Methodology to assess volumes and patterns of
official development assistance (ODA) for health and
HIV services: the reality of European governments'
financial contributions for the HIV response in
developing countries in the period of 2007-2009
Marco Simonelli1, Joachim Rüppel2, Olga Golichenko3, Sieglinde Mauder2
1ActionAid
Italy / Action for Global Health, Rome, Italy, 2Medical Mission Institute, Wurzburg, Germany,3International HIV/AIDS Alliance / Action for Global
Health, Hove, United Kingdom
ODA Definition and Criteria
Official Development Assistance (ODA) is defined as
those flows to developing countries and
multilateral institutions provided by official
agencies, including state and local governments, or
by their executive agencies, each transaction of
which meets the following tests:
• it is administered with the promotion of the
economic development and welfare of
developing countries as its main objective;
• it is concessional in character and conveys a grant
element of at least 25 per cent.
Source: OECD-DAC
2
Aid Activities
Aid activities include:
• projects and programmes
• cash transfers
• deliveries of goods
• training courses
• research projects
• debt relief operations
• contributions to non-governmental
organizations.
3
Necessary Dimensions of ODA Analysis
This research attempts to analyse the volume of the Official
Development Assistance (ODA) on the part of the 17
European countries belonging to the DAC (Development
Assistance Committee / OECD) on the following levels:
• Total volume of resources differentiating between official
figures and real resource transfers
• ODA contributions for health promotion, and finally
• ODA contributions for specific interventions to confront
HIV
A comprehensive and objective assessment of donor
contributions for the response to the epidemic cannot focus solely
on the aid for specific programmes of HIV prevention, treatment
and support
Considering all Relevant Funding Channels or
Mechanisms
• Bilateral flows (provided directly by a donor
country to an aid recipient country)
• Multilateral flows (channelled via an
international organization active in
development e.g. World Bank, UN
Organizations, Global Fund, etc.)
• Funding channelled via the European Commission
represents a special case, but is subsumed by
DAC/OECD as multilateral
5
Multilateral Health Financing Organizations
•
•
•
•
•
•
•
•
•
•
•
•
•
IDA/World Bank
World Health Organization
UNAIDS (Unified Budget and Work Plan)
UNDP (United Nations Development Programme)
UNFPA (United Nations Population Fund)
UNICEF (United Nations Children's Fund)
Global Fund to Fight AIDS, Tuberculosis and Malaria
UNITAID
GAVI Alliance
International Finance Facility for Immunisation (IFFIm)
Advance Market Commitments (AMC)
African Development Fund
Asian Development Fund
Multilateral Health Financing Organizations, continued
•
•
•
•
•
•
•
•
•
Drugs for Neglected Diseases initiative (DNDi)
Medicines for Malaria Venture (MMV)
Global TB Alliance
International Partnership for Microbicides (IPM)
International Initiative for AIDS Vaccine (IAVI)
World Food Program (WFP)
International Committee of the Red Cross
International Planned Parenthood Federation (IPPF)
Other…
Classification of Projects according to Needs
Assessments developed by Millennium Project
(Health Sector) and UNAIDS (HIV Response)
Health funding needs include:
• the cost of running a health system offering essential
medical interventions, such as emergency obstetric
care, treatment for the major infectious diseases, and
interventions to reduce child mortality.
• interventions primarily provided outside the health
system, such as preventing major diseases and
mitigating the social impact
8
Relevant Information Sources
Source
Purposes and Contents
CRS Aid Activity database
of DAC/OECD
Basic data on (sub-)sectors, recipients, policy issues and
financial volumes on a disaggregated level, i.e. for individual
activities, for bilateral and most multilateral organizations
DAC Statistics database
Comprehensive data on the volume, origin and
types of aid and resource flows on an aggregated level
World Bank Project
Database
Data on recipients, sources, amounts of commitments and
financial share of up to 5 sectors, as well as other aspects
Global Fund Pledges and
Contributions Tables
Pledges made and contributions paid and unpaid for Global
Fund
Annual Reports of International Organizations
Contributions paid to UN organizations, UNITAID, GAVI, etc.
by donor; in some cases breakdowns by sector or theme
World Health Assembly
Documentation
Status of collection of annual regular budget assessed
contributions
National Health Accounts
(NHA)
General government expenditure on health as % of total
government expenditure
9
Methodological Features
• The project-level information system of DAC/OECD
constitutes the most important basis for the analysis
• Examination of every single aid activity reported in the
health and population sectors in order to determine
the main purposes (linking activities over the years)
• Insufficient or contradictory data are complemented
through web-based research and direct
communication with implementing agencies
• Health-relevant projects recorded in other sectors are
identified via text search and scrutinized accordingly
Result: consolidated and structured list of pertinent
projects correcting for misclassifications, reporting
errors and double counting
Examples of Reporting Problems
Other flows recorded as Health Projects:
Annual Action Programme for the Thematic Programme
on Cooperation in the Area of Migration and Asylum for
2009,
Commitment: 60.3 million US$
Population Census support initiative,
Disbursement in 2009: 1 million US$
Recherche et analyse démographique
Total Disbursements in 2009: 7 million US$
Programa de Apoyo a la Política Nacional de Seguridad
Alimentaria Nutricional (Food Security)
Disbursement in 2009: 12.5 million US$
Examples of Reporting Problems
Other flows recorded as HIV control:
 Total commitment of 30 million Euros: 24 million
sector budget support, 3 million for technical
assistance to the Ministry of Health, and 3 million to
help the National AIDS Council
(imputed HIV support: 5.7 million Euros or 19%)
 Co-Financing Health Sector Budget Support
Disbursement in 2009: 8.4 million US$
 General medical and laboratory equipment, laboratory
infrastructure and laboratory design components
Disbursements in 2009: 24.8 million US$
Examples of Reporting Problems
Core contributions to international organizations
recorded as bilateral aid (potential double counting):
France for UNITAID
Disbursements in 2008: 207.7 million US$
Germany for UNAIDS
Disbursement in 2009: 4.9 million US$
United Kingdom for International Partnership on
Microbicides
Disbursement in 2009: 9.8 million US$
Examples of Reporting Problems
HIV Components not recorded as HIV control:
European and Developing Countries Clinical Trials
Partnership (EDCTP), to help facilitate and develop
clinical trials for new drugs and vaccines against
HIV/AIDS, malaria and TB
Total disbursement in 2007: 53.6 million US$, imputable
HIV contribution: 32.2 million US$
Higher Education HIV & AIDS (HEAIDS)
Disbursement in 2007: 0.7 million US$
Emergency Food Aid for HIV/AIDS-patients
Disbursements in 2009: 1 million US$
General ODA
• OECD-accepted ODA includes expenditure items and
accounting entries that do not represent real transfers
of financial, technical or personnel resources, namely
debt relief, imputed student costs, administrative costs
and expenditure for refugees in donor countries
• Some European DAC countries provide a considerable
part of their ODA in the form of loans, a practice that
contravenes the orientation towards needs.
• Real ODA Grant Transfers after deducting these
questionable items show great differences and are in
many cases significantly lower than official figures
Euro Million
12,000
Evolution of France's
ODA 2004-2010:
11,000
Composition of
Gross Disbursements
10,000
and Repayments from Recipients
9,000
Administrative Costs
1,859
Refugees in donor
countries
Imputed student costs
1,009
8,000
2,789
7,000
1,412
5,000
496
1,799
188
764
733
2,176
2,232
151
88
658
4,000
3,000
675
1,094
2,706
6,000
1,873
1,329
Debt Relief
1,722
2,206
666
651
3,421
3,344
2,147
1,758
159
207
2,322
2,211
-860
-979
2004
2005
Bilateral Loans
Bilateral Grants (real
Transfers)
Multilateral Loans
Multilateral Grants
2,000
1,000
1,290
2,544
2,691
3,060
Repayments (negative
amount)
0
-1,000
-2,000
-1,525
2006
-1,034
-993
-900
-847
2007
2008
2009
2010
Data for multilateral loans in 2010 are
not available yet and were calculated
on the basis of the proportions
of loans in the previous year
Evolution of France's
ODA in relation to
Gross national Income:
0.70%
0.60%
Collective Intermediate Target of EU: 0.56% of GNI
Minimum Target of EU: 0.51% of GNI
0.50%
0.47%
0.47%
0.41%
0.47%
0.38%
0.40%
0.39%
0.29%
0.30%
0.24%
0.23%
0.23%
0.20%
0.20%
0.18%
0.18%
2005
2006
0.50%
0.35%
0.37%
DAC standard
Real Transfers
0.25%
Grants only
0.20%
0.21%
0.22%
2007
2008
2009
0.24%
0.10%
0.00%
2004
ODA ratios
according to different
modes of calculation
2010
Euro Million
12,000
Evolution of Germany's
ODA 2004-2010:
11,000
Composition of
Gross Disbursements
10,000
9,000
1,778
8,000
2,066
2,121
7,000
2,802
6,000
397
4,000
and Repayments from Recipients
1,914
Administrative Costs
1,158
Refugees in donor
countries
Imputed student costs
1,145
917
854
3,826
583
5,000
61
125
4,071
3,351
573
Bilateral Loans
2,849
2,769
2,190
Bilateral Grants (real
Transfers)
Multilateral Loans
2,536
3,000
2,000
2,994
2,120
1,000
2,709
3,171
3,410
3,578
3,556
Multilateral Grants
Repayments (negative
amount)
0
-934
-843
-1,053
-927
-890
-868
-1,011
2004
2005
2006
2007
2008
2009
2010
-1,000
-2,000
Debt Relief
Evolution of Germany's
ODA in relation to
Gross National Income:
0.70%
0.60%
Collective Intermediate Target of EU: 0.56% of GNI
Minimum Target of EU: 0.51% of GNI
0.50%
0.40%
0.30%
0.36%
0.36%
0.37%
0.20%
0.19%
0.35%
0.28%
0.28%
0.22%
0.38%
0.23%
0.19%
0.38%
DAC standard
0.34%
0.21%
0.27%
0.26%
2009
2010
0.23%
0.10%
0.00%
2004
2005
2006
Real Transfers
0.25%
0.19%
0.17%
0.31%
ODA ratios
according to different
modes of calculation
2007
2008
Grants only
0.70%
0.60%
0.56%
Collective Intermediate Target of EU: 0.56% of GNI
Minimum Target: 0.51% of GNI
0.50%
0.51%
0.51%
0.47%
0.43%
0.40%
0.30%
0.36%
0.35%
0.30%
0.30%
0.28%
0.29%
2004
2005
0.33%
0.36%
0.33%
0.39%
Evolution of
United Kongdom's
ODA in relation to
Gross National Income:
0.54% ODA ratios
0.51% according to different
modes of calculation
0.49%
0.46%
DAC standard
0.36%
Real Transfers
0.30%
Grants only
0.20%
0.10%
0.00%
2006
2007
2008
2009
2010
as a % of GNI
0.70%
0.60%
Collective Intermediate Target of EU: 0.56% of GNI
0.50%
0.45%
0.44%
0.44%
0.41%
0.40%
0.30%
Evolution of European
DAC member's ODA
in relation to
Gross National Income:
0.46%
0.40%
0.36%
0.30%
0.31%
0.28%
0.28%
2005
2006
0.33%
0.33%
0.36%
0.48% ODA ratios
according to different
0.41%
DAC standard
0.36%
Real Transfers
0.30%
Grants only
0.20%
0.10%
0.00%
2007
2008
2009
2010
100.0%
Share of European
DAC member's ODA
in relation to all
DAC Members
90.0%
80.0%
70.0%
DAC standard
60.0%
Real Transfers
50.0%
Grants only
40.0%
GNI
30.0%
20.0%
10.0%
0.0%
2005
2006
2007
2008
2009
2010
Official Development Assistance of European DAC Member Countries:
Real ODA Transfers and Grants in relation to Gross National Income (GNI)
1.04%
Luxembourg
1.04%
0.94%
Norway
0.92%
0.85%
Sweden
0.85%
0.81%
Denmark
0.80%
0.67%
Netherlands
0.67%
United Kingdom
0.51%
0.50%
Ireland
0.50%
0.49%
0.47%
Belgium
0.46%
Grants only
0.34%
Switzerland
0.33%
Spain
0.30%
Germany
0.26%
France
0.24%
0.38%
0.34%
0.36%
Minimum
Ratio of EU
for 2010:
0.51%
0.24%
Austria
0.24%
0.17%
0.27%
0.14%
Italy
0.13%
Greece
0.13%
0.00%
Real Transfers
0.50%
Finland
Portugal
0.54%
UN Target
since 1970:
0.7%
0.13%
0.10%
0.20%
0.30%
0.40%
0.50%
0.60%
0.70%
0.80%
0.90%
1.00%
1.10%
ODA for Health
• Only four out of 17 countries (Luxemburg, Norway,
Sweden and Ireland) reached in 2009 the target level of
0.1% recommended by the Commission on
Macroeconomics and Health
• Only the first three countries achieved the target of
0.12% of GNI based on the assumption that European
DAC countries cover at least 50% of financing needs
• The main part of the European gap results from the fact
that most of the larger economies (Germany, France,
Italy, Spain) fall far short of the targets
• The extremely low contributions from some medium-sized
economies (Austria, Switzerland) also have a considerable
negative impact
Germany's Bilateral ODA Contributions for Health Promotion and the Response to
the HIV Epidemic (US$ millions)
Commitments
Contributions for Health
Category of Aid Activity
2007
2008
2009
Contributions for HIV Response
Share
in %
2007
2008
2009
Recorded in Health
Sectors
Recorded in Other
Sectors
Total Contributions
Total Contributions
2007
2008
2009
2007
2008
2009
Specific HIV Interventions
59.2
110.0
115.5
100%
59.2
110.0
115.5
57.6
104.6
112.5
1.6
5.4
2.9
Projects of Reproductive Health
15.9
31.6
65.1
25%
4.0
7.9
16.3
15.9
31.4
58.1
0.0
0.1
7.0
167.8
227.3
221.3
10%
16.8
22.7
22.1
166.9
215.5
218.0
0.9
11.8
3.2
0.0
0.6
3.5
10%
0.0
0.1
0.3
0.0
0.6
3.4
0.0
0.0
0.1
Immunisation
83.8
66.2
73.9
0%
0.0
0.0
0.0
83.8
66.2
73.9
0.0
0.0
0.0
Other Health Problems
24.4
35.5
40.6
0%
0.0
0.0
0.0
23.8
35.4
40.6
0.6
0.1
0.0
351.1
471.2
519.9
79.9
140.7
154.2
348.1
453.7
506.6
3.1
17.5
13.2
10.8
20.1
19.4
1.1
2.0
1.9
361.9
491.3
539.2
XXX
81.0
142.7
156.2
0.0
0.0
0.0
XXX
na
na
na
22.6
22.4
7.4
XXX
na
na
na
9.4
3.8
4.2
XXX
na
na
na
6.8%
6.2%
6.8%
XXX
Health Sector Programmes
Child health
ODA for Specific Health Projects
General Budget Support
Total Bilateral ODA for Health
Memo: Emergency Projects
Memo: Multilateral shown separately
Memo: Other Sectors recorded as Health
Share of Bilateral Real ODA
XXX
10%
1.5%
1.8%
2.0%
Germany's Bilateral ODA Contributions for Health Promotion and the Response to
the HIV Epidemic (US$ millions)
Disbursements
Contributions for Health
Category of Aid Activity
2007
2008
2009
Contributions for HIV Response
Share
in %
2007
2008
2009
Recorded in Health
Sectors
Recorded in Other
Sectors
Total Contributions
Total Contributions
2007
2008
2009
2007
2008
2009
Specific HIV Interventions
75.0
85.2
91.4
100%
75.0
85.2
91.4
73.0
82.3
88.3
2.0
2.8
3.1
Projects of Reproductive Health
40.0
30.1
36.6
25%
10.0
7.5
9.2
38.2
28.2
34.5
1.8
1.9
2.2
141.6
188.9
218.1
10%
14.2
18.9
21.8
140.3
177.1
212.2
1.2
11.8
5.9
0.5
2.0
4.2
10%
0.0
0.2
0.4
0.5
2.0
4.2
0.0
0.0
0.0
Immunisation
40.5
65.4
27.1
0%
0.0
0.0
0.0
40.5
65.4
27.1
0.0
0.0
0.0
Other Health Problems
25.7
29.6
30.0
0%
0.0
0.0
0.0
25.7
29.5
30.0
0.0
0.1
0.0
323.2
401.1
407.3
99.2
111.8
122.8
318.1
384.5
396.1
5.1
16.7
11.2
10.5
7.8
19.6
1.0
0.8
2.0
Gross Bilateral ODA for Health, total
333.7
408.9
426.8
XXX
100.2
112.6
124.7
Imputable Repayments
-37.5
-38.2
-36.5
XXX
-0.1
-0.1
-0.1
Net Bilateral ODA for Health, total
296.2
370.7
390.4
XXX
100.1
112.5
124.6
0.0
0.0
0.0
XXX
na
na
na
25.7
13.2
14.3
XXX
na
na
na
6.3
7.9
14.3
XXX
na
na
na
7.8%
7.3%
7.0%
XXX
Health Sector Programmes
Child health
ODA for Specific Health Projects
General Budget Support
Memo: Emergency Projects
Memo: Multilateral shown separately
Memo: Other Sectors recorded as Health
Share of Bilateral Real ODA
XXX
10%
2.6%
2.2%
2.2%
Germany's ODA Disbursements for Health Promotion and HIV Response through multilateral Organizations and Total
Estimate
ODA Contributions for Health
Pomotion
Total ODA Contributions
Financing Mechanism
2007
2008
2009
2010
2007
2008
2009
ODA Contributions for HIV Response
2010
2007
2008
2009
2010
Share of Health Pomotion
2007
2,452.3
2,812.6
2,891.0
2,926.0
200.1
224.1
199.2
201.6
60.8
56.3
41.6
42.1
IDA / World Bank
1,097.1
1,135.8
1,029.7
691.92
116.0
118.2
95.3
56.9
36.5
37.8
23.5
17.7
10.6%
10.4%
29.4
30.9
31.1
30.2
29.4
30.9
31.1
30.2
2.7
2.9
3.0
2.9
100.0%
100.0%
1.6
2.7
5.1
3.6
1.6
2.7
5.1
3.6
1.6
2.7
5.1
3.6
100.0%
100.0%
UNDP
47.0
40.7
38.4
29.5
1.7
1.4
1.5
1.2
1.6
1.2
1.5
1.1
3.7%
UNFPA
25.7
26.0
25.1
19.5
21.5
21.4
18.0
14.0
7.5
8.4
7.7
6.0
UNICEF
6.1
8.3
9.1
8.2
1.2
1.5
2.1
1.9
0.4
0.5
0.5
0.5
116.7
312.2
271.4
265.8
116.7
312.2
271.4
265.8
74.3
192.9
127.5
UNITAID
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
GAVI
5.9
0.0
5.7
5.1
5.9
0.0
5.7
5.1
0.1
0.0
IFFIm
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
AMC
0.0
0.0
0.0
0.0
0.0
0.0
0.0
AfDF
125.7
213.3
217.3
222.3
13.0
18.4
11.6
AsDF
50.6
53.3
52.5
53.7
0.8
0.9
1.1
WFP
65.8
100.7
132.1
168.0
1.4
2.4
DNDi
0.0
0.5
1.0
0.0
0.0
MMV
0.0
0.0
0.0
0.0
WHO core
UNAIDS
Global Fund
Global TB Alliance
IPM
8.0%
2009
6.9%
2010
2007
2008
2009
2010
6.9%
2.5%
2.0%
1.4%
1.4%
9.3%
8.2%
3.3%
3.3%
2.3%
2.6%
100.0%
100.0%
9.1%
9.5%
9.5%
9.5%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
3.3%
4.0%
4.0%
3.5%
3.0%
3.8%
3.8%
83.7%
82.3%
71.7%
71.7%
29.2%
32.3%
30.5%
30.5%
19.4%
17.7%
23.3%
23.3%
6.9%
5.4%
6.0%
6.0%
124.8
100.0%
100.0%
100.0%
100.0%
63.7%
61.8%
47.0%
47.0%
0.0
0.0
100.0%
100.0%
100.0%
100.0%
49.3%
49.3%
49.3%
49.3%
0.1
0.1
100.0%
100.0%
100.0%
100.0%
2.5%
2.7%
1.3%
1.3%
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
2.5%
2.7%
1.3%
1.3%
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
2.5%
2.7%
1.3%
1.3%
11.8
1.9
3.4
1.7
1.7
10.4%
8.6%
5.3%
5.3%
1.5%
1.6%
0.8%
0.8%
1.1
0.1
0.1
0.1
0.1
1.5%
1.6%
2.1%
2.1%
0.2%
0.2%
0.2%
0.2%
3.4
4.3
1.4
2.4
3.4
4.3
2.1%
2.4%
2.6%
2.6%
2.1%
2.4%
2.6%
2.6%
0.5
1.0
0.0
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
1.4
1.4
1.4
0.0
1.4
1.4
1.4
0.0
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
1.4
1.4
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
ICRC
19.8
30.7
28.4
28.6
1.5
2.9
3.6
3.6
0.2
0.3
0.4
0.4
7.8%
9.5%
12.7%
12.7%
0.8%
0.9%
1.3%
1.3%
IPPF
4.9
5.2
8.3
5.9
4.9
5.2
8.3
5.9
1.2
1.3
2.1
1.5
100.0%
100.0%
100.0%
100.0%
25.0%
25.0%
25.0%
25.0%
FIND
na
0.0
0.0%
IAVI
1.4
8.2%
2008
Europ. Union
Share of HIV Response
0.0
0.0
IUATLD
Other: BACKUP-Initiative (Global Fund)
na
0.0
0.0
0.0
na
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100.0%
100.0%
100.0%
100.0%
0.0%
0.0%
0.0%
0.0%
100.0%
100.0%
100.0%
100.0%
63.7%
61.8%
47.0%
47.0%
13.1
5.0
8.0
8.0
13.1
5.0
8.0
8.0
8.3
3.1
3.8
3.8
Total Multilateral (relevant Org.)
4,063.1
4,779.3
4,755.5
4,466.2
530.2
749.0
667.8
615.1
200.1
314.7
223.1
210.4
Bilateral Health Projects
na
na
na
na
125.0
323.2
401.1
407.3
447.4
99.2
111.8
122.8
72.9
56.5
136.1
136.1
10.5
7.8
19.6
16.8
1.0
0.8
2.0
1.7
-1,230.3
-1,255.0
-1,196.6
-1,422.2
-37.5
-38.2
-36.5
-43.3
-0.1
-0.1
-0.1
-0.1
126.5
General Budget Support
Imputable repayments
Net Bilateral Real Transfers total
3,794.3
5,086.4
5,585.5
6,587.8
296.2
370.7
390.4
420.8
100.1
112.5
124.6
Net ODA (Real Transfers), total
8,226.7
10,118.6
10,714.5
11,297.3
826.4
1,119.7
1,058.2
1,035.9
300.2
427.1
347.7
337.0
0.25%
0.28%
0.31%
0.34%
0.025%
0.031%
0.031%
0.031%
0.009%
0.012%
0.010%
0.010%
9.9%
9.2%
3.6%
4.2%
3.2%
3.0%
Total Contributions as a % of GNI
Share of Total Real ODA Transfers
na
Net ODA (Real Transfers), total, Euro
6,009.6
7,015.2
7,694.1
8,529.9
603.7
776.3
759.9
782.1
219.3
296.1
249.7
254.4
1.53
1.86
1.95
2.03
0.15
0.21
0.19
0.19
0.06
0.08
0.06
0.06
Net ODA per cap. of devel. regions US$
na
na
na
10.0%
11.1%
Official Development Assistance of European DAC Member Countries:
Net Disbursements for Health Promotion in relation to Gross National Income (GNI) including Loans
0.186%
Luxembourg
0.149%
Norway
0.132%
Sweden
0.103%
Ireland
0.098%
Netherlands
0.078%
United Kingdom
0.056%
Belgium
0.050%
Spain
0.031%
Germany
0.028%
Switzerland
Greece
Portugal
0.000%
2007
0.041%
France
Austria
2008
0.052%
Finland
Italy
2009
0.091%
Denmark
Appropriate
Contribution Level
for European
Donors: 0.12%
0.017%
0.017%
0.014%
0.013%
0.100%
0.200%
Official Development Assistance of European DAC Member Countries:
Net Disbursements for Health Promotion in relation to Gross National Income (GNI) with and without Loans
0.186%
Luxembourg
0.186%
0.149%
Norway
0.149%
0.132%
Sweden
0.132%
0.103%
Ireland
0.103%
0.098%
Netherlands
0.098%
Grants
only
0.091%
Denmark
0.091%
0.078%
United Kingdom
0.078%
0.056%
Belgium
0.056%
0.052%
Finland
All
Transfers
0.052%
0.048%
Spain
0.050%
0.041%
France
0.041%
Germany
0.029%
Switzerland
0.028%
0.031%
Appropriate
Contribution Level
for European
Donors: 0.12%
0.028%
Austria
0.017%
Italy
0.017%
Greece
0.014%
Portugal
0.013%
0.017%
0.017%
0.014%
0.013%
0.000%
0.100%
0.200%
Volumes and Composition of European's DAC Members ODA for Health in 2009
US$ million
Ranked by GNI, Lending includes ODA Loans and Equity Investments
2,000
1,800
Bilateral Lending
1,600
1,400
1,200
Bilateral Grants
Multilateral Grants
1,000
Imputable Repayments
800
600
400
200
0
-200
ODA Transfers and Grants of European's DAC Members for Health in 2009
US$ million
Ranked by GNI, Lending includes ODA Loans and Equity Investments
4,500
4,000
3,500
3,000
2,500
2,000
1,500
1,000
500
0
Target Volume 0.12% of GNI
Target Volume 0.1% of GNI
Net ODA Transfers for Health
Net ODA Grants for Health
ODA for HIV Response
• The analysis was completed for 11 countries with higher
GNI representing 92% of total GNI of European DAC
members
• We observe abysmal differences regarding financial
efforts: Whereas few countries contributed their fair
share others paid less than a tenth of what they should
pay
• Again, the backlog of the majority of larger economies
(Germany, France, Spain and especially Italy) is
responsible for the main part of the gap
• The effect of the correction through project-by-project
review is even larger than in the case of ODA for health
Official Development Assistance of European DAC Member Countries:
Net Disbursements for the HIV Response in relation to Gross National Income (GNI)
0.057%
Sweden
0.046%
Norway
0.039%
Netherlands
0.024%
United Kingdom
0.015%
Spain
2008
0.015%
Belgium
0.014%
France
2007
0.010%
Germany
0.007%
Switzerland
Appropriate
Contribution Level
for European
Donors: 0,05%
0.004%
Austria
Italy
2009
0.003%
0.000%
0.010%
0.020%
0.030%
0.040%
0.050%
0.060%
0.070%
0.080%
0.090%
0.100%
Geographic Distribution
• Analysis of Health ODA per capita made
available by 5 larger economies and the
European Union casts doubt on coordination
and orientation towards countries with
highest needs
• Final appraisal will take into account ODA for
Health promotion and HIV response by all
donors
Share of Sub-Saharan Africa in ODA for Health and for HIV Response by
European Donors
100.0%
ODA for HIV Response
ODA for Health
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
France
Germany
Italy
Spain
United Kingdom
European Union
0.0%
2007
2008
2009
2007
2008
2009
12.00
10.00
9.00
7.00
6.00
4.00
Equatorial Guinea
Djibouti
Grenada
Moldova
Zimbabwe
Palestinian Adm. Areas
Sierra Leone
Malawi
Zambia
Liberia
Mozambique
Rwanda
Comoros
Namibia
Serbia
St. Lucia
Guinea-Bissau
Mauritania
Libya
Cape Verde
Cambodia
Sao Tome & Principe
Burkina Faso
Senegal
Nicaragua
Guyana
Kyrgyz Rep.
Burundi
Morocco
Ghana
Benin
Kenya
Peru
Gabon
Tanzania
Afghanistan
Central African Rep.
Barbados
Togo
Albania
Niger
Angola
Suriname
Congo, Dem. Rep.
Mali
Lebanon
Swaziland
Lesotho
South Africa
Bolivia
Nepal
El Salvador
Syria
Paraguay
Uganda
Montenegro
Tajikistan
Georgia
Jamaica
Cameroon
Dominican Republic
Chad
Nigeria
Timor-Leste
Somalia
Ethiopia
Guinea
Argentina
Myanmar
Laos
Bosnia and Herzegovina
Guatemala
Haiti
Armenia
Ecuador
Gambia
Viet Nam
Congo, Rep.
Tunisia
Trinidad & Tobago
Bhutan
Côte d'Ivoire
Mongolia
Jordan
Yemen
Bangladesh
Honduras
Philippines
Sudan
Uruguay
India
Papua New Guinea
Macedonia, FYR
Cuba
Uzbekistan
Iraq
Azerbaijan
Egypt
Panama
Ukraine
Indonesia
Botswana
Madagascar
Pakistan
Kazakhstan
Kosovo
Venezuela
Eritrea
Thailand
Sri Lanka
China
Colombia
Chile
Belarus
Fiji
Costa Rica
Korea, Dem. Rep.
Mexico
Brazil
Croatia
Algeria
Solomon Islands
Turkey
US$
ODA for Health from Five European DAC Members per Capita in 2009, all Recipients
14.00
13.00
European Union
11.00
United Kingdom
Spain
8.00
Italy
5.00
Germany
France
3.00
2.00
1.00
0.00
12.00
10.00
9.00
7.00
6.00
4.00
Equatorial Guinea
Djibouti
Grenada
Moldova
Zimbabwe
Palestinian Adm. Areas
Sierra Leone
Malawi
Zambia
Liberia
Mozambique
Rwanda
Comoros
Namibia
Serbia
St. Lucia
Guinea-Bissau
Mauritania
Libya
Cape Verde
Cambodia
Sao Tome & Principe
Burkina Faso
Senegal
Nicaragua
Guyana
Kyrgyz Rep.
Burundi
Morocco
Ghana
Benin
Kenya
Peru
Gabon
Tanzania
Afghanistan
Central African Rep.
Barbados
Togo
Albania
Niger
Angola
Suriname
Congo, Dem. Rep.
Mali
Lebanon
Swaziland
Lesotho
South Africa
Bolivia
Nepal
El Salvador
Syria
Paraguay
Uganda
Montenegro
Tajikistan
Georgia
Jamaica
Cameroon
Dominican Republic
Chad
US$
ODA for Health from Five European DAC Members per Capita in 2009, Recipients > 1€
14.00
13.00
European Union
11.00
United Kingdom
Spain
8.00
Italy
5.00
Germany
France
3.00
2.00
1.00
0.00
Eritrea
Madagascar
Botswana
Sudan
Côte d'Ivoire
Congo, Rep.
Gambia
Guinea
4.00
Ethiopia
6.00
Nigeria
7.00
Somalia
9.00
Chad
10.00
Cameroon
11.00
Uganda
12.00
South Africa
Lesotho
Swaziland
Mali
Congo, Dem. Rep.
Angola
Niger
Togo
Central African Rep.
Tanzania
Gabon
Kenya
Benin
Ghana
Burundi
Senegal
Burkina Faso
Sao Tome & Principe
Cape Verde
Mauritania
Guinea-Bissau
Namibia
Comoros
Rwanda
Mozambique
Liberia
Zambia
Malawi
Sierra Leone
14.00
Mauritius
Zimbabwe
Djibouti
Equatorial Guinea
US$
ODA for Health from Five European DAC Members per Capita in 2009, Sub-Saharan
Africa
13.00
European Union
United Kingdom
Spain
8.00
Italy
Germany
5.00
France
3.00
2.00
1.00
0.00
Next steps
• Action for Global Health plans to develop partnerships with
local organisations from civil society in order to track the
internal ODA flows in a sample of African countries including
the allocation by sub-regions, delivery channels, target
populations and programmatic orientations. This in-depth
analysis will consider the interplay with other funding sources,
mainly the resources raised domestically by the general
government and households. Thereby we expect to produce
reliable results and to contribute, simultaneously, to
strengthening the capacity of democratic control in the field
of development and health financing
More information see:
www.actionforglobalhealth.eu
www.medmissio.de