This book provides comprehensive data on the volume, origin and types of aid and other resource flows to around 150 developing countries. The data show each country's intake of official development assistance and well as other official and private funds from members of the Development Assistance Committee of the OECD, multilateral agencies and other key external funders. Key development indicators are given for reference. The data cover net and gross disbursements, commitments, terms and the sector/purpose allocation of bilateral Official Development Assistance commitments. The aim of the book is to present a comprehensive record of the external financing of each country shown. The data show the transactions of each recipient country with: DAC member countries (individually or as a group); multilateral agencies (individually or as a group); and other major external funders.
Resource allocation and health financing
In 2001, the World Health Organisation’s Commission for Macroeconomics and Health (CMH) released its report, ‘Macroeconomics and Health: Investing in health for economic development’, urging the international community to invest substantially in health as a means of promoting development. According to this article, many observers credit the report as one of the key drivers for successfully raising the profile of global health in the international arena and promoting the long-neglected link between health and wealth. But reports on the success of the Commission are mixed. Howard Stein of the University of Michigan criticises the Commission for failing to mention the causes of poverty and poor health, including the gross inequities of the global economy caused by neoliberalism, suggesting that this is a consequence of the fact that most Commission members supported neoliberal economic policies at the time. Although at least 60 countries now offer a basic health care package, the concept failed to be supported by external funders, who continue to fund specific vertical interventions rather than an integral set of services. The Commission expected the pharmaceutical industry to voluntarily lower prices, which the authors argue has not happened.
With recent threats by the United states (US) Congress for extensive cuts to the federal government's budget for global health programmes, the author of ths paper argues that there could not be a worse time to pull back from long-standing American commitments to the health of people around the world. The cuts are argued to be particularly brutal at a time when medical science and field research shows the potential to achieve huge advances in the quality and scope of actions in global health. Major progress has been made in terms of providing care to malaria- and HIV-infected individuals. Rather than slashing global health funding, which represents less than 1% of the federal budget, the author argues that the US should be ensuring funding of successful international health initiatives and exploring new ways of generating predictable revenue for vital lifesaving programmes.
The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. This study was performed to estimate the costs associated with induced abortions in Uganda. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Results showed that the average societal cost per induced abortion was US$177, equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 and the average direct non-medical cost was $19. The average indirect cost was $92, while patients incurred $62 costs on average while government incurred $14 on average. In conclusion, induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers - that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.
At the 16th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA), held in December 2011 in Ethiopia, the Global Fund announced that it has put transitional funding mechanisms in place to ensure continued treatment for people living with HIV and AIDS. The mechanisms will bridge funding gaps that may arise following delayed payments by those who had pledged contributions to the Fund. In November 2011 the Fund adopted exceptional measures to suspend Round 11 but denied that the Fund is in financial trouble, arguing that only one of its funders has announced a decrease in funding. It identified the main problem as delayed payments. According to United States president, Barack Obama, the Fund remains on track to support more than US$8 billion in grant renewals and new grant commitments between 2011 and the end of 2013. The Fund is undergoing reforms to allow it to transition to a more flexible, sustainable and predictable funding model that will ensure that resources go to high-impact interventions and to people who need the help most. The Board has also taken steps to better target Global Fund resources on countries with the greatest need and least ability to pay. The article indicates that this means that at least 55% of Fund resources will be directed to low-income countries.
Speaking at the opening of the national consultative health forum’s National Health Insurance (NHI) conference on 7 December 2011, Organisation for Economic Co-operation and Development economist Ankit Kumar said South Africa should look to South Korea, which achieved universal health care for its entire population in just 12 years by investing in a strong primary healthcare system, eliminating fragmentation and containing hospital prices. South Koreans achieved universal coverage by starting the rollout of health insurance with the informal labour market before gradually expanding coverage to the formal labour market. In preparation for the roll out of South Africa’s NHI, the country’s Health Minister, Aaron Motsoaledi, reiterated his call for the establishment of a pricing commission to tackle uncontrolled commercialism and the exorbitant cost of private healthcare. Fragmentation in the form of private health care for the wealthy and public health care for the poor was also contributing to low levels of access to health care, he added.
This study focuses on two main areas, namely aid agency effectiveness (cost effectiveness of agencies) and aid policy effectiveness (the cost of parallel development policy making). Whereas other areas of the Paris agenda are equally important (like ownership, mutual accountability, and a focus on results), this study explored the costs, and put a price-tag on not implementing the Paris agenda. The study reviewed the aid effectiveness literature to date, most of which point to benefits of coordination. The European Commission found direct savings for the European Union (EU) through lower administrative costs from harmonising, from reducing the number of partner countries, changing the aid modality towards Budget Support (general or sectoral), untying aid and eliminating aid volatility. The total efficiency gains were estimated at € 5 billion per year.
In 2001, the World Health Organisation’s Commission for Macroeconomics and Health (CMH) released its report, ‘Macroeconomics and Health: Investing in health for economic development’, urging the international community to invest substantially in health as a means of promoting development. According to this article, many observers credit the report as one of the key drivers for successfully raising the profile of global health in the international arena and promoting the long-neglected link between health and wealth. But reports on the success of the Commission are mixed. Howard Stein of the University of Michigan criticises the Commission for failing to mention the causes of poverty and poor health, including the gross inequities of the global economy caused by neoliberalism, suggesting that this is a consequence of the fact that most Commission members supported neoliberal economic policies at the time. Although at least 60 countries now offer a basic health care package, the concept failed to be supported by external funders, who continue to fund specific vertical interventions rather than an integral set of services. The Commission expected the pharmaceutical industry to voluntarily lower prices, which the authors argue has not happened.
The district hospital has been considered a critical avenue for the delivery of child-saving interventions. It has been suggested that improving the performance of district hospitals would reduce child mortality by 3-30% in the areas they serve. It has however been
shown that the quality of care delivered in these hospitals in Kenya is inadequate. To improve the quality of care of children admitted in district hospitals in Kenya, the study developed clinical guidelines
in selected district hospitals. The guidelines were linked with health
worker training, job aids, follow-up and supervision and performance feedback termed the 'Emergency Triage and Treatment Plus (ETAT+) strategy. The strategy improved the quality of care of children admitted in hospitals by 25%. The total cost of scaling up the intervention was calculated at about US$ 3.6 million, estimated to be only 0.6% of the annual child health budget in Kenya. The ETAT+ strategy is argued to be cost-effective in improving the quality of care of children admitted in hospitals in Kenya.
The global financial transaction tax (FTT) is a key proposal that civil society campaigned for at the G20 Cannes Summit, hosted in Cannes, France, from 3-4 November 2011. It has the potential to raise billions of dollars to support social justice goals – estimates of the amount that FTT could generate range from about US$50 billion to as much as $250 billion if a wide range of transactions are included. The author identifies seven global taxes that could be included as ‘further transactions’. 1. A tax of 5% on First and Business class air tickets already funds UNITAID, and raises US$200 million annually – if generalised, it could raise $8 billion globally. 2. A tax on polluting activities, amounting $20-25 for every ton of CO2 would raise $300 billion, while taxation of air and sea international transportation could raise US$40 billion. 3. An additional tax on top of national taxes on transnational societies would eliminate tax havens and would turn these companies into global tax payers, thereby raising $100 billion. 4. A tax on arm sales could garner US$30 billion a year. 5. A tax on capital profits could amount to US$50 billion if it was generalised, if it covered all tax havens and if it was controlled. 6. The tax on currency exchange transactions limited to a rate of 0.005%, and applied to principal currency exchange markets (US$, pound and yen) would generate at least US$33 billion – if increased to 0.1%, this tax would raise $150-300 billion, as well as becoming an efficient instrument against rampant speculation. 7. A tax of $0.05 on every pack of cigarettes in rich countries (and of $0.01 in poorest countries) would raise an additional $7.7 billion.