title from view and slide master | 27 july 2006 aid effectiveness for health: towards the 4th...

TITLE from VIEW and SLIDE MASTER | 27 July 2006AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 1

AID EFFECTIVENESS FOR HEALTH

TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011


Main Messages

Health provides unique insights and lessons into the complexities of aid architecture

Effective aid creates conditions for success

There have been significant achievements in the health sector

There are still significant challenges and risks in the health sector

Lessons from the health sector



Total Commitments - Million - Constant 2008 US$

0

5,000

10,000

15,000

20,000

25,000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009



-

2,000.00

4,000.00

6,000.00

8,000.00

10,000.00

12,000.00

14,000.00

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

MDG6

Other ODA for Health

ODA for Health



0

1

2

3

4

5

6

7

8

9

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

MDG6

Other ODA for Health

Health ODA per capita - AFRO



Too many cooks?



7



Which successes?– Health system development

• Better sector planning, budgeting and governance • Strengthened national health systems

– Better health outcomes• Polio Eradication• AIDS epidemic under control• Decreased vaccine preventable deaths• Decreased malaria mortality• TB Control



Tension and challenges: striking the right balance–Finding better complementarities between:

• programmes that score well on delivering shorter term measurable results, though often at the expense of aid effectiveness and

• longer term transformational change, and whole-of-sector approaches that are more sustainable, focus on greater alignment with country needs, institutions and priorities, but are more challenging to measure and report

Using health as a “tracer” sector has deepened understanding of the risks and benefits of diversity and has leveraged action for a more coordinated and coherent approach to the global aid architecture



Efforts to improve aid effectiveness in health has led to a shift in how donors and partner countries engage– from a focus on delivering on discreet projects and activities – to a strategic developmental discourse

This shift in approach is central for "development effectiveness"



Good progress in implementing the Paris principles – strengthening country ownership (+ country systems)

• CSOs, private sector, Parliament– Alignment, harmonisation, division of labour and implementation of

common arrangements are improving• Global health programmes?

– Dialogue and information sharing between donors and countries – Donors have made systematic efforts to improve aid predictability


There are still significant challenges and risks in the health sector

There is a significant ‘disconnect’ between global commitments and country level practices – a significant proportion of aid for health is still ‘off budget’, – increase in aid for health is not matched by a commensurate increase in use of

budget support – aid remains highly unpredictable – countries have also not consistently met commitments, (Abuja target)– strengthening country systems (i.e. PFM) systems depends on wider

government reform – Demonstrating the impact of aid effectiveness on health outcomes is

challenging– The transaction costs of aid effectiveness processes are high,


Lessons from the health sector

In for the long haul: Set realistic expectations about what can be achieved and when Context and politics matter: Genuine and sustainable changes in donor and country

behaviour is as much about country context and politics as it is about technical fixes and changing aid modalities.

The Paris principles are a means to an end Concentrate efforts on those principles with greatest potential for development– aligning with national priorities and providing predictable, sustained and on-budget aid.

Don’t reinvent the wheel: Existing health sector compacts, codes of conduct, tools and accountability can be adapted and used for other sectors.

Think twice: Avoid establishing new global funds and programmes (duplication, competition, fragmentation). Country problems solutions must be based on a clear analysis of the existing global and national institutional context.

Plan for measuring results since the start: Invest early on in developing a common understanding and expectation of results and in regular, robust, independent monitoring and evaluation of aid effectiveness processes and impact.

title from view and slide master | 27 july 2006 aid effectiveness for health: towards the 4th...

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