Health is not a priority sector; however, support to the Global Fund is substantial
EU institutions spent US$990 million on global health in 2015. This corresponds to 5% of the EU’s total ODA, just over half of the 9% average among members of the Development Assistance Committee (DAC) of the OECD.
The Commission has indicated that health ODA will remain largely flat until 2020, but will concentrate on fewer partner countries. The Commission agrees on three priority sectors with each partner country, in line with the country’s own priorities. Only 15 partner countries (of which 10 are in sub-Saharan Africa) requested health as a priority sector – down from 40 in the previous programming period (2007-2013). The top spenders on social sectors (including health) are Nigeria, Ethiopia, and DRC.
More than two-thirds of the EU’s ODA to health was provided as bilateral ODA (US$685 million). Multilateral support in health focused on the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund), with the Commission committing US$283 million in 2015. The commitment saw a sharp rise compared to 2014 (US$139 million), as the EU aimed to meet the payment schedule of its pledge to the Global Fund. The contribution is expected to reduce again in 2016. Over the 2001-2016 period, the Commission contributed a total of US$1.7 billion to the Global Fund. It pledged €475 million (US$593 million) to the organization for the 2017-2019 funding period.
The Commission also provides funding to Gavi, though after having contributed US$93 million in the 2000-2012 period, the EU did not fund Gavi in 2013 and 2014. This is because Gavi funding that had been provided for within the multiannual financial framework (MFF) ended in 2013, and budget negotiations were ongoing into 2014. The Commission resumed funding to Gavi in 2015 with a contribution of US$22 million, and pledged US$240 million for 2016 to 2020.
The EU institutions’ support to the Global Polio Eradication Initiative (GPEI) stands at US$126 million for 2006 to 2015. It increased its funding level to US$11 million in 2014 and US$13 million in 2015. Funding for the remaining years of the financing period until 2020 is unclear. The Commission has announced that it will continue to provide support to polio-endemic Afghanistan and Nigeria through its bilateral health programs, as well as a new contribution to Ukraine, which might be reported as contributions to GPEI.
The EU disbursed US$685 million as bilateral health ODA in 2015, equaling 4% of total bilateral ODA. This funding increased by US$55 million compared to 2014, largely due to increased spending on health system strengthening (HSS) in sub-Saharan Africa as a result of the Ebola epidemic. Funding in 2015 focused on basic health care (39% of bilateral health ODA), basic nutrition (19%), and HSS (23%).
The EU channels substantial funding from its bilateral health ODA as budget support (in 2015, US$165 million, or 8% of all budget support, went to the health sector). Apart from the funding that is reported as health ODA, the EU provides general budget support (US$965 million in 2015) that also benefits the health sector – meaning that actual funding provided for health is higher than the reported ‘health’ ODA.
DG DEVCO’s Directorate on Human Development and Migration leads policy development on health
The Council defines the overall priorities, while the Commission’s Directorate-General for Development Cooperation – EuropeAid (DG DEVCO) is in charge of developing the EU’s policies and thematic programs around global health. Within DG DEVCO, global health is covered by the Unit B4 (Education, Health, Research, Culture) within DG DEVCO Directorate B (Human Development and Migration).