The landscape and distribution of aid donors has shifted rather dramatically from 1990 to 2011. In 1990, the main players were the UN and countries like the US, France, Sweeden and Japan. The United States gave over $900 million in development assistance representing 15.66% of the total given in 1990.
The introduction of large funding bodies like the Global Fund and GAVI, a rise in money invested in NGOs provide a different picture in 2011.
Other players grew quickly during the late 90's and early 00's, but the United States came back around beginning in 2003 to a point where it provided $7.5 billion in development assistance in 2011 and represented 27.3% of total money given.
visualization from the Institute for Health Metrics and Evaluation shows how players have emerged and shifted over the period of two decades. The data is connected to research that tracks the stagnation of development assistance.
The authors note that this research shows several trends that have implications for global health financing. The first is that there have been shifts in the recipients and purpose of DAH with the increased role of IBRD in DAH, as IBRD primarily provides loans to middle-income countries for health improvement and broader economic stimulus. Second is that with the slowdown of DAH from bilateral agencies in general, and in particular the US, organizations that rely on these funds, such as the US President’s Emergency Plan for AIDS Relief, are likely to be affected.The interactive data is neat to see shift over time. Can anyone account for the growth of proportion of assistance provided by NGOs? They peak at near 16% of total money in 2006 and decline back to 9.56% in 2011, roughly the same as in 1990. Same goes for the WHO who accounted for 1/5 of spending in 1990 and now only 7%.
In addition, stagnation in UN funding may pose risks to several health focus areas in which these channels play an important role, including maternal and child health, noncommunicable diseases, and tuberculosis. Finally, while the newer funder GFATM has channeled large amounts to DAH over recent years, it announced that it would make no new grants for the next two years due to declines in donor funding, so DAH from GFATM may not expand as rapidly as it has in the past.
Given the international community’s focus on meeting the Millennium Development Goals by 2015 and persistent economic hardship in donor countries, the authors stress that continued measurement of development assistance for health is essential for policymaking.