Report analyzes global health funding trends, predicts lower funding growth

Dec 2 2010

A report from the Institute for Health Metrics and Evaluation (IHME) finds that the recent global economic downturn "hasn't quelled generous government and private donors from giving record amounts to improve global health," but the analysis also revealed "that growth in funding is beginning to taper off, cut by more than half between 2008 and 2010," the Seattle Times' "The Business of Giving" blog reports (Heim, 11/30).

"After climbing 13 percent annually from 2004 through 2008, growth in health-related aid averaged six percent over the next two years, following the near meltdown of the U.S. financial system, the study found," Agence France-Presse writes (11/30). The report, which was released on Tuesday, examines "the total amount of health funding between 1990 and 2008 from aid agencies and governments in 23 developed countries, multilateral institutions such as the World Health Organization, and hundreds of nonprofit groups and charities," according to a press release from the IHME. The study also incorporates "new analytical methods that draw on government budgets, expenditure patterns, and data from funders to make preliminary estimates for 2009 and 2010, overcoming a two-year lag in the reporting of health assistance" (11/30). Though total global health giving this year will likely reach an all time high of $27 billion, reductions could come soon when donor governments' multi-year commitments expire, according to IHME director Christopher Murray, who led the research, AFP reports.

The report notes that "[g]overnments and private sources have stepped up donations, while funds from strapped non-governmental organisations (NGOs) dropped by 24 percent from 2009 to 2010," according to the news service (11/30). The data show that the "U.S. government is the largest single contributor of global health funding," "The Business of Giving" writes. "Beginning in 2004, the U.S. government and private donors increased spending by double digits each year to a total of almost $12 billion in 2008, about half of all health assistance to developing countries, according to the report. ... Private donors, including individuals and foundations, gave $1.16 billion in cash to NGOs in 2008. Corporations also donated almost $600 million" worth of in-kind donations to NGOs in addition to cash contributions, the blog reports. Private donations to NGOs "dropped by 33 percent in the last two years, while corporate [in-kind] donations fell by 59 percent," according to the blog (11/30).

The Chronicle of Philanthropy reports that "[f]oundations - and not just the Bill & Melinda Gates Foundation - have helped to drive that increase. Money from other U.S. foundations for charities' global-health work grew by 366 percent from 1990 to 2010, to $542.78 million, belying concerns that the Gates money would dissuade other donors from giving to global health" (Preston, 11/30).

According to the press release, the report found that "[t]he commitment to health in the developing world grew dramatically over the past two decades. Governments of developing countries increased spending on health" (11/30).

The research also looked at "how money was distributed," AFP writes. "Spending from all sources on HIV/AIDS topped six billion dollars in 2008, the last year for which a breakdown by disease is available, taking nearly as large a slice of the donor pie as all other health problems combined, the report showed," AFP reports. Aid for malaria was $1.19 billion in 2008 and in the same year tuberculosis funding totalled $830 million. Maternal, newborn and child health funding received about half as much as HIV/AIDS in 2008 (11/30).

The researchers suggest "that the intensified focus on certain health issues - such as maternal, newborn, and child health, noncommunicable diseases, and health sector support - is likely to magnify the competition for limited resources and exacerbate the effects of any downturn in development assistance for health," the IHME press release states. Murray pointed out that each year, more than 300,000 mothers and 7 million children under the age of 5 die. "Chronic diseases need more attention, and countries need better health care infrastructure," he said. "All of these pressing health issues require funding, and it is becoming increasingly difficult to balance competing needs," Murray added (11/30).

According to the research, "[t]here was also a poor match between need and funding for some of the world's poorest nations, especially in Africa," AFP writes (11/30). "Most development assistance for health goes to countries with the biggest health challenges, but 11 of the 30 countries with the highest disease burden receive less funding than countries with less disease and stronger economies," the researchers wrote, afrol News reports. In particular, "sub-Saharan African countries - with the highest number of people suffering from disease and high mortality - receive less health funding than other developing countries with stronger economies and lower disease burdens, the numbers show. In 2008, $6.9 billion were spent on health aid for sub-Saharan Africa," according to the news service (11/30).  

Of the study findings, "Thomas Tighe, chief executive of Direct Relief International, said it remains to be seen how the enhanced pressure to reduce deficit spending in the U.S. will affect global health financing," according to "The Business of Giving."  

"Tighe, who served as chief of staff and chief operating officer of the Peace Corps from 1995 to 2000, said one 'clear imperative of flattening of global health expenditures is an increasing premium on execution with existing resources.'" He said the report does not account for "the equally important concept of what the expenditures have bought and whether there has been good health value for the dollars spent" (11/30).