It’s fair to say that global health has been at the spearpoint of the aid and development agenda for the last 15 years or so, as funding for initiatives aimed at curbing AIDS, malaria, TB and other select diseases of poverty has swelled over the past decade and a half.
But funding has leveled off over the past few years, due to the global economic crisis and perhaps also to a re-thinking of the international anti-poverty agenda. A new report on Financing Global Health from the University of Washington’s Institute for Health Metrics and Evaluation documents this transition (subtitle: Transition in an Age of Austerity) and includes some great visual illustrations of what’s going on.
In a nutshell, this fifth edition of IHME’s assessment of the global health funding landscape makes these key points:
- Global health funding has leveled off since 2010 at about $30 billion. That amount increased by a few percentage points, to $31.3 billion, in 2013 – a record amount – but the overall trend continues to be relatively flat as compared to the first decade of the millennium.
- Much of the sustained level of funding has come despite cuts in direct government support for global health projects. The US government, though the largest single donor at $7.4 billion in 2013, reduced its global health contribution. Britain, the UK, was a notable exception, increasing its funding for global health projects.
- Most of the increased funding was shifted to public-private partnerships and consortiums such as the Global Fund to Fight AIDS, TB and Malaria and GAVI (child immunizations).
- Looked at geographically, sub-Saharan Africa was the biggest recipient of global health spending, receiving $8.8 billion in 2011 (most recent year data was available) or nearly 29 percent of the total.
- Many of the countries with the highest disease burdens still do not receive a proportionate share of the funding.
The significant proportion of deaths and disabilities caused by non-communicable diseases like heart disease, cancer and diabetes are not proportionately funded according to their disease burden, the study authors say. Infectious diseases, child and maternal health needs continue to receive large shares of the funding in global health.
“The Global Burden of Disease shows the prominence of non-communicable disease burden in all regions except sub-Saharan Africa,” said study co-author Joseph Dieleman, a health finance researcher at IHME. “There is relatively little development assistance for health in these countries for (non-communicable disease) related programs.”
Chris Murray, director at IHME and lead author of the study, said the report shows that health continues to be a leading priority on the development agenda. But it is also a relatively small amount, he and his colleagues note, representing only about one percent on average for health spending in poor countries as compared to the much higher amounts spent in rich countries.
Murray and his colleagues also emphasize that the global health agenda, still dominated by the traditional focus on infectious diseases, has not adapted to the increasing disease burden seen worldwide toward more chronic, non-communicable diseases.