MSF provides treatment for HIV and tuberculosis (TB) in more than 20 countries around the world. The report Burden sharing or burden shifting? How the HIV/TB response is being derailed examines the situation in nine countries where MSF runs programmes: Central African Republic, Democratic Republic ...of Congo, Eswatini, Guinea, Kenya, Malawi, Mozambique, Myanmar and Zimbabwe. With a focus on the financial resources available, this report highlights the current risks and gaps in HIV and TB service delivery in these countries.
Given the findings of gaps in diagnosis, prevention and care services and dwindling resources, MSF calls for a robust assessment of the needs and the resource capacity of each affected country, and calls on international donors to ensure that the financial burden is shared, rather than shifted onto those countries worst affected by the diseases.
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This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and fut...ure scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
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In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scal...e-up nutrition-specific interventions at the level needed to achieve the global targets. However, the world is off-track to meet the global targets. And it is unclear whether additional resources will be mobilized for life-saving and cost-effective nutrition-specific interventions, or whether donor support will be enough to meet the annual resource need established by the framework.
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During the first year of the Covid-19 pandemic, the world’s economy slowed. Yet, the global annual average particulate pollution (PM2.5) was largely unchanged from 2019 levels. At the same time, growing evidence shows air pollution—even when experienced at very low levels—hurts human health. T...his recently led the World Health Organization (WHO) to revise its guideline for what it considers a safe level of exposure of particulate pollution, bringing most of the world—97.3 percent of the global population—into the unsafe zone. The AQLI finds that particulate air pollution takes 2.2 years off global average life expectancy, or a combined 17 billion life-years, relative to a world that met the WHO guideline. This impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.
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Tracking global malaria spending provides insight into how far the world is from reaching the malaria funding target of $6·6 billion annually by 2020. Because most countries with a high burden of malaria are low income or lower-middle income, mobilising additional government resources for malaria m...ight be challenging.
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The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20...30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
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Past quantitative research on health financing has focused mostly on the level and distribution of total expenditure, with little emphasis on the specific role of public funds, despite their known importance for universal health coverage (UHC). Health Accounts data do not disaggregate public expendi...ture on health by source of funding. Achieving a better understanding of public financing for health in the context of the macro-fiscal and health financing environment is of fundamental importance to the development of future health financing policy, particularly in low- and middle-income countries (LMICs).
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There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting... and suggest improvements. Methods: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation’s Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources.
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I examine the effectiveness of donors in targeting the highest burden of malaria in the Democratic Republic of Congo when health information structure is fragmented. I exploit local variations in the burden of malaria induced by mining activities as well as financial and epidemiological data from he...alth facilities to estimate how local aid is matching local health needs. Using a regression discontinuity design, I find significant but quantitatively small variations in aid to health facilities located within mining areas. Comparing local aid with the additional cost of treatment and prevention associated with the increased risk of malaria transmission, I find suggestive evidence that local populations with the highest burden of the disease receive a proportionately lower share of aid compared to neighbouring areas with reduced exposure to malaria infection. The evidence of disparities in the allocation of aid for malaria supports the view that donors may have inaccurate information about local population needs.
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Background: Disbursements of development assistance for health (DAH) have risen substantially during the past several decades. More recently, the international community's attention has turned to other international challenges, introducing uncertainty about the future of disbursements for DAH.
Meth...ods: We collected audited budget statements, annual reports, and project-level records from the main international agencies that disbursed DAH from 1990 to the end of 2015. We standardised and combined records to provide a comprehensive set of annual disbursements. We tracked each dollar of DAH back to the source and forward to the recipient. We removed transfers between agencies to avoid double-counting and adjusted for inflation. We classified assistance into nine primary health focus areas: HIV/AIDS, tuberculosis, malaria, maternal health, newborn and child health, other infectious diseases, non-communicable diseases, Ebola, and sector-wide approaches and health system strengthening. For our statistical analysis, we grouped these health focus areas into two categories: MDG-related focus areas (HIV/AIDS, tuberculosis, malaria, child and newborn health, and maternal health) and non-MDG-related focus areas (other infectious diseases, non-communicable diseases, sector-wide approaches, and other). We used linear regression to test for structural shifts in disbursement patterns at the onset of the Millennium Development Goals (MDGs; ie, from 2000) and the global financial crisis (impact estimated to occur in 2010). We built on past trends and associations with an ensemble model to estimate DAH through the end of 2040.
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Background: A recent report by the Institute for Health Metrics and Evaluation (IHME) highlights that mental health receives little attention despite being a major cause of disease burden. This paper extends previous assessments of development assistance for mental health (DAMH) in two significant w...ays; first by contrasting DAMH against that for other disease categories, and second by benchmarking allocated development assistance against the core disease burden metric (disability-adjusted life year) as estimated by the Global Burden of Disease Studies. Methods: In order to track DAH, IHME collates information from audited financial records, project level data, and budget information from the primary global health channels. The diverse set of data were standardised and put into a single inflation adjusted currency (2015 US dollars) and each dollar disbursed was assigned up to one health focus areas from 1990 through 2015. We tied these health financing estimates to disease burden estimates (DALYs) produced by the Global Burden of Disease 2015 Study to calculated a standardised measure across health focus areas—development assistance for health (in US Dollars) per DALY.
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The Global Burden of Disease (GBD) 2010 Study has published disability-adjusted life year (DALY) data
at both regional and country levels from 1990 to 2010. Concurrently, the Institute for Health Metrics and Evaluation
(IHME) has published estimates of development assistance for health (DAH) at th...e country-disease level for this
same period of time.
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Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response to HIV/AIDS. To understand whether domestic resources could fill the financing gaps created by declines in development assistance, we aimed to track spe...nding on HIV/AIDS and estimated the potential for governments to devote additional domestic funds to HIV/AIDS.
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Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health
(RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and
the Organisation for Economic Co-operation and Development (OECD) policy marker. We... aimed to compare the
estimates, trends, and methodologies of these initiatives and make recommendations for future aid tracking.
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Development assistance for health (DAH) has grown substantially, totaling more than $31.3 billion in 2013. However, the degree that countries with high concentrations of armed conflict, ethnic violence, inequality, debt, and corruption have received this health aid and how that assistance might be d...ifferent from the funding provided to other countries has not been assessed.
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To better understand the global response to HIV/AIDS, this study tracked
development assistance for HIV/AIDS at a granular, program level.
Little is known about the patterns of development assistance (DA) for each component of reproductive, maternal, newborn, child and adolescent health (RMNCAH) in conflict-affected countries nor about the DA allocation in relation to the burden of disease
Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD) ...for 2011–2019; and clarified its flows, including aid type,
channel, target region, and target health focus area. Data from the OECD iLibrary were used. The DAH definition was based on the OECD sector classification. For core funding to non-healthspecific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for
calculating imputed multilateral official development assistance (ODA).
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