opinionBy Dr Aminu Magashi
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 disability-adjusted life years (DALYs) reveals imbalances between disease burden and international investments. Non-communicable 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 for health (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 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, sub-Saharan 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."