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Donor Funding for Health in Low- & Middle-Income Countries, 2002-2013

Executive Summary
  1. KFF. Financing the Response to AIDS in Low- and Middle-Income Countries: International Assistance from Donor Governments in 2014; July 14, 2015.

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  2. See the Global Fund, www.theglobalfund.org/.

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  3. See PEPFAR, www.pepfar.gov/.

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  4. Data in this report are not directly comparable to prior year reports.  First, prior to 2011, reports analyzed commitments, not disbursements, as reported here.  Second, donors may change data in the DAC database over time and this report reflects the most current data for the period, as of the data extraction date. Finally, prior Kaiser reports analyzed donor contributions to health as defined by the OECD DAC, but expanded this definition to include the water sector. Starting with the 2011 report, the water sector has been considered as a separate sector.

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  5. “Health” funding in this analysis combines data from three OECD CRS subsectors: (1) Health; (2) Population Policies/Programs & Reproductive Health (which includes HIV/AIDS & STDs); & (3) Other Social Infrastructure and Services - Social Mitigation of HIV/AIDS. The first 2 constitute the OECD’s statistical definition of health (see, OECD. Recent Trends in Official Development Assistance to Health, 2006).

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  6. See www.kff.org/hivaids/internationalfinancing.cfm.

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Introduction
  1. Author analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS), November 7, 2012 (www.oecd.org/dataoecd/50/17/5037721.htm).

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  2. The 24 DAC member governments are: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway, Portugal, South Korea, Spain, Sweden, Switzerland, United Kingdom, United States, and European Commission.

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  3. Multilaterals include: The Global Fund to Fight AIDS, Tuberculosis and Malaria; The World Bank; African Development Fund (AfDF); Asian Development Fund (AsDF); Regional Development Banks; UNAIDS; UNDP; UNECE; UNFPA; UNICEF; WFP; and WHO. Data are not available for some UN Agencies. The OECD estimates that 85% of multilateral ODA for health is captured. See OECD, Recent Trends in Official Development Assistance to Health; 2006.

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  4. See, for example: Grepin KA, Leach-Kemon K, Schneider M, Sridar D. “How to do (or not to do) . . . Tracking data on development assistance for health”, Health Policy and Planning; 27: 527-534; 2012; Murray CJL, Anderson B, Burstein R, Leach-Kemon K, Schneider M, Tardiff A, Zhang R. “Development Assistance for Health: Trends and Prospects”, Lancet; 378: 8-10; July 2011; Ravishankar N, Gubbins P, Cooley RJ, Leach-Kemon K, Michaud CM, Jamison DT, Murray CJL. “Financing of global health: tracking development assistance for health from 1990 to 2007”, Lancet; 373: 2113–24; June 20, 2009; Schieber GJ et al. “Financing Global Health: Mission Unaccomplished,” Health Affairs, Vol. 26, No. 4, July/August 2007.

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  5. See OECD. “Development: Aid to developing countries falls because of global recession.” http://www.oecd.org/dac/aidstatistics/developmentaidtodevelopingcountriesfallsbecauseofglobalrecession.htm.

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Detailed Findings
  1. See also: OECD, “Development Aid from OECD Countries Fell 5.1% in 2006,” April 3, 2007 (http://www.oecd.org/document/17/0,2340,en_2649_201185_38341265_1_1_1_1,00.html).

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  2. Also see OECD DAC, “Debt Relief is down: Other ODA rises slightly”, April 2008 (www.oecd.org/document/8/0,3343,en_2649_33721_40381960_1_1_1_1,00.html.)

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  3. It is important to note that debt relief, although reported to the DAC at full face value, often costs creditors significantly less, such as in cases where forgiven or rescheduled loans are already unserviceable or in arrears.

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  4. “Multisector/Other” represents combined data from five OECD CRS sectors and sub-sectors: (1) Multisector/Cross-cutting; (2) Administrative Costs of Donors; (3) Support of NGO’s; (4) Refugees in Donor Countries; (5) Other Social Infrastructure & Services (excluding Social Mitigation of HIV/AIDS).

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  5. It is possible that these sub-sectors receive funding reported in other sub-sectors (e.g., training categorized as HIV/AIDS/STDs). For example, the U.S. Office of the Global AIDS Coordinator reported to Congress that in FY 2008, PEPFAR provided an estimated $310 million to support training activities and supported close to 130,000 health care workers (see: US State Department Office of the Global AIDS Coordinator, Celebrating Life: The U.S. President’s Emergency Plan for AIDS Relief 2009 Annual Report to Congress). Such disaggregation, however, is not possible through the DAC or CRS databases.

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  6. The U.S. reports its maternal and child health (MCH) funding under several CRS sub-sectors. In recent years, this funding has largely be reported under the “Reproductive health care” (13020) subsector. As a result, funding for the family planning and reproductive health subsector may appear higher than its true value.

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  7. See Global Fund Donors and Contributions, http://www.theglobalfund.org/en/about/donors/public/.

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  8. See OECD, “Non-DAC Countries reporting their development assistance to the DAC,” http://www.oecd.org/dac/aidstatistics/non-daccountriesreportingtheirdevelopmentassistancetothedac.htm

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Conclusion
  1. It is possible that these sub-sectors receive funding reported in other sub-sectors (e.g., training categorized as HIV/AIDS/STDs). For example, the U.S. Office of the Global AIDS Coordinator reported to Congress that in FY 2008, PEPFAR provided an estimated $310 million to support training activities and supported close to 130,000 health care workers (see: US State Department Office of the Global AIDS Coordinator, Celebrating Life: The U.S. President’s Emergency Plan for AIDS Relief 2009 Annual Report to Congress). Such disaggregation, however, is not possible through the DAC or CRS databases.

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Methodology
  1. OECD, “History of DAC Lists of Aid Recipient Countries,” www.oecd.org/document/55/0,3343,en_2649_34447_35832055_1_1_1_1,00.html.

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