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Financing Global Health 2016 Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage

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Financing Global Health 2016 Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage Financing Global Health 2016 Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage | | Financing Global Health 2016 Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage This report was prepared by the Institute for Health Metrics and Evaluation (IHME) through core funding from the Bill & Melinda Gates Foundation. The views expressed are those of the authors. The contents of this publication may be reproduced and redistributed in whole or in part, provided the intended use is for noncommercial purposes, the contents are not altered, and full acknowledgment is given to IHME. This work is licensed under the Creative Commons Attribution- NonCommercial-NoDerivs 4.0 Unported License. To view a copy of this license, please visit https://creativecommons.org/licenses/by-nc-nd/4.0/. For any usage that falls outside of these license restrictions, please contact IHME Global Engagement at [email protected]. Citation: Institute for Health Metrics and Evaluation (IHME). Financing Global Health 2016: Development Assistance, Public and Private Health Spending for the Pursuit of Universal Health Coverage. Seattle, WA: IHME, 2017. Institute for Health Metrics and Evaluation To request copies of this report, please contact IHME: 2301 Fifth Ave., Suite 600 Telephone: +1-206-897-2800 Seattle, WA 98121 Fax: +1-206-897-2899 USA Email: [email protected] www.healthdata.org Printed in the United States of America ISBN 978-0-9910735-9-7 © 2017 Institute for Health Metrics and Evaluation Contents 4 About IHME 5 Research team 5 Acknowledgments 6 Acronyms 8 Figures, boxes, and tables 11 EXECUTIVE SUMMARY 15 INTRODUCTION 19 CHAPTER 1: Development assistance for health 22 Sources of development assistance for health 28 Channels of development assistance for health 34 Recipients of development assistance for health 39 CHAPTER 2: Development assistance for health focus areas 39 Overview of health focus areas 45 HIV/AIDS 50 Maternal, newborn, and child health 53 Malaria 57 Tuberculosis 60 Non-communicable diseases 62 Other infectious diseases 64 Health system strengthening and sector-wide approaches 69 CHAPTER 3: Health financing context: evolution and future estimates of national health spending 70 Overview of total health spending 78 Looking ahead: Global health financing 2016–2040 83 CONCLUSION 85 References 87 ANNEX 1: Methods 89 ANNEX 2: Tabulated data ABOUT IHME The Institute for Health Metrics and Evaluation IHME( ) is a population health research center that is part of UW Medicine at the University of Washington. IHME provides rigorous and comparable measurement of health problems and evaluates the strategies used to address them. IHME makes this information freely available so that researchers, policymakers, and other health stakeholders have the necessary evidence to make informed decisions. For more information about IHME and its work, please visit www.healthdata.org. CALL FOR COLLABORATORS In addition to conducting the FGH study, IHME coordinates the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study, a comprehensive effort to measure epidemiological levels and trends worldwide. (More information on GBD is available at http://www.healthdata.org/gbd.) The GBD study relies on a worldwide network of over 2,000 collaborators in over 120 countries. Current collaborator areas of expertise include epidemiology, public health, demography, statistics, and other related fields. During the coming GBD analyses, IHME plans to expand the scope of GBD to encompass quantification of health resource flows, health system attributes, and the performance of health systems. To that end, IHME is seeking GBD collaborators who are experts in health financing and health systems. GBD collaborators – many of whom have co-authored GBD publications – provide timely feedback related to the interpretation of GBD results, data sources, and methodological approaches per- taining to their areas of expertise. We invite researchers and analysts with expertise in health financing to join the GBD collaborator network. Potential collaborators may apply at http://www.healthdata.org/gbd/call-for-collaborators. 4 Financing Global Health 2016 RESEARCH TEAM ACKNOWLEDGMENTS We extend our deepest appreciation to past authors Joseph L. Dieleman, PhD of this report for developing and refining the analytical foundation upon which this work is based. We would Madeline Campbell, BS like to acknowledge the staff members of the numerous development agencies, public-private partnerships, Abby Chapin, BA international organizations, non-governmental organi- zations, and foundations who responded to our data Erika Eldrenkamp, BA requests and questions. We greatly appreciate their time and assistance. Margot Kahn Case, MFA We would also like to acknowledge the efforts of the IHME community, which contributed greatly to the Yingying Lui, MS production of this year’s report. In particular, we thank IHME’s Board and Scientific Oversight Group for their Taylor Matyasz, MS continued leadership, William Heisel and Katherine Leach-Kemon for editorial guidance, Adrienne Chew Angela Micah, PhD for editing, Joan Williams for production oversight and publication management, Nicholas Arian and Shawn Alex Reynolds, BA Minnig for figure production, and Dawn Shepard and Sofia Cababa Wood for design. Finally, we would like to Nafis Sadat, MA extend our gratitude to the Bill & Melinda Gates Foundation for generously funding IHME and for Matthew Schneider, MPH its consistent support of this research and report. Reed Sorensen, MPH Christopher J.L. Murray, MD, DPhil ACRONYMS ADB ....... Asian Development Bank AfDB ...... African Development Bank DAH ....... Development assistance for health DALYs ..... Disability-adjusted life years DfID ....... United Kingdom’s Department for International Development GBD ....... Global Burden of Diseases, Injuries, and Risk Factors Study GDP ....... Gross domestic product GHES ...... Government health expenditure as a source HSS ....... Health system strengthening IBRD ...... International Bank for Reconstruction and Development IDA ........ International Development Association IDB ........ Inter-American Development Bank IHME ...... Institute for Health Metrics and Evaluation MDGs ..... Millennium Development Goals MNCH. Maternal, newborn, and child health NCDs ...... Non-communicable diseases NGOs ..... Non-governmental organizations NTDs ...... Neglected tropical diseases ODA. Official development assistance OECD ..... Organisation for Economic Co-operation and Development 6 Financing Global Health 2016 OOP ...... Out-of-pocket PAHO ..... Pan American Health Organization PEPFAR ... United States President’s Emergency Plan for AIDS Relief PMI. United States President’s Malaria Initiative PMTCT .... Prevention of mother-to-child transmission of HIV PPP ........ Prepaid private spending SDGs ...... Sustainable Development Goals SWAps .... Sector-wide approaches TB ......... Tuberculosis UHC ....... Universal health coverage UI ......... Uncertainty interval UK ........ United Kingdom UN ........ United Nations UNAIDS ... Joint United Nations Programme on HIV/AIDS UNDP ..... United Nations Development Program UNFPA .... United Nations Population Fund UNICEF ... United Nations International Children’s Emergency Fund US ......... United States USAID ..... United States Agency for International Development WHO ...... World Health Organization Acronyms 7 FIGURES ,BOXES, AND TABLES FIGURES 20 Figure 1: Sources, channels, implementing institutions 23 Figure 2: DAH by source of funding, 1990–2016 24 Figure 3: Total DAH relative to DAH measured as a share of a source’s GDP, 1990–2016 29 Figure 4: DAH by channel of assistance, 1990–2016 30 Figure 5: Change in DAH by source, 2010–2016 30 Figure 6: Change in DAH by channel, 2010–2016 34 Figure 7: Total DAH, 2000–2016, observed versus potential 35 Figure 8: DAH by recipient region, 1990–2014 35 Figure 9: Flows of DAH from source to channel to recipient region, 2000–2014 40 Figure 10: DAH by health focus area, 1990–2016 41 Figure 11: DAH by health focus areas and program areas, 2000–2016 42 Figure 12: Absolute and relative change in DAH by health focus area, 2010–2016 43 Figure 13: Annualized rate of change in DAH by health focus area, 1990–2016 44 Figure 14: Flows of DAH from source to channel to health focus area, 2000–2016 45 Figure 15: Share of DAH allocated by health focus area, 1990–2016 46 Figure 16: DAH for HIV/AIDS by channel of assistance, 1990–2016 47 Figure 17: DAH for HIV/AIDS by program area, 1990–2016 48 Figure 18: Flows of HIV/AIDS DAH from source to channel to program area, 2000–2016 49 Figure 19: Top 20 countries by 2015 HIV/AIDS burden of disease versus average 2012–2014 DAH 50 Figure 20: DAH for maternal, newborn, and child health by channel of assistance, 1990–2016 51 Figure 21: DAH for maternal, newborn, and child health by program area, 1990–2016 8 Financing Global Health 2016 52 Figure 22: Top 20 countries by 2015 maternal, newborn, and child health burden of disease versus average 2012–2014 DAH 53 Figure 23: Flows of maternal, newborn, and child health DAH from source to channel to program area, 2000–2016 54 Figure 24: Flows of malaria DAH from source to channel to program area, 2000–2016 55 Figure 25: DAH for malaria by program area, 1990–2016 56 Figure 26: DAH for malaria by channel of assistance, 1990–2016 57 Figure 27: Top 20 countries by 2015 malaria burden of disease versus average 2012–2014
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