Health is one of Australia’s development priorities but overall health funding has recently declined

‘Health and education’ is one of the six priority areas of the government’s development strategy. In 2015, Australia invested US$379 million on health official development assistance (ODA), equivalent to 11% of total ODA. This is higher than the average health ODA spent by other members of the OECD Development Assistance Committee (DAC; the average is 9%) and is expected to increase to 13% in fiscal year (FY) 2016-17 (according to the budget). This makes it Australia’s fifth-largest investment priority in FY2016-17. However, health ODA continues to suffer from budget cuts, decreasing by 20% between 2013 and 2015, and it will further decrease in absolute terms to A$473 million (US$355 million) in FY2016-17. Cuts resulted in severe reductions in contributions to WHO, UNFPA, UNICEF and UNAIDS.

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Australia delivered a third of its health ODA multilaterally (33% or US$127 million in 2015), which is substantially lower than the DAC average (55%). Australia is a donor to Gavi and the Global Fund.

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At the Global Fund’s 2016 replenishment conference, Australia increased its pledge by 10% (from A$200 million, US$180 million for 2014 to 2016), reaching A$220 million (US$197 million for 2017 to 2019). In June 2017, Australia further announced an additional contribution to the Global Polio Eradication Initiative (GPEI; US$14 million for FY2019-2020).

Australia also pledged A$1.6 billion for 2011-2015 to the Global Strategy for Women’s and Children’s Health. Australia did not meet its aim of doubling annual family planning contributions that it set as part of this commitment, spending only A$17 million (US$13 million) in FY2015-16 compared to the promised A$53 million (US$40 million) annual spending by 2016. In February 2017, Minister Bishop announced A$9.5 million (US$7.1 million) in financing to the International Planned Parenthood Federation to deliver the Sexual and Reproductive Health Program in Crisis and Post-Crisis Settings (SPRINT) in the Indo-Pacific region over three years. The investment aims at strengthening sexual and reproductive health, rights, and support during humanitarian crises. At the family planning summit in July 2017, Australia has committed A$30 million to family planning in the South Pacific, partnering with UNFPA. In this context, Australia has further announced an additional pledge of A$3.5 million to support UNFPA Supplies.

Australia’s bilateral ODA to health amounted to 67% (US$253 million) of health ODA in 2015. This corresponds to 9% of Australia’s total bilateral ODA (DAC average: 7%). Earmarked funding to multilaterals amounted to US$50 million of the bilateral ODA to health. Australia’s development financing focuses on Southeast Asia and the Pacific. Investments in 2014 focused on sexually transmitted disease (STD) control, including HIV/AIDS (20%), basic health infrastructure (16%), basic health care (15%), and reproductive health care (14%).

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Australia's priority countries for bilateral cooperation on health:

  • Cambodia
  • Pakistan
  • Papua-New Guinea
  • Solomon Islands
  • Timor-Leste

The Development Policy Division leads on policy development within global health

Australia’s investments in health are guided by the ‘Health for Development Strategy 2015-2020’. Funds to deliver the strategy come from country, regional, and global programs, and are delivered through the regular budget process. Priorities and delivery strategies are set by the relevant program areas, taking into account partners’ priorities. The Development Policy Division (DPD) is the driver of health development policy, and provides operational guidance to assist with the implementation of the strategy, for example, on health systems reform, regional health security, private sector engagement, nutrition and health, and water, sanitation, and hygiene (WASH). It also works with the Department of Foreign Affairs and Trade (DFAT) programs and external partners to plan and adjust pipeline investments. Australia’s areas of strategic focus are: 1) health systems strengthening (HSS); including maternal, newborn and child health (MNCH), and family planning services; 2)  cross-border health threats (including HIV, tuberculosis, and malaria); 3) effective global health response (including through engagement with global health funds); 4)  access to WASH and nutrition; and 5)  health innovation (including research and development (R&D)).

Despite this focus, many bilateral programs are reducing the priority given to health, particularly for HIV.  Australia’s regional HIV initiative in East Asia has ended. HSS and HIV programs in Indonesia have not been extended beyond 2016. The government has been shifting its focus from direct health service delivery towards building the Papua New Guinea government’s capacity to deliver its own health programs, which civil society has feared may affect their HIV funding. However, the Minister for International Development and the Pacific has stated there will be new instruments for health financing, including for non-government organizations (NGOs), to Papua New Guinea in 2017-2018. Furthermore, Australia has increased tuberculosis program funding to respond to increasing multi-drug resistant tuberculosis problems in three Papua New Guinea provinces.