afrol News, 30 November - New research reveals that the part of development aid directed towards health issues has increased strongly during the last two decades. But Africa receives far less health aid than less challenged developing countries, compared to needs.
In a 99-page research report released today by the Seattle-based Institute for Health Metrics and Evaluation (IHME), two decades of development assistance for health are thoroughly studied.
The research shows that world-wide development assistance for health has grown 375 percent from US$ 5.66 billion in 1990 to US$ 26.87 billion in 2010. Despite the economic slump during the last two years, donors still "give generously to global health," according to the paper.
However, IHME's preliminary estimates show that the growth rate is slowing. "Between 2004 and 2008, the period of the most dramatic increases in health funding, assistance grew by an annual average of 13 percent. But between 2008 and 2010, the rate of growth was cut by more than half to 6 percent annually," the report reveals.
"Everyone in the global health community is worried about how the economic crisis is going to affect giving," researcher Christopher Murray said. "Research has shown that economic downturns don't usually have an immediate effect on charitable giving, but we were still surprised to see sustained growth through 2010," he added.
Equally interesting are the researchers' finding regarding where these large health development funds are directed. "Most development assistance for health goes to countries with the biggest health challenges, but 11 of the 30 countries with the highest disease burden receive less funding than countries with less disease and stronger economies," they found.
And especially sub-Saharan African countries - with the highest number of people suffering from disease and high mortality - receive less health funding than other developing countries with stronger economies and lower disease burdens, the numbers show. In 2008, US$ 6.9 billion were spent on health aid for sub-Saharan Africa.
Spending on HIV/AIDS programmes continued to rise at a strong rate, now making HIV/AIDS the most funded of all health focus areas, the study found. Other sectors were down-prioritised, with funding for maternal, newborn, and child health received about half as much funding as HIV/AIDS as of 2008.
According to the study, malaria and tuberculosis were often included with
Development aid spent on "disability adjusted life years" (DALY) for malaria per country in 2003-08
AIDS as top priorities in combating infectious diseases, "but both receive far less funding than AIDS." Some US$ 1.19 billion were spent for malaria in 2008 and US$ 0.83 billion for tuberculosis.
"Funding for malaria and tuberculosis also appears to go to countries that do not have large groups at risk for these diseases," the researchers found. "For example, of the 30 countries that receive the most malaria health funding adjusted for disease burden, only three - Eritrea, Săo Tomé and Príncipe, and Swaziland - are located in sub-Saharan Africa, where malaria is most acute."
In all of West, Central and East Africa, where malaria is an especially tough burden on public health, development aid funding to fight the parasitic disease is minimal. This includes populous countries such as Nigeria and Cameroon and the entire Sahel (see map).
Several African countries with enormous health challenges stand out for receiving very little health aid. Somalia in 2008, for example, only received US$ 2.55 per capita in health aid; Guinea even only US$ 2.36 per capita and Comoros, least of all, only US$ 0.94.
Other African countries receiving less than US$ 4 per capita in health aid in 2008 include Cameroon, Chad, Congo Kinshasa (DRC), Madagascar, Nigeria and Sudan.
The African country by distance receiving most health aid per capita in 2008 was Botswana (US$ 123), a country investing strongly in fighting its disastrous AIDS pandemic. Botswana is followed by Namibia (US$ 39 in health aid per capita), Zambia (US$ 32), Săo Tomé (US$ 31), Swaziland (US$ 25), Rwanda (US$ 23) and Cape Verde (US$ 20).
Both Botswana and Cape Verde are middle-income countries, therefore among the richest in Africa and having relatively well functioning public health facilities.
At the same time as foreign funding of health services in developing countries has increased, governments in these developing countries have also increased their health spending. "The commitment to health in the developing world grew dramatically over the past two decades," the study concludes. In sub-Saharan Africa at large, public health spending doubled from 1995 to 2006; in West Africa, it even quadrupled.
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