From Whom to Whom? Official Development Assistance for Health WHO/HSS/HPW/2012.1 From Whom to Whom? Official Development Assistance for Health Second Edition 2000-2010
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From Whom to Whom? Official Development Assistance for Health Contents Introduction Questions and Answers iii xi A B C D E F Afghanistan Albania Algeria Angola Argentina Armenia Azerbaijan Bangladesh Belarus Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d Ivoire Croatia Cuba Democratic People s Republic of Korea Democratic Republic of the Congo Djibouti Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Ethiopia Fiji G H I J K L M N Gabon Gambia Georgia Ghana Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras India Indonesia Iran (Islamic Republic of) Iraq Jamaica Jordan Kazakhstan Kenya Kyrgyzstan Lao People s Democratic Republic Lebanon Lesotho Liberia Madagascar Malawi Malaysia Mali Mauritania Mauritius Mexico Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nepal Nicaragua Niger Nigeria P R S T U V Y Z Pakistan Panama Papua New Guinea Paraguay Peru Philippines Republic of Moldova Rwanda Senegal Serbia Sierra Leone Solomon Islands Somalia South Africa Sri Lanka Sudan Suriname Swaziland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Trinidad and Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Republic of Tanzania Uruguay Uzbekistan Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe i
From Whom to Whom? Official Development Assistance for Health Introduction S From whom to whom in 2011, WHO has received several requests by the health development community to expand the publication s scope and depth, and to provide more detailed data and The objective of this publication is to increase knowledge and transparency of ODA in health, and to provide countries with a better overview of resources for 1 shows that 73 countries are reviewing their national health plans in 2012-2015 with the processes are based on a sound situation analysis including information on external funding such as major donors, planned commitments and funding available for implementation, recipient countries are better equipped to allocate resources and the sources, volumes and purposes of existing aid for health, they can better plan their support within the scope of the national health plans, in line with the principles donors are forced to reduce their development budgets given the rising pressure of What s new in this edition: Revised and completed purpose codes from 2000 to 2011 by OECD/DAC Addition of disbursement data complementing commitment information The data presented here comes from the Creditor Reporting System database of 1 iii
From Whom to Whom? Official Development Assistance for Health Recipient country profiles (CRS) database maintained by the Organisation for Economic Co-operation and Development 2 bilateral and multilateral donors belonging to the Development Assistance Committee programmable (Country Programmable Aid), as opposed to ODA committed or disbursed at the regional or global level, in which case it will be mostly disbursed at The report covers 119 WHO Member States with a population of more than This new second edition incorporates comments and feedback received by users and practitioners, and provides information related to both donors commitments from the WHO web site ( ) Definitions with the promotion of the economic development and welfare of developing countries as the main objective, and which are concessional in character with a grant element A backed by the appropriation or availability of the necessary funds, to provide 2 v
A Country Programmable Aid (CPA) is the portion of aid donors programme for individual countries, and over
From Whom to Whom? Official Development Assistance for Health How to read the country profile sheet Table one 3 It presents ODA commitments and disbursements from the country perspective by showing the relative average ODA commitments and disbursements per capita within the same WHO region presents data on total, government and private health expenditures per capita 5 Charts one (ODA for Health Commitments) and two (ODA for Health Disbursements) Charts three (ODA for Health Commitments, per capita) and four (ODA for Health Disbursements, per capita) 6 3 5 vii
Tables two and three (Purpose of Allocation of ODA for Health) Commitments and disbursements to each country are presented according to four broad distinct purposes that Data presented in the table are also displayed as a series of yearly pie charts in order to show changes in the Tables four and five (Sources of ODA for Health in 2009 and 2010 Bilateral and Multilateral Donors) The total amounts disbursed by the Development Assistance Committee (DAC) donors, for the period 2009- viii
From Whom to Whom? Official Development Assistance for Health Chart six (5 largest sources of ODA for health) The rate reported on the right of the chart shows the contribution of each Table six and chart seven (7 largest SINGLE disbursements in 2009-2010) Table six reports the seven largest single disbursements by donors and their purpose during the period 2009- by the donor to the implementing partners in the country, and presents the number of different disbursements Major Finding ODA data used to compile this report are also available at http://www.who.int/gho/governance_aid_effectiveness/en/index.html Original data upon which this report is based were downloaded on 21/12/2010 from: http://stats.oecd.org/index.aspx?datasetcode=crsnew Contact: Pivap@who.int ix
From Whom to Whom? Official Development Assistance for Health Questions and Answers Q: Why are countries with populations below 500,000 inhabitants excluded from this analysis? A: Data, trends and indicators of ODA for health in very small countries are quite irregular making it difficult to interpret trends of ODA for health and its patterns in these countries. Q: Why is it that, in some countries, there are years with ODA commitments or disbursements per capita higher than the total health expenditures per capita? A: The figures cannot be compared sensu stricto for the following reasons: ODA funds, either committed or disbursed, at any particular time are most often spent over a multiple year period of time after commitments have been made. Total expenditures per capita are best estimates of expenditures that have occurred in a given year and they include ODA funds that were committed and disbursed in the past and have been spent at the country level in that year. In addition, the two figures use different measures: while the OECD reports ODA commitments and disbursements in constant 2009 US dollars, WHO reports expenditures per capita at the exchange rate. Q: How are the original country CRS purpose codes grouped to reflect internationally agreed development benchmarks? A: MDG6 groups the following four Creditor Reporting System (CRS) purpose codes: Malaria Control; Infectious Disease Control; Tuberculosis Control; and STD control Including HIV/AIDS. Reproductive Health & Family planning groups the following two CRS purpose codes: Reproductive Health Care; and Family Planning. Other health purpose groups the following 9 CRS purpose codes: Basic Health Care; Basic Health Infrastructure; Basic Nutrition; Health Education; Health Personnel Development; Medical Education and Training; Medical Research; Medical Services, Personnel Development for Population and Reproductive Health; Health Policy and Administration Management groups Health Policy and Administration Management and Population Policy and Administration Management. Q: How are the Regional Average of ODA for health commitments and disbursements per capita calculated? A: The Regional Average of ODA for health commitments and disbursements per capita are the sum of all ODA commitments and disbursements to all countries of a specific WHO region in any given year divided by the sum of the population in the same year of all countries to which respective commitments or disbursements were made. Q: In country fact sheets, do reported disbursements include all the ODA for health that has been or will be spent in a country? A: No, funds reported in the fact sheet systematically underreport actual funds disbursed for health because donors often commit funds at a global or regional/multi-country level that cannot be unequivocally presented to any particular recipient country. In the period 2009-2010 disbursements made at the global or regional level amounted to more than 25% of all disbursements in the same period. Data presented include only official donors belonging to the Development Assistance Committee (DAC) and do not include new emerging donors or private donations and philanthropies. Q: Do reported disbursements correspond to funds that have been already spent in the country? A: Not necessarily. Funds disbursed are moneys that have been transferred from a donor to an implementing agent, that is the channel of implementation such as the Government, a UN Organization, or an NGO, and that are therefore available for immediate implementation. It is likely that at least some of the money has been spent but not necessarily all of it. xi
Q: Why is the number of disbursements reported by donor? Isn t it the total amount disbursed that matters? A: The number of disbursements reported for each donor provides useful information on the number of channels of implementation of ODA for health, and on the number of narrative and financial reports and associated transaction costs of ODA. Q: Why do the country sheets report both commitments and disbursements? A: One commitment may be fulfilled over several years. Disbursements are the actual transfers to the countries during the fiscal year and can only take place after a commitment has been made. Disbursements can only be made against a commitment and are sometimes made in installments over several years. The increase or decrease of commitments will be inevitably followed by increased or decreased disbursements. Monitoring the volume and trend of commitments gives an indication of the availability of funds for health activities in the near future. Q: In country fact sheets, do reported commitments or disbursements include humanitarian and emergency funds? A: No, only funds committed for health development purposes are reported on. Q: Why are funds from large philanthropies and private foundations not reported in the datasheet? A: The datasheet only reports on ODA, which is aid that is provided by the Official sector of the donor country to promote development. Therefore, private donations are excluded. Aid must contain a grant component of at least 25%. xii
From Whom to Whom? Official Development Assistance for Health ABBREVIATIONS AND ACRONYMS AfDF AFESD AFRO AMRO AsDB DAC EMRO EU EURO GAVI IDA IDB Sp.Fund MDGs OECD OFID SEARO UN UNAIDS UNDP UNFPA UNICEF UNPBF UNRWA WFP WPRO African Development Fund Arab Fund for Economic and Social Development Special Funds Asian Development Bank Special Funds Development Assistance Committee Institutions European Commission, European Community Global Alliance for Vaccines and Immunization Global Fund to Fight AIDS, Tuberculosis and Malaria International Development Association (World Bank) Inter American Development Bank, Special Fund Millennium Development Goals Organisation for Economic Co-operation and Development OPEC Fund for International Development United Nations Joint United Nations Programme on HIV/AIDS United Nations Development Programme United Nations Population Fund United Nations Children s Fund United Nations Peace building Fund United Nations Relief and Works Agency World Food Programme xiii
From Whom to Whom? Official Development Assistance for Health Countries A B C D E F Afghanistan Albania Algeria Angola Argentina Armenia Azerbaijan Bangladesh Belarus Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d Ivoire Croatia Cuba Democratic People s Republic of Korea Democratic Republic of the Congo Djibouti Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Ethiopia Fiji G H I J K L M N Gabon Gambia Georgia Ghana Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras India Indonesia Iran (Islamic Republic of) Iraq Jamaica Jordan Kazakhstan Kenya Kyrgyzstan Lao People s Democratic Republic Lebanon Lesotho Liberia Libya Madagascar Malawi Malaysia Mali Mauritania Mauritius Mexico Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nepal Nicaragua Niger Nigeria O P R S T U V Y Z Oman Pakistan Panama Papua New Guinea Paraguay Peru Philippines Republic of Moldova Rwanda Senegal Serbia Sierra Leone Solomon Islands Somalia South Africa Sri Lanka Sudan Suriname Swaziland Syrian Arab Republic Tajikistan Thailand The Former Yugoslav Republic of Macedonia Timor-Leste Togo Trinidad and Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Republic of Tanzania Uruguay Uzbekistan Venezuela (Bolivarian Republic of) Viet Nam Yemen Zambia Zimbabwe xv