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Action For Global Health Health as a Tracer Sector Berlin 8 April 2008 Elisabeth SANDOR OECD DCD

Action For Global Health Health as a Tracer Sector Berlin 8 April 2008 Elisabeth SANDOR OECD DCD. Content. 1. Background on Health as a tracer sector 2. The challenges and progress in Aid Effectiveness in Health 3. Health as a Tracer Sector  in Accra. Better results are needed !.

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Action For Global Health Health as a Tracer Sector Berlin 8 April 2008 Elisabeth SANDOR OECD DCD

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  1. Action For Global Health Health as a Tracer Sector Berlin 8 April 2008 Elisabeth SANDOR OECD DCD

  2. Content 1. Background on Health as a tracer sector 2. The challenges and progress in AidEffectiveness in Health 3. Health as a Tracer Sector in Accra

  3. Better results are needed ! Tracking Health MDGs in SSA: • HIV prevalence among pregnant women aged 15-24: only 8 out of 36 countries on target • TB prevalence only 4 countries on target, 27 with worsening trend • Under-5 Mortality Rate: 2 countries on target, 25 making progress but behind time-bound target, 9 with worsening trend Source: Global Fund, 2007

  4. Background • High-Level Fora on Aid Effectiveness and Scaling up for Better Health (2004-2006) focused on AE: lack of aid predictability, alignment and C&H, insufficient ownership and use of country systems + produced best practice for GHPs’ interventions in countries • Dec.2006: WHO/WB/OECD meeting on “Aid Effectiveness and health”: participants endorsed “Health as a tracer sector” • Health as a tracer sector to feed the broader agenda on AE (best practice, lessons, keeping public support to financing for development)

  5. Background (2) • OECD work on AE in health : DCR 2007, DCD EFF coordinates with IHP and other health-related initiatives (HMN, IHME, Global Innovative financing), preparation of HLF3 in Accra • One Task Team on HaTS to pilot and guide the work up to Accra and beyond (links with IHP and UNSG’ Steering Committee on MDGs in Africa) • So objective: not only for Accra…but keep Health as a source of lessons for better AE/results and development impact

  6. The challenges in AE in Health: more aid is needed • Health captured a large part of the ODA increase but more aid is still needed to reach common agreed objectives (also DAH increase brings greater need for accountability) • The current uncertainties about future increase of aid • The bulk of the increase in DAH has been going to specific initiatives and few bilateral programs

  7. The path to delivering the 2010 promises is getting steeper and what will there be for health ?

  8. DAH has significantly increased and changed • Most of the • recent increase: • focused on Africa • focused on specific diseases • was channeled through bilateral (US) and new multilateral agencies (GAVI A, GFTAM) Source: Michaud 2006

  9. Bilateral ODAH (in constant USD millions)

  10. Bilateral ODAH (in constant USD Millions)

  11. Managing for Results 4 Mutual accountability 5 Ownership (Partner countries) Partners set the agenda 1 Aligning with partners’ agenda Alignment (Donors - Partner) Using partners’ systems 2 Establishing common arrangements Sharing information Harmonisation (Donors - Donors) Simplifying procedures 3 The challenges in AE in HealthBetter aid is neededImplementing the 2005 Paris Declaration

  12. The challenges in AE in health: better aid is needed Improve AE is key in a sector which is: - complex (large number of actors, multi-sectoral nature of the determinants of health and multiple financing streams, health results require long-term and sustained investments) - heavily fragmented at global and country levels

  13. Fragmentation in international effort …. Source; Don De Savigny & COHRED

  14. Health aid can be very volatile and unpredictable Disbursements from DAC members 2001- 2005 Source: OCDE, 2007

  15. The challenges in AE in Health: Donor aid can be poorly aligned within country systems and priorities Example from Rwanda (Scaling up for Better Health, 2005): • Donor preference to disburse via NGOs/manage funds themselves/send them directly to local-level projects . Central Government manages only 14% of donor support to the health sector. • Inequalities in the distribution of donor funding by strategic objective: $18mn earmarked for malaria (the biggest cause of mortality and morbidity), $1mn for the integrated management of childhood illnesses and $47mn for HIV/AIDS.

  16. Donor collaboration is a challenge WHO INT NGO CIDA 3/5 UNAIDS GTZ RNE UNICEF Norad WB Sida USAID T-MAP MOF UNTG PMO CF DAC GFCCP PRSP PEPFAR HSSP GFATM MOEC MOH SWAP CCM NCTP CTU CCAIDS NACP LOCAL GVT CIVIL SOCIETY PRIVATE SECTOR Source: Mbewe, WHO

  17. The progress and remaining challengesin AE in health: • The current renewed interest for Health Systems has generated a set of interventions which need to be coordinated/harmonised • Changes in aid modality can have unintended consequences for health • It’s important to report on progress about the different ongoing initiatives and innovative financing for development

  18. The progress and remaining challenges in AE in Health • Division of labour and coordination at the global level: informal group of the H8 and IHP • Global Programs continuous effort to implement the Paris agenda • Harmonise M&E • Change behaviour remains key

  19. What is Accra ? • High Levelpoliticaleventon aid, a few monthsbeforeFinancing for Development in Doha • Mid-termStock-taking of the Paris Declarationmutualcommitments • Forwardlookingevent : road to 2011. • 100 partner countries, mostdonors, most international aidagencies, • 800 to 1000 participants • Strong civil society engagement (consultations + Advisory Group-CSO contribution + pre Accra meeting)

  20. List of Roundtables • RT 1 : Country ownership • RT 2 : Alignment : country syst, predictability • RT 3 : Harmonisation- complementarity • RT 4 : Results & impacts • RT 5 : Mutual accountability • RT 6 : Civil society & aid effectiveness • RT 7 : Situations of fragility & conflicts • RT 8 : Sector applications (health, education, infrastructure…) • RT 9 : Aid architecture (incl. Global Health Partnerships)

  21. Core Issues (Partner Countries) for the RTs and the Accra Agenda for Action • Untying • Conditionality • Predictability • Division of Labour • Incentives • Capacity Development + «cross cutting» issues: human rights, environment, gender

  22. Health as a Tracer Sector in Accra • A contribution to the Roundtable on sector application of the PD (will look at lessons – Sector Wide Approaches and Programme-Based Approaches - across 4 sectors + priority areas and cross-cutting issues) • One Report on Health and Aid Effectiveness to take stock of progress and remaining challenges • Other inputs: to other RTs and to the Market place • Concrete recommendations for the Accra Action Agenda = all prepared by the Task Team on HaTS

  23. Examples of inputs on HaTS in Accra • Compacts for mutual accountability in a set of partner countries • Study on donors constraints to provide long-term health aid • Best practice and lessons from GHPs • Study on Human Rights and AE in health • Monitoring progress in AE in health (country and global levels)

  24. Thank You ! www.accrahlf.net

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