Download Diseases without borders

Diseases without borders
What must the Global Development
Community Do?
World Bank Seminar Series
Tawhid Nawaz, Operations Advisor
Human Development Network
Slide 1
Official Development Assistance 1990-2010
2003 US$ billions
Percent
120
0.35
0.32
ODA as % of donors' GNI(right axis)
100
0.30
0.30
0.25
0.25
80
0.20
Total ODA (left axis)
60
0.15
40
0.10
20
Total ODA to SSA (left axis)
0.05
0
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
0.00
Source: The World Bank. Development Economics.
Note: This graph is an updated version of the one contained in Chapter 5 of the Global Monitoring Report
2005: Millennium Development Goals-From Consensus to Momentum, and uses data obtained from the
OECD DAC.
Slide 2
Development Assistance for Health, 1990- 2003
10000
Amount (million US$)
9000
8000
7000
6000
5000
4000
3000
2000
1000
Year
Source: Michaud 2003, World Bank estimates
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
0
Slide 3: What Must The Global Development
Community Do?
Since Donors as a group have convening
power responsibilities include providing both
coordination of financial assistance as well
as technical leadership:
- support global governance
- intervene on key issues to improve systems
of prevention, control and treatment
Slide 4: Attempts to set common goals by the
international development community

The Monterrey Consensus—March 2002
- a framework of mutual accountability
between developing and developed
countries
- developing countries to improve their
policies and governance
- developed countries to open their
markets and provide more and better
aid
Focus shift: from consensus to implementation
Slide 5: Communicable diseases and global
challenges
Three main challenges during implementation:

Ensuring the sustained and predictable financing
required to expand the recurrent cost intensive services

Making sure that resources translate into effective
service delivery, by improving governance and
accountability

Scaling up skilled providers--doctors and nurses-needed to rapidly expand health services
Slide 6: A major challenge remains
progress in health outcomes for the poor:

In two-thirds of the countries that have reduced
child mortality since 1990, outcomes for families
in the lowest income quintile have improved less
than for the population as a whole

However, there are exceptions:
- Mali, Turkey, Egypt, Peru and Cameroon
achieved faster reductions in child mortality for
the poorest quintiles
Slide 7: Effective Donor strategies for
reaching the poor in low income countries:
- prioritizing the expansion of services in
poor and rural regions
- expanding health care services that
have a direct impact
- eliminating user fees for essential health
services
Slide 8: Major Global Programs in Health





Global Fund to Fight AIDS, TB and Malaria
The Global Alliance for Vaccination and
Immunization
The World Bank’s Multi-Country AIDS Program
The US President’s Emergency Plan for AIDS
Relief
70 other global health initiatives
Slide 9: Donor Contribution on
Communicable Diseases
HIV/AIDS
 Financing, research and global advocacy for HIV/AIDS
have increased significantly
 Commitments for HIV/AIDS prevention and treatment
programs jumped from less than $400 million in the late
1990s to an estimated $6 billion in 2005
 Faster progress for harmonizing donor aid at the country
level and implementing the “Three Ones” principle: one
strategy, one implementation agency, one monitoring
and evaluation system
Impact: by 2003, 80% of public spending on HIV/AIDS in
low-income countries was financed by external grants
Slide 10: Donor Action on Malaria

Global funding has quintupled in the past few years, from
$120 million to $570 million, thanks largely to the Global
Fund to Fight AIDS, Tuberculosis and Malaria

The Roll Back Malaria effort: global framework for
intensified progress

Donor action needed on technical issues:
- increase use of bednets
- new and more expensive treatment for vector control
and drug resistance

As much as $1 billion or more each year is needed
Slide 11: Major Achievements:



Raising global awareness
Stimulating new drug and vaccine research
Making aid for health pro-poor
More Challenges:



‘Verticalization’ of health sector support through diverse,
specialized global initiatives is having adverse impacts
Donor support needed to organize country-led health
strategies for all communicable disease priorities
Donors need to view themselves as partners
Slide 12: CONCLUSIONS:
Many low-income countries rely heavily on
development assistance (ODA). The international
development community needs to focus on:




building country capacity and promoting 13the
development and use of country systems
strengthen partnerships and harmonize
aid
strengthen the focus on results
ensure the flexibility and predictability of aid flows