2016 GH Sesi 3 YM Foreign aid for health
Foreign aid for health and development
Yodi Mahendradhata
Funding malaria control in Indonesia
Budget Gap Analysis by Source of Funding
90,000,000
80,000,000
70,000,000
GAP
60,000,000
Proposed TFM
GF R8
50,000,000
GF R6
GF R1
40,000,000
Unicef
WHO
30,000,000
Local Government
Central Government
20,000,000
10,000,000
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Foreign aid and economic growth in Africa?
Resource flow of foreign aid for health
CHANNELS OF
ASSISTANCE
FUNDING SOURCES
•
•
•
•
National
treasuries
Debt
repayments
Private
philanthropist
Corporate
donations
•
•
•
•
•
•
•
•
Bilateral
development
agencies
European
commission
UN agencies
Development
banks
GFATM
GAVI
Foundations
International
NGOs
IMPLEMENTING
INSTITUTIONS
•
•
•
•
•
Ministries of
health
Health
programs
National NGOs
Private sector
Universities
and research
bodies
Health aid
by origins
Health aid as
percentage of
national income
Health aid
by channel
Health aid geo distribution
Health aid disease distribution
Mortality vs donor funding
DALYs vs donor funding
National health budget vs donor (US$ million)
Country
HIV prevalence
National health
budget
Donor
commitment
(HIV)
Ethiopia
1.4%
113
130
Rwanda
3.1%
37
47
Uganda
6.7%
112
167
The emerging donors: BRICS
Foreign aid and economic growth in Africa?
World Bank: Indonesia HIV/AIDS and STDs prevention and
management project
Relevance
Substantial
Efficiency
Negligible
Efficacy
Negligible
Outcome
Unsatisfactory
Institutional
development impact
Sustainability
Negligible
Bank performance
Unsatisfactory
Borrower performance
Unsatisfactory
Unlikely
The real value of aid? (Crisp 2010)
Value on
paper
• Trade/mining
concessions
• Debt repayment
• Donor service
payment
Real
value
Channeling aid back to donor country
Country recipient
External technical
assistance
US$200,000
Typical annual cost for
international consultant (>1/3 for
school fees and child allowance)
Hosti g
ultiple do or
issio s…
Li ited i tegratio with ou try syste …
The global financial crisis?
WHO 2 year budget*
6000
5000
4000
3000
2000
1000
0
2006/2007
*Figures in US$ million
2012/2013
The end of the golden era for global health?
NGO & FBO spending*
Private donation*
2500
4000
3500
2000
3000
2500
1500
2000
1000
1500
1000
500
500
0
0
2008
2011
*Figures presented in US$ Million
2008
2010
7 deadly sins of donor agencies
Nr
Sin
Description
1
Impatience
With institution building
2
Envy
Collusion and coordination failure
3
Ignorance
Failure to evaluate
4
Pride
Failure to exit
5
Sloth
Pretending participation = ownership
6
Greed
Unreliable/stingy transfers
7
Foolishness
Underfunding of global and regional public
goods
The Paris Declaration
Principle
Description
Ownership
Developing countries exercise leadership over their
development policies and plans
Alignment
Do ors ase their support o ou tries’
development strategies and systems
Harmonisation
Donors co-ordinate their activities and minimise
the cost of delivering aid
Managing for results Developing countries and donors orient their
activities to achieve the desired results
Mutual
accountability
Donors and developing countries are accountable
to each other for progress in managing aid better
and in achieving development results
Yodi Mahendradhata
Funding malaria control in Indonesia
Budget Gap Analysis by Source of Funding
90,000,000
80,000,000
70,000,000
GAP
60,000,000
Proposed TFM
GF R8
50,000,000
GF R6
GF R1
40,000,000
Unicef
WHO
30,000,000
Local Government
Central Government
20,000,000
10,000,000
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Foreign aid and economic growth in Africa?
Resource flow of foreign aid for health
CHANNELS OF
ASSISTANCE
FUNDING SOURCES
•
•
•
•
National
treasuries
Debt
repayments
Private
philanthropist
Corporate
donations
•
•
•
•
•
•
•
•
Bilateral
development
agencies
European
commission
UN agencies
Development
banks
GFATM
GAVI
Foundations
International
NGOs
IMPLEMENTING
INSTITUTIONS
•
•
•
•
•
Ministries of
health
Health
programs
National NGOs
Private sector
Universities
and research
bodies
Health aid
by origins
Health aid as
percentage of
national income
Health aid
by channel
Health aid geo distribution
Health aid disease distribution
Mortality vs donor funding
DALYs vs donor funding
National health budget vs donor (US$ million)
Country
HIV prevalence
National health
budget
Donor
commitment
(HIV)
Ethiopia
1.4%
113
130
Rwanda
3.1%
37
47
Uganda
6.7%
112
167
The emerging donors: BRICS
Foreign aid and economic growth in Africa?
World Bank: Indonesia HIV/AIDS and STDs prevention and
management project
Relevance
Substantial
Efficiency
Negligible
Efficacy
Negligible
Outcome
Unsatisfactory
Institutional
development impact
Sustainability
Negligible
Bank performance
Unsatisfactory
Borrower performance
Unsatisfactory
Unlikely
The real value of aid? (Crisp 2010)
Value on
paper
• Trade/mining
concessions
• Debt repayment
• Donor service
payment
Real
value
Channeling aid back to donor country
Country recipient
External technical
assistance
US$200,000
Typical annual cost for
international consultant (>1/3 for
school fees and child allowance)
Hosti g
ultiple do or
issio s…
Li ited i tegratio with ou try syste …
The global financial crisis?
WHO 2 year budget*
6000
5000
4000
3000
2000
1000
0
2006/2007
*Figures in US$ million
2012/2013
The end of the golden era for global health?
NGO & FBO spending*
Private donation*
2500
4000
3500
2000
3000
2500
1500
2000
1000
1500
1000
500
500
0
0
2008
2011
*Figures presented in US$ Million
2008
2010
7 deadly sins of donor agencies
Nr
Sin
Description
1
Impatience
With institution building
2
Envy
Collusion and coordination failure
3
Ignorance
Failure to evaluate
4
Pride
Failure to exit
5
Sloth
Pretending participation = ownership
6
Greed
Unreliable/stingy transfers
7
Foolishness
Underfunding of global and regional public
goods
The Paris Declaration
Principle
Description
Ownership
Developing countries exercise leadership over their
development policies and plans
Alignment
Do ors ase their support o ou tries’
development strategies and systems
Harmonisation
Donors co-ordinate their activities and minimise
the cost of delivering aid
Managing for results Developing countries and donors orient their
activities to achieve the desired results
Mutual
accountability
Donors and developing countries are accountable
to each other for progress in managing aid better
and in achieving development results