Over the last five years, governments and private companies have made some $7 billion in global health commitments affecting more than 600 million lives, and according to a new report, most of them have followed through.
The Global Citizen Health Accountability report, released today by international advocacy organization Global Citizen, tracks the progress of 43 separate commitments, from efforts to eradicate polio to vaccinating against malaria.
Thirty-four of the commitments have met or exceeded their target, according to the report, while four commitments are progressing but with risk of falling behind. The U.S., for example, has met 98 percent of its target to fund polio eradication efforts, and Canada is on track to deliver its C$250 million commitment.
Norway has also delivered on its 2014 promise to commit NOK 6.25 billion to Gavi, the Vaccine Alliance, helping to immunize millions of children each year against measles, rubella, HPV and a host of other preventable diseases.
Two commitments, however, are significantly at risk. According to the report, Australia lowered its AU$130 million contribution to polio eradication to AU$86 million, putting world’s status of near-eradication at risk. Malawi also pledged to add 17,000 new community health workers, but the report warns there has been little evidence of increase.
The remaining pledges in the report were made too recently to determine progress.
While global health pledges have seen follow-through overall, the authors raise concerns about the shifting trend in funding. Donor funding for global health is declining relative to domestic funding, the report stated, which means the world’s poorest countries are better able to invest in improving their own health systems. At the same time, the authors said, such success must not detract from the need for donors.
“Donors must not use this as an excuse to scale back their support,” said Simon Moss, co-founder of Global Citizen, in an email to Humanosphere. “The support provided by donors is often used to target the poorest and most vulnerable people – for a disease like polio, it’s been vital to enabling Pakistan and Afghanistan to take the whole world to the brink of eradication, something they wouldn’t have been able to do by themselves.”
The authors also warn that success stories can make the global community lose sight of the continued need for funding health systems. The knowledge that the Global Fund has been able to save 20 million lives, for example, is a story that shows donors that their efforts really are making an impact. But with this success, Moss said, comes a risk for how donor governments think about investments in global health.
“Not all issues have a clear and simple intervention like vaccines,” said Moss. “Take maternal health. To stop mothers from dying in pregnancy and childbirth – 343,000 a year at last count, 99 percent in the world’s poorest countries – you can’t just give them one shot.”
“They need a system that works,” he added, “from local nurses and health workers, to midwives and doctors, to hospitals and emergency care if something goes wrong.”
Moss also cited the 2014 Ebola outbreak in West Africa. Without a vaccine to treat such a disease, the outbreak exposed the crippling weakness of the region’s health systems, serving as a devastating wake-up call for systems in similar contexts around the world. This, Moss explained, is why it remains critical for donors and governments to ensure their funds build systems for tomorrow as well as save lives today.