james droop 16 march 2010 dfid and the health mdgs

James Droop

16 March 2010

DFID and the Health MDGs

• 1.C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger (Prevalence of underweight children under-five years of age)

• 4: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

• 5.A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio. B: Achieve, by 2015, universal access to reproductive health

• 6.A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS. B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

DFID health spend by types of aid 2008/09 (provisional data)

Source: DFID, Health Portfolio Review 2009

General budget support£56.8m

Sector budget support£133.4m

Other financial

aid£121.1m

DFID Health Portfolio£1008.9m

Multilateral

£242.8m

Bilateral programmes

£766.2m

Financial aid £311.3m

Technical cooperation

£131.3m

Other bilateral aid£323.6m

Multilateral orgs.

£142.2m

Not for profit orgs.

£144.3m

Human-itarian£22.0m

Other

£1.5m

Debt relief

£13.6m

25 x increase 02/03 - 08/09 (2% to 17% bilateral aid)

ODA Commitments for Health (1995-2008)

Source: OECD/DACNote: RH includes population policy and administrative management, reproductive health care, family planning, personnel development for population and reproductive health

ODA Commitments for Nutrition, 1995-2007

HIV/AIDS

Total Health

RH0500

0100

00

150

00

200

00

con

sta

nt

US

$ m

illions

1995 1998 2001 2004 2007Year

Total ODA Commitments for Health1995-2008

HIV/AIDS

Total Health

RH0500

0100

00

150

00

200

00

con

sta

nt

US

$ m

illions

1995 1998 2001 2004 2007Year

ODA Commitments for Health, 1995-200860 High MMR Countries: Ratio>300

Source: OECD DACNote:RH includes population commitments

ODA Commitments for Health, 1995-2008

Maternal Mortality v. Fertility

Belize

Botswana

EthiopiaNigeria

Chad

Uganda

Ukraine

Brazil

Mali

Niger

China

IndonesiaIndia

Mexico

Poland

Bangladesh

Egypt

55010

022

050

015

00

Mate

rnal m

ort

ality

ratio

(M

MR

)

1 1.5 2 2.5 3 4 5 6 7Total fertility rate (TFR)

Source: WDINote: Median TFR=3; Median MMR=220Note: Colors mark HIV prevalence among females aged 15-24Red=high prevalence (greater than 1.3%)Yellow=middle prevalence (between 0.3% and 1.3%)Green=low prevalence (less than 0.3%)

Maternal mortality vs fertility in developing countries, 2005

Health Financing:Needs and Resources

If commitments met and GDP growth continues – no gap (when aggregated across countries)

If stay at current levels of DAH – gap $28bn – $37bn by 2015

2007 DFID Health Strategy

• Increasing the amount and improving the use of resources for health

• Expanding access to basic services through stronger systems

• Improving effectiveness of multilateral system

• Demonstrating results and improving evidence

• £7bn health spend 2008/15 (£1009m 08/09)

White Paper 4

AIDS Strategy

• Between 2004-2008 over £1.5 billion to support the global AIDS response - second largest donor after the US.

• £1 bn for the Global Fund for 2008-2015. £6 bn over 7 years for health

• A 50% increase in funding for research and development of AIDS vaccines and microbicides

• Stronger health systems to facilitate the scale up of preventative measures, such as prevention of mother to child transmission of HIV, help more effectively address co-morbidity of HIV with TB, malaria and other diseases and they will help deliver ARVs to those who need them.

DFID and Global Health

• £7bn Commitment to health 2008 – 2015• £1bn to GFTAM

• Policy engagement• Strong health systems and coordination focus• Board membership - GFATM, GAVI and UNITAID

• Primary spend through bilateral programmes

• Significant funding to GHIs and multilaterals• EC, WB, GFATM, UNITAID, GAVI and UNFPA

Health systems *36%

HIV/AIDS including STD Prevention

22%

Infectious diseases16%

Health Research7%

Maternal and Neonatal Health8%

Other5%

Reproductive Health Care6%

Bilateral Spend: sub-sectors (provisional data)


DFID health spend by types of aid 2008/09 (provisional data)


General budget support£56.8m

Sector budget support£133.4m

Other financial

aid£121.1m


Multilateral

£242.8m

Bilateral programmes

£766.2m

Financial aid £311.3m

Technical cooperation

£131.3m

Other bilateral aid£323.6m

Multilateral orgs.

£142.2m

Not for profit orgs.

£144.3m

Human-itarian£22.0m

Other

£1.5m

Debt relief

£13.6m

25 x increase 02/03 - 08/09 (2% to 17% bilateral aid)

DFID Imputed Multilateral Spend on Health 2008/09 (provisional data)

Note: DFID counts GAVI and UNITAID as bilateral spendSource: DFID, Health Portfolio Review 2009


Bilateral£766.2m

Multilateral£242.8m

United Nations

£57.1

GFATM£50.0m

IFFIm£16.8m

UNICEF£7.3m

UNFPA£25.0m

UNAIDS£10.0m

WHO£13.0m

UNDP£1.8m

WB£56.5m

EC£57.8m

RegionalBanks£4.6m

Health Systems Spend Health aid by sub sector

0% 20% 40% 60% 80% 100%

UnitedKingdom

Multilateral

Bilateral

All

General health

TB Malaria and otherinfectious diseases

Other basic health

HIV/AIDs control

Other reproductive health

Source: OECD DAC data

THE UK IS READY TO STAND WITH COUNTRIES READY TO PROVIDE FREE HEALTHCARE AND IN ADDITION TO PROVIDING RESOURCES, THE UK WILL ALSO SHARE OUR EXPERTISE. SO I AM NOW ANNOUNCING THE CREATION OF A NEW CENTRE FOR PROGRESSIVE HEALTH FINANCE - TO PROVIDE DEDICATED ADVICE FOR COUNTRIES WHO HOPE TO ABOLISH USER FEES AND MOVE FORWARD TO FREE HEALTHCARE.

DURING THE 1980S FLAWED DEVELOPMENT POLICIES AND BAD ADVICE LED MANY POOR COUNTRIES TO CHARGE FEES. THESE FEES – OFTEN ONLY A FEW PENCE – HAVE BECOME A DEATH SENTENCE FOR MILLIONS.

International Engagement

More Money for Health, More Health for the Money

Source; Don De Savigny & COHRED

Contra-ceptives and

RHequipm ent

STIDrugs

EssentialDrugs

Vaccinesand

Vitamin ATB/Leprosy

BloodSafety

Reagents(inc. HIV

tests)

DFID

KfW

UNICEF

JICA

GOK, W B/IDA

Source offunds for

commodities

CommodityType

(colour coded) M OHEquip-ment

Point of firstwarehousing

KEM SA Central W arehouse

KEM SARegionalDepots

Organizationresponsible

for delivery todistrict levels

KEM SA and KEM SA Regional Depots (essential drugs, m alaria drugs,

consum able supplies)

ProcurementAgent/Body

Crow nAgents

Governmentof Kenya

GOK

GTZ(p rocurem ent

im plem entationunit)

JSI/DELIVER/KEM SA LogisticsM anagement Unit (contraceptives,

condom s, STI kits, HIV test kits, TBdrugs, RH equipm ent etc)

EU

KfW

UNICEF

KEPI ColdStore

KEPI(vaccines

andvitam in A)

M alaria

USAID

USAID

UNFPA

EUROPA

Condom sfor STI/

HIV/AIDSprevention

CIDA

UNFPA

USGov

CDC

NPHLS store

M EDS(to M issionfacilities)

PrivateDrug

Source

GDF

Governm ent

NGO/Private

Bilateral Donor

M ultilateral Donor

W orld Bank Loan

Organization Key

JapanesePrivate

Com pany

WHO

GAVI

SIDA

NLTP(TB/

Leprosydrugs

Com modity Logistics System in Kenya (as of April 2004) Constructed and produced by Steve Kinzett, JSI/Kenya - please communicateany inaccuracies to skinzett@ cb.jsikenya.com or telephone 2727210

Anti-RetroVirals

(ARVs)

Labor-atorysupp-

lies

GlobalFund forAIDS, TB

and M alaria

The"Consortium "

(Crow n Agents,GTZ, JSI and

KEMSA)

BTC

M EDS

DANIDA

M ainly District level staff: DPHO, DPHN, DTLP, DASCO, DPHO, etc or staff from the Health Centres,Dispensaries come up and collect from the District level

M EDS

Provincial andDistrict

HospitalLaboratory

Staff

Organizationresponsible fordelivery to sub-

district levels

KNCV

M SF

M SF

International Health Partnership (IHP+)

"To work together in more efficient ways to improve health care and health outcomes…

Led by country governments acting with their civil society we will tackle the challenges facing country health systems….

To build on and use the existing systems at country level…

To be held to account in implementing this compact"

Global Compact, September 2007

james droop 16 march 2010 dfid and the health mdgs

Documents

health mdgs slide

unfpa slide

fertility slide

bn health

bilateral aid slide

global health

health financing

dfid health strategy