ institutional dynamics than with poverty reduction. The brief calls for a more nuanced political analysis to ensure that budget support enhances rather than undermines democratic accountability in developing countries.
The WRR Council notes that it is significant that three quarters of Dutch development aid is spent on healthcare and education, and less than a quarter on infrastructure, agriculture and economic activity. Although it is important to provide social care from a humanitarian perspective, the Council adds that it does not automatically lead to the fundamental changes which promote growth and development, and which gradually make countries and peoples self-sufficient. It is important to start approaching development from a far broader perspective. Stability and security, trade conditions that facilitate development, combating tax evasion, a fair tax system which does not entice companies to pay taxes in the Netherlands instead of in developing countries, less stringent intellectual property rights for poor countries, a more productive policy on knowledge exchange, and a more properly thought-out migration policy can all be of greater significance to the development of countries than classical aid provided in situ. The development perspective will have to be better incorporated into policy in these areas, and that calls for more policy coherence for development. Furthermore, attention to global public goods such as financial stability, climate policy and the eradication of contagious diseases will become increasingly important.
This document outlines Greenpeace’s assessment of the decisions taken at the Copenhagen Summit on Climate Change held in Denmark in December 2009. In this, Greenpeace calls for a financial mechanism for dealing with climate change that is transparent and inclusive. At Copenhagen, Governments agreed to establish a Copenhagen Climate Fund, which Greenpeace believes is one step to ensuring that investments take place where they are most needed, noting that developing country action on climate change must have technological and financial support from industrialised countries.
South Africa is reported to be facing large cuts in external funding, such as in falling US funding, for its HIV and AIDS programme over the next five years, despite needing an extra R2-billion a year to reach all those who need antiretroviral treatment. Almost a million South Africans will soon be on lifelong antiretroviral treatment and this number will triple in the next decade if government keeps to its implementation plan. Scenario planning by Treasury indicates that the demand for treatment and care will peak in 2021, when the country would need close to South African Rands 30-billion (about 4.3 billion US dollars).
This information sheet presents evidence on the distribution of benefit of health services in South Africa. Within the public sector, the poor benefit relatively more than the rich from outpatient services at lower levels of care. The rich benefit considerably more than the poor from regional and central hospital services (both outpatient and inpatient services) and also benefit more from public sector inpatient services overall. The rich benefit far more from private sector services than the poor; the richest 40% of the population receive about 70% of the benefits of private outpatient services (from general practitioners, specialists, dentists and retail pharmacies) and nearly 80% of the benefits of inpatient care in private hospitals. Overall, health care benefits in South Africa are very ‘pro-rich’, with the richest 20% of the population receiving more than a third of total benefits while the poorest 20% receive less than 13% of the benefits, despite poor people bearing a much greater share of the burden of ill-health than rich people.
The South African Budget and Expenditure Monitoring Forum meeting in February 2010 was reported to raise a number of issues relevant to antiretroviral (ARV) tenders to ensure adequate supplies of appropriate medicines at the lowest possible prices. The meeting noted the need for co-operation between treasury and health departments to achieve a scale of procurement to use the leverage of the world’s largest ARV treatment programme to get the best possible deals from drug companies.