IHME Director Dr. Christopher Murray shared the Institute’s latest findings on trends in global health financing with members of the Council on Foreign Relations (CFR) and invited guests at the Council’s offices in New York. Laurie Garrett, Senior Fellow for Global Health at CFR, acted as Chair of the discussion. During his talk, Financing Global Health 2010: Development assistance and country spending in economic uncertainty, Dr. Murray provided the following findings:
- DAH spending has continued to go up through 2010, but the trend in growth is slowing.
- The growth in DAH is almost entirely dependent on four main channels: the US government, the UK government, the GAVI Alliance, and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).
- While DAH funding generally goes to countries with the greatest health needs, some countries that have a high disease burden receive less funding than countries that have a lower disease burden. For example, 11 of the 30 countries with the highest number of people suffering from disease and high mortality receive less health funding than countries with stronger economies and lower disease burdens.
- Spending on HIV/AIDS programs has continued to rise at a strong rate, making HIV/AIDS the most funded of all health focus areas. Funding for maternal, newborn, and child health received about half as much funding as HIV/AIDS as of 2008.
- Malaria and tuberculosis are often included with AIDS as top priorities in combating infectious diseases, but both receive far less funding than AIDS: $1.19 billion for malaria in 2008 and $0.83 billion for tuberculosis.
- Despite much discussion about the need for general health sector support, funding for that area has grown slowly since 2006. Funding for noncommunicable diseases, another popular topic among global health advocates, represents just 0.5% of all development assistance for health.
- IHME’s recalculation of the way in-kind donations to NGOs are valued has dramatically reduced the percentage of DAH funding tied to NGOs, and donations through NGOs also have dropped.
- The commitment to health in the developing world grew dramatically over the past two decades. Governments of developing countries increased spending on health.
- In countries whose governments receive significant donor funding, development assistance for health appears to be partially replacing domestic health spending instead of fully supplementing it.
Dr. Murray presented several reasons for the global health community to remain optimistic about the future for DAH funding, including the fact that even though the UK has drastically reduced its budget, it actually is expanding its commitment to development assistance. Dr. Murray also noted that the recent GFATM replenishment at $11.7 billion for 2011 to 2013 was lower than projected needs but still represented continued growth compared to 2008 to 2010 replenishment.
Dr. Murray said that, even if DAH continued to rise at the current rate, the health needs in developing countries would not be met.
“The needs for HIV, tuberculosis, and malaria are going to so far outstrip the financing that we need to focus very hard on being cost effective,” Dr. Murray said.
The findings generated a vigorous discussion among the representatives from government agencies, UN agencies, private companies, and foundations.