Canada - Global health
At a glance
Global health is a top priority, with a strong focus on MNCH and SRHR
Health is a cornerstone of Canada’s Feminist International Assistance Policy (FIAP). Prime Minister (PM) Justin Trudeau has stated that Canada’s focus on health is “driven by evidence and outcomes, not ideology, including by closing existing gaps in reproductive rights and health care for women”. As a result of this commitment, Canada places a strong emphasis on SRHR and maternal, newborn, and child health (MNCH).
In 2016, (the latest year for which multilateral and bilateral OECD data is available) Canada’s total ODA to health was US$815 million. This corresponds to 19% of the country’s official development assistance (ODA) in that year, making Canada the second-highest relative donor to global health among members of the Organisation for Economic Co-operation and Development’s (OECD) Development Assistance Committee after the US (DAC average 2016: 8%). 58% of these funds were channeled bilaterally and 42% as core funding to multilaterals.
In recent years, Canada’s bilateral ODA to health has been steadily increasing, rising by 6% from US$441 million in 2015 to US$566 million in 2018 (including both bilateral funds and earmarked funding to multilaterals). Health accounted for 16% of Canada’s overall bilateral ODA in 2018 making it the second-most funded sector.
Within the sector, investments in basic nutrition accounted for 19% of bilateral health ODA in 2018 (US$105 million). Other bilateral investments to health targeted reproductive health care (12%), basic health care (10%), personnel development for population and reproductive health (8%), infectious disease control (8%), and population policy and administrative management (8%). These highlight Canada’s thematic priorities within the MNCH sector, including nutrition, health systems strengthening, and treatment and prevention of diseases, including infectious diseases and SRHR.
Canada does not have priority countries for bilateral health cooperation, although the FIAP stipulates that by fiscal year (FY) 2021-2022, at least 50% of Canada’s bilateral ODA will be directed to sub-Saharan African (SSA) countries. In 2018 only 25% went to SSA.
Canada remains a strong supporter of multilateral health initiatives. Canada pledged US$699 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) for 2020-2023. This is the largest contribution that Canada has ever made to a multilateral in the health sector. Canada also supported Gavi, the Vaccine Alliance (Gavi) with US$410 million in direct funding and US$26 million in Advance Market Commitments between 2016 and 2020. In mid-May 2020, against the backdrop of – though not specifically related to – COVID-19, Canada announced CAD600 million (US$463 million) for Gavi for 2021-2025.
At the same time in May, Canada pledged additional support for global vaccination efforts through the Global Polio Eradication Initiative (GPEI). The government has committed CAD48 million (US$37 million) annually over four years for the GPEI’s ‘end-game strategy’ which is working to secure routine immunizations for hundreds of millions of children globally. The 2020 pledge follows a 2018 commitment of CAD100 (US$77 million), CAD30 million of which was earmarked to support the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) with programs in Afghanistan, with the rest given in flexible funding. Canada is one of the GPEI’s top-five donors since 1985 and support for the GPEI is likely to remain strong.
Much of Canada’s health-related funding for the international response to COVID-19 has been channeled through multilateral organizations. Canada has announced COVID-19 related funding for WHO, the Pan-American Health Organization, the United Nations High Commissioner for Refugees, the International Federation of the Red Cross and Red Crescent Societies, the World Food Program, and the Food and Agriculture Organization of the United Nations (UN). In line with its broader policy priorities, Canada is targeting vulnerable populations (including refugees, migrants, and those affected by armed conflict and violence) in its COVID-19 response. Canadian government ministers also joined leaders from 58 other countries, stating the importance of safeguarding sexual and reproductive health and rights (SRHR) during the crisis.
This aligns with Canada’s broader commitment to the issue of women's and girls’ health and SRHR. Earlier examples of the government’s prioritization of gender in health include a historic announcement at the Women Deliver conference held in Vancouver in June 2019, when the PM announced CAD1.4 billion (US$1.1 billion) annual commitment to support women and girls’ health for ten years, starting in 2023. CAD700 million (US$540 million) of this will be dedicated to SRHR annually. In July 2019, Canada’s International Development Research Centre announced funding for seven new research projects (in addition to the 10 it was already funding) focused on SRHR in West Africa and the Middle East and North African region (MENA), each funded with CAD750,000 (US$579,000).
Earlier commitments and contributions to SRHR include US$15 million (as of March 2018) to ‘She Decides’, which was launched in response to the global expansion of the Mexico City policy, also known as the ‘Global Gag Rule’. The Global Gag Rule is a US government policy that blocks all funding to organizations that provide abortion services, engage in abortion rights advocacy, or fund or support other groups which provide or discuss abortion. (For more, see US Donor Profile, sector: ‘Global health’). Between 2014 and 2018 Canada was the 11th-largest provider of core contributions and the second-largest provider of non-core contributions to the United Nations Population Fund (UNFPA). The focus of this funding has been SRHR in conflict zones, health system strengthening, and midwifery projects. Canada’s 2018 contributions to the UNFPA totaled US$129 million. In 2017, PM Trudeau announced an investment of CAD650 million (US$501 million) over three years to fill gaps in global SRHR funding. In late 2018, Global Affairs Canada (GAC) also launched a monitoring framework for the commitment.
GAC’s Minister of International Development leads on policy development with support from the Deputy Minister of International Development
Under the leadership of the Prime Minister, GAC steers development policy, including for global health. GAC is headed by the Minister of Foreign Affairs. With their oversight, the Minister of International Development sets development policy within GAC.
The Deputy Minister of International Development, Leslie MacLean, manages GAC’s development policy units and budget allocation. Other branches within GAC relevant to health development policy are: the Global Issues and Development Branch, under Assistant Deputy Minister Christopher MacLennan, which manages multilateral policies and contributions; the Strategic Policy Branch, headed by Elissa Golberg; and the four geographic branches (Americas; Asia Pacific; Europe, Middle-East and Maghreb; and sub-Saharan Africa) that manage country programs. Within the Global Issues and Development branch, relevant units include Food Security and Environment, Health and Nutrition, International Humanitarian Assistance, and International Organizations.