It would be easy to assume that the worldwide economic crisis had signalled the death knell for global health funding. But, according to the latest report on global health expenditure from the Institute for Health Metrics and Evaluation (IHME), the picture is not so gloomy. So how does the good news weigh up against the bad?
The good news. Development assistance for health from government aid agencies, multilateral donors, private foundations, and charities seems to have held steady from 2010 to 2012. After reaching a historic high of US$28·2 billion in 2010, development assistance for health dropped in 2011 and recovered in 2012, largely thanks to increases in spending from the GAVI Alliance and UNICEF. Additionally, donations from the UK and Australia increased from 2011 to 2012. And money for HIV/AIDS, tuberculosis, and maternal, newborn, and child health continued to increase through 2010.
The bad news. Global health funding is still flat-lining. From 2011 to 2012, overall health spending from government aid agencies decreased by 4·4%. Development assistance for health from the USA, the largest donor, dropped by 3·3%, from Germany it decreased by 9·1%, and France by 13%. Development health assistance for health sector support, non-communicable disease, and malaria fell slightly from 2009 to 2010.
Furthermore, the report noted a disconnect between donor priorities and global health needs. IHME combined their funding estimates with the new findings from the Global Burden of Disease Study 2010 to compare the amount of development assistance a country receives with its disease burden. The analysis showed that of the top 20 countries with the highest all-cause disability adjusted life-years, only 12 are among the top 20 recipients of development health assistance.
Some nations, such as Germany, are weathering the economic storm better than others, so their decreases in global health spending are hard to justify. Overall, however, the international community is holding steady on its promises to improve the health of poorer nations. But donors must use the latest IHME data to set priorities, and make sure that funds go to those most in need.