world crisis : its impact on health cooperation external relations, mobilization of resources, and...

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WORLD CRISIS: Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization and Alignment of Harmonization and Alignment of Cooperation in Middle-income Countries Cooperation in Middle-income Countries Dr. Juan Manuel Sotelo Dr. Juan Manuel Sotelo Pan American Health Organization Pan American Health Organization (PAHO/WHO) (PAHO/WHO) Integrated health services networks and vertical programs: Maximizing synergies for collaborative work Cuzco, Peru 11-12 November 2009

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Page 1: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Regional consultation meetingRegional consultation meeting

Harmonization and Alignment of Cooperation in Middle-income Harmonization and Alignment of Cooperation in Middle-income CountriesCountries

Dr. Juan Manuel SoteloDr. Juan Manuel SoteloPan American Health Organization (PAHO/WHO)Pan American Health Organization (PAHO/WHO)

Integrated health services networks and vertical programs: Maximizing synergies for collaborative work

Cuzco, Peru11-12 November 2009

Page 2: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnershipsActors inActors inInternational Cooperation on HealthInternational Cooperation on Health

GOVERNMENTALASSISTANCE

NON-GOVERNMENTALASSISTANCE

OFFICIAL AGENCYBilateral Path

Page 3: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

0.33

Source: OECD database

ODE as % of GDP

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

DP

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GDP Total ODA to Africa Total ODA

Page 4: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

NI

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GNI Total ODA to Africa Total ODA

0.33

0.22

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

ODA as % of GDP

Source: OECD database

Page 5: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

NI

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GNI Total ODA to Africa Total ODA

0.33

0.22

ODA as % of GDP

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

Source: OECD database

Page 6: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

NI

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GNI Total ODA to Africa Total ODA

0.33

0.22

0.33

Total ODA

ODA as % of GDP

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

Source: OECD database

Page 7: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

NI

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GNI Total ODA to Africa Total ODA

0.33

0.22

0.28

0.33

Total ODA

ODA as % of GDP

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

Source: OECD database

Page 8: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

0.33

0.22

0.28

0.35

0.33

Increase required to achieve goals by 2010

ODA as % of GNI

Total ODA

ODA of OECD members, 1990-2010ODA of OECD members, 1990-2010

Source: OECD database

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

% o

f G

NI

0

20

40

60

80

100

120

140

OD

A (

2004

US

D B

illo

n)

ODA as % GDP Total ODA to Africa Total ODA

Page 9: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Latin America in the global Latin America in the global contextcontext

•Latin America has lost a share of ODA.

•In the past two years, ODA to the region has registered the lowest levels of the decade as a percentage of total ODA to developing countries.

•In per capita terms, Latin America receives one-third of what Eastern Europe or sub-Saharan Africa receives.

ODA by world region 2005 – 2007

-

5 000

10 000

15 000

20 000

25 000

30 000

35 000

40 000

45 000

50 000

AFRICA

AMERICA

ASIA

EUROPE

OCEANIA

US

D M

illio

n 2005

2006

2007

ODA to Latin America and the Caribbean in %

0.0

2.0

4.0

6.0

8.0

10.0

12.0

2003 2004 2005 2006 2007

Year

%

Page 10: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Latin America and the Caribbean, HDI 2007

Source: PAHO with data of UNDP 0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1

Haiti

Nicaragua

Guatemala

Guyana

Bolivia

Honduras

El Salvador

Paraguay

Jamaica

Suriname

Belize

St. Vincent & the Grenadines

Dominican Republic

Ecuador

Peru

Colombia

Grenada

Brazil

Dominica

St. Lucia

Trinidad & Tobago

St. Kitts & Nevis

Panama

Venezuela

Costa Rica

Mexico

Cuba

Uruguay

Argentina

Antigua & Barbuda

Chile

Barbados

Page 11: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid, by source, 2007

Source Cooperationon health Channel

Government65.7%

US$ 14,322 million

Private sources26.7%

US$ 5,814 million

Debt forgiveness1.8%

US$ 398 million

Other and unclassified5.8%

US$ 1,253 million

Bilateral agencies34%

US$ 7,398 million

Development Banks7.2%

US$ 1,575 million

UN agencies14%

US$ 3,059 million

European Commission2.4%

US$ 521 million

Global Partnerships on Health12.5%

US$ 2,718 million

Philanthropic foundations5.2%

US$ 1,143 million

NGOs24.7%

US$ 5,375 million

International cooperationon health

100%US$º 21,788 million

Source: Author, with Health Metrics and Evaluation data, University of Washington.

Page 12: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Changes in international health aid, 1990-2007, LAC

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0

200

400

600

800

1000

1200

1400

1600

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

US

D M

illi

on

Page 13: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid by subregion in Latin America and the

Caribbean, 1990-2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

200.00

400.00

600.00

800.00

1000.00

1200.00

1400.00

1600.00

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

US

D M

illi

on

Caribbean

MERCOSUR

Andean

Central America

Page 14: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid by subregion in Latin America and the

Caribbean, 1990-2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

A

0

200

400

600

800

1000

1200

1990-1991 1992-1993 1994-1995 1996-1997 1998-1999 2000-2001 2002-2003 2004-2005 2006-2007

Biennia

US

D M

illi

on

Central America

Andean

MERCOSUR

Caribbean

Page 15: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnershipsHealth aid in Andean countries,

1990 -2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

100.00

200.00

300.00

400.00

500.00

600.00

700.00

1990-1991 1992-1993 1994-1995 1996-1997 1998-1999 2000-2001 2002-2003 2004-2005 2006-2007

Biennia

US

D M

illio

n

Colombia

Bolivia

Peru

Ecuador

Chile

Page 16: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid in Central American countries,1990-2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00

160.00

1990-1991 1992-1993 1994-1995 1996-1997 1998-1999 2000-2001 2002-2003 2004-2005 2006-2007

US

D M

illilo

n

Nicaragua

Honduras

Guatemala

Dominican Republic

El Salvador

Page 17: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid in MERCOSUR countries,1990-2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

50.00

100.00

150.00

200.00

250.00

300.00

350.00

400.00

450.00

500.00

1990-1991 1992-1993 1994-1995 1996-1997 1998-1999 2000-2001 2002-2003 2004-2005 2006-2007

US

D M

illio

n

Argentina

Brazil

Paraguay

Uruguay

Venezuela

Page 18: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid in Caribbean countries,1990-2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

10.00

20.00

30.00

40.00

50.00

60.00

1990-1991 1992-1993 1994-1995 1996-1997 1998-1999 2000-2001 2002-2003 2004-2005 2006-2007

US

D M

illio

n

Guyana

Cuba

Jamaica

Suriname

St. Helena

Belize

Page 19: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Health aid in Latin American and Caribbean countries, 2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

20.00

40.00

60.00

80.00

100.00

120.00

140.00

Hai

tiA

rgen

tina

Bra

zil

Col

ombi

aN

icar

agua

Bol

ivia

Hon

dura

sP

eru

Gua

tem

ala

Mex

ico

Ecu

ador

Dom

inic

an R

epub

licE

l Sal

vado

rG

uyan

aP

arag

uay

Cub

aJa

mai

caC

hile

Sur

inam

eU

rugu

ayP

anam

aC

osta

Ric

aS

t. H

elen

aV

enez

uela

Bel

ize

Gre

nada

St.

Luci

aS

t. K

itts

& N

evis

St.

Vin

cent

& th

e G

rena

dine

sD

omin

ica

Mon

tser

rat

Trin

idad

& T

obag

oB

arba

dos

Ang

uilla

Turk

s &

Cai

cos

Is.

Ant

igua

& B

arbu

da

Net

herla

nds

Ant

illes

US

D M

illio

n

Page 20: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Per capita health aid in Latin American and

Caribbean countries, 2007

Source: PAHO with data from the Institute for Health Metrics and Evaluation.

University of Washington

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

Guy

ana

Sur

inam

eH

aiti

Nic

arag

uaH

ondu

ras

Gre

nada

Bol

ivia

Bel

ize

El S

alva

dor

Jam

aica

Dom

inic

an R

epub

licG

uate

mal

aE

cuad

orA

rgen

tina

Par

agua

yU

rugu

ayC

olom

bia

Per

uS

t. Lu

cia

Pan

ama

St.

Vin

cent

& th

e G

rena

dine

sC

uba

Cos

ta R

ica

Chi

leB

razi

lM

exic

oV

enez

uela

Ang

uilla

Net

herla

nds

Ant

illes

Ant

igua

& B

arbu

daB

arba

dos

Dom

inic

aS

t. K

itts

& N

evis

Mon

tser

rat

St.

Hel

ena

Turk

s &

Cai

cos

Is.

Trin

idad

& T

obag

o

US

D p

er c

apit

a

Page 21: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Paris Declaration: aid effectiveness

What do we mean by “aid effectiveness”?

Page 22: WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization

WORLD CRISIS: Its impact on health cooperationExternal relations, mobilization of resources, and partnerships

Road map: Paris Declaration