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Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories

Globan Burden of Disease 2020 Health Financing Collaborator Network The Lancet (2021) CC

The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was di... more

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11 years of tracking aid to reproductive, maternal, newborn, and child health: estimates and analysis for 2003–13 from the Countdown to 2015

Grollman, C.; L. Arregoces, M. Martínez-Álvarez et al. Lancet Glob Health (2017) C1

Background:Tracking aid fl ows helps to hold donors accountable and to compare the allocation of resources in relation to health need. With the use of data reported by donors in 2015, we provided estimates of offi cial development assistance and grants from the Bill & Melinda Gates Foundation (coll... more

Aid Transparency Index 2022

Publish What You Fund Publish What You Fund (2022) CC

The 2022 Aid Transparency Index reveals that more aid organisations than ever before are publishing good quality information and score “very good” or “good” in the global ranking. However, the whole data set could be under threat as the Aid Transparency Index, the only tool driving tangible ... more

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Financing the SDGs: Evidence in Four Countries

Jennifer Turner AidData at William & Mary (2019) CC

Achieving the Sustainable Development Goals (SDGs) will require the international community to mobilize significant additional financing over the next decade. Tracking and analyzing this funding is central to measuring progress and making more informed choices to direct financial flows where they wi... more

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Assessing development assistance for child survival between 2000 and 2014: A multisectoral perspective

Lu, C.; A. Chu, Z. Li et al. PLOS One (2017) CC

The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on... more

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Countdown to 2015: assessment of donor assistance to maternal, newborn, and child health between 2003 and 2006

Greco, G.; T. Powell-Jackson; J. Borghi et al. Lancet (2008) C1

Background: To track donor assistance to maternal, newborn, and child health-related activities is necessary to assess progress towards Millennium Development Goals 4 and 5 and to foster donor accountability. Our aim was to analyse aid flows to maternal, newborn, and child health for 2005 and 2006 a... more

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Countdown to 2015: assessment of official development assistance to maternal, newborn, and child health, 2003–08

Pitt, C.; G. Greco; T. Powell-Jackson et al. Lancet (2010) C1

Background: Achievement of high coverage of effective interventions and Millennium Development Goals (MDGs) 4 and 5A requires adequate financing. Many of the 68 priority countries in the Countdown to 2015 Initiative are dependent on official development assistance (ODA). We analysed aid flows for ma... more

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Countdown to 2015: changes in official development assistance to maternal, newborn, and child health in 2009–10, and assessment of progress since 2003

Hsu, J.; C. Pitt; G. Greco et al. Lancet (2012) C1

Background: Tracking of financial resources to maternal, newborn, and child health provides crucial information to assess accountability of donors. We analysed official development assistance (ODA) flows to maternal, newborn, and child health for 2009 and 2010, and assessed progress since our monito... more

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Countdown to 2015: changes in official development assistance to reproductive, maternal, newborn, and child health, and assessment of progress between 2003 and 2012

Arregoces, L.; F. Daly; C. Pitt et al. Lancet Glob Health (2015) C1

Background: Tracking of aid resources to reproductive, maternal, newborn, and child health (RMNCH) provides timely and crucial information to hold donors accountable. For the first time, we examine flows in official development assistance (ODA) and grants from the Bill & Melinda Gates Foundation (co... more

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Donor funding health policy and systems research in low- and middle-income countries: how much, from where and to whom

Grépin, K.; Pinkstaff C.B.; Z. C. Shroff et al. Health Research Policy and Systems (2017) C1

Background: The need for sufficient and reliable funding to support health policy and systems research (HPSR) in low- and middle-income countries (LMICs) has been widely recognised. Currently, most resources to support such activities come from traditional development assistance for health (DAH) don... more

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Public financing of health in developing countries: a cross-national systematic analysis

Lu, C.; Schneider, M.T.; Gubbins, P.; Leach-Kemon, K.; Jamison, D.; Murray, C.J.L. (2010) CC

Government spending on health from domestic sources is an important indicator of a government's commitment to the health of its people, and is essential for the sustainability of health programmes. We aimed to systematically analyse all data sources available for government spending on health in dev... more

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Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Global Burden of Disease Health Financing Collaborator Network (2017) CC

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we furth... more

Ending disease in Africa: vision, strategies and special initiatives, 2023-2030

World Health Organisation (WHO) (2023) C_WHO

While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades of progress threatened, including positive tr... in decreasing inequality. In the African Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled. The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015. more

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Tracking aid for global health goals: a systematic comparison of four approaches applied to reproductive, maternal, newborn, and child health

Pitt C.; Grollman C.; Martinez-Alvarez M. et al The Lancet (2018) CC

Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health (RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and the Organisation for Economic Co-operation and Development (OECD) policy marker. We... more

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990

Dr. Micah et al. Global Burden of Disease 2020 Health Financing Collaborator Network (2021) CC

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Estimates of aid for reproductive, maternal, newborn, and child health: findings from application of the Muskoka2 method, 2002–17

Dingle, A.; Schäferhoff, M.; Borghi, J. et al. The Lancet (2020) CC

Background Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017. Methods Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators. Findings After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million). Interpretation Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention. Funding Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health. more

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National spending on health by source for 184 countries between 2013 and 2040

Dieleman, J.; Templin, T.; Sadat, N. et al. (2016) CC

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at simi...lar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. Methods We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Findings Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Interpretation Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Funding Bill & Melinda Gates Foundation. more

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Burden of Peripheral Artery Disease and Its Attributable Risk Factors in 204 Countries and Territories From 1990 to 2019

Lin, J.; Chen, Y.; Jiang, N. et al. Frontiers in Cardiovascular Medicine (2022) CC

Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019. Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD... more

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Understanding China’s shifting priorities and priority-setting processes in development assistance for health

Guo B.; Fan V.; Strange A. et al. Health Policy and Planning (2024) CC

Over the past two decades, China has become a distinctive and increasingly important donor of development assistance for health (DAH). However, little is known about what factors influence China’s priority-setting for DAH. In this study, we provide an updated analysis of ... in the priorities of Chinese DAH and compare them to comparable trends among OECD Development Assistance Committee (DAC) donors using data from the AidData’s Global Chinese Development Finance Dataset (2000–2017, version 2.0) and the Creditor Reporting System (CRS) database (2000–2017). We also analyse Chinese medical aid exports before and after the start of the COVID-19 pandemic using a Chinese Aid Exports Database. more

Global alcohol action plan 2022-2030

World Health Organization WHO (2021) C_WHO

Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr... more