Diseases without borders What must the Global Development Community Do?

1. Diseases without bordersWhat must the Global Development Community Do? World Bank Seminar Series Tawhid Nawaz, Operations Advisor Human Development Network

2. Slide 1

3. Slide 2

4. Slide 3: What Must The Global Development Community Do? Since Donors as a group have convening power responsibilities include providing both coordination of financial assistance as well as technical leadership: - support global governance - intervene on key issues to improve systems of prevention, control and treatment

5. Slide 4: Attempts to set common goals by the international development community • The Monterrey Consensus—March 2002 - a framework of mutual accountability between developing and developed countries - developing countries to improve their policies and governance - developed countries to open their markets and provide more and better aid Focus shift: from consensus to implementation

6. Slide 5: Communicable diseases and global challenges Three main challenges during implementation: • Ensuring the sustained and predictable financing required to expand the recurrent cost intensive services • Making sure that resources translate into effective service delivery, by improving governance and accountability • Scaling up skilled providers--doctors and nurses--needed to rapidly expand health services

7. Slide 6: A major challenge remains progress in health outcomes for the poor: • In two-thirds of the countries that have reduced child mortality since 1990, outcomes for families in the lowest income quintile have improved less than for the population as a whole • However, there are exceptions: - Mali, Turkey, Egypt, Peru and Cameroon achieved faster reductions in child mortality for the poorest quintiles

8. Slide 7: Effective Donor strategies for reaching the poor in low income countries: - prioritizing the expansion of services in poor and rural regions - expanding health care services that have a direct impact - eliminating user fees for essential health services

9. Slide 8: Major Global Programs in Health • Global Fund to Fight AIDS, TB and Malaria • The Global Alliance for Vaccination and Immunization • The World Bank’s Multi-Country AIDS Program • The US President’s Emergency Plan for AIDS Relief • 70 other global health initiatives

10. Slide 9: Donor Contribution on Communicable Diseases HIV/AIDS • Financing, research and global advocacy for HIV/AIDS have increased significantly • Commitments for HIV/AIDS prevention and treatment programs jumped from less than $400 million in the late 1990s to an estimated $6 billion in 2005 • Faster progress for harmonizing donor aid at the country level and implementing the “Three Ones” principle: one strategy, one implementation agency, one monitoring and evaluation system Impact: by 2003, 80% of public spending on HIV/AIDS in low-income countries was financed by external grants

11. Slide 10: Donor Action on Malaria • Global funding has quintupled in the past few years, from $120 million to $570 million, thanks largely to the Global Fund to Fight AIDS, Tuberculosis and Malaria • The Roll Back Malaria effort: global framework for intensified progress • Donor action needed on technical issues: - increase use of bednets - new and more expensive treatment for vector control and drug resistance • As much as $1 billion or more each year is needed

12. Slide 11: Major Achievements: • Raising global awareness • Stimulating new drug and vaccine research • Making aid for health pro-poor More Challenges: • ‘Verticalization’ of health sector support through diverse, specialized global initiatives is having adverse impacts • Donor support needed to organize country-led health strategies for all communicable disease priorities • Donors need to view themselves as partners

13. Slide 12: CONCLUSIONS: Many low-income countries rely heavily on development assistance (ODA). The international development community needs to focus on: • building country capacity and promoting 13the development and use of country systems • strengthen partnerships and harmonize aid • strengthen the focus on results • ensure the flexibility and predictability of aid flows