1. www.actionforglobalhealth.eu Achieving the health-related Millennium Development Goals Simon Wright

2. www.actionforglobalhealth.eu Action for Global Health 15 NGOs in Brussels, France, Germany, Italy, Spain and UK Diverse organisations working together for common goals: funding, prioritising of health systems, equitable access especially gender “Health Warning” looked at quantity EU ODA for health Next report will look at harmonisation of health ODA for health systems.

3. www.actionforglobalhealth.eu Health MDGs MDG 4: Reduce child mortality by two-thirds. Progress in all regions except sub-Saharan Africa where rate estimated at 160 per 1000 live births. Just four of 46 sub- Saharan African countries are on track. MDG 5: Reduce maternal mortality by three-quarters. Slowest progress: rates in sub-Saharan Africa are 920 per 100,000 live births (compared with 8 per 100,000 in industrialised countries). In Africa, risk of maternal death 1:22. MDG 6: Combat HIV, AIDS, malaria and tuberculosis. HIV infection rates rising, not reversed, but some places show hope. One quarter of people who need antiretrovirals are receiving them. Bednet coverage increasing fast from low base. MDG 8: Develop a global partnership for development. Access to medicines remains a major obstacle to healthcare.

4. www.actionforglobalhealth.eu Influencing from Europe Trade and patent laws for medicines Brain-drain of health workers Macro-economic policies imposed by IMF and World Bank Technical assistance if not imposed Pilots and projects Research and development Official Development Assistance.

5. www.actionforglobalhealth.eu Financing for MDGs WHO Commission on Macroeconomics and Health (2001): $27 billion ODA for health in 2007, rising to $38bn by 2015 Equivalent of 0.1 % of donor GNI to ODA for health, within the 0.7% commitment Assumes aid is provided efficiently and used effectively Estimates for available ODA for health in 2007 were maximum of $6-12bn in 2004, noting that much of increase was for HIV.

6. www.actionforglobalhealth.eu ODA falling Country2007/US$m2007/%GNI2006/%GNI% Change France9.9400.390.47-15.9 Italy3.9290.190.2-3.6 Spain5.7440.410.3233.8 Germany12.2670.370.365.9 United Kingdom 9.9210.360.51-29.1 DAC-EU62.0950.40.43-5.8 EC11.771--3 Total DAC103.6550.280.31-8.4 OECD DAC Preliminary figures for 2007

7. www.actionforglobalhealth.eu Health ODA rising Country20052006Change Health (General + Basic) Population Pol/ Program me & Reproduc tive Health Health (General + Basic) Population Pol/ Program me & Reprodu ctive Health Health (General + Basic) Population Pol/ Program me & Reprodu ctive Health France278.877.54270.262.39▼ 8.61▼ 5.15 Italy101.7710.4694.493.91▼ 7.28▼ 6.55 Spain116.6428.94105.1740.9▼ 11.47▲11.96 Germany123.574.58247.4226.75▲123.9▲152.17 United Kingd om 283.08304.76394.42283.66▲111.34▼21.1 DAC-EU1543.08699.312239.171004.78▲696.09▲305.47 EC613.9855.44469.54110.63▼144.44▲55.19 Total DAC3448.053175.384532.824011.15▲1084.77▲835,77 OECD DAC 2006 figures

8. www.actionforglobalhealth.eu Aid effectiveness Paris Declaration 2005 5 Paris Principles of aid effectiveness: –Ownership –Alignment –Harmonisation –Mutual accountability –Managing for results

9. www.actionforglobalhealth.eu Harmonisation of health ODA Donors prefer bilateral relationships, citizens need to educate politicians Aid “darlings” and “orphans” Confusion of mechanisms; donors promote their own, not recipient’s choice Duplication and monitoring burden New initiatives – International Health Partnership, MDG Contracting, Providing for Health Initiative.

10. www.actionforglobalhealth.eu Our concerns Aid effectiveness agenda must not allow donors to escape their commitments ODA target needs greater action especially if economic growth slowing Long-term predicable aid for health systems No competition between horizontal and vertical Donor governments must stop launching and start harmonising new initiatives Civil society key to effectiveness of aid.