United Kingdom - Global health
At a glance
The UK is the second-largest government donor to global health after the US, funding is increasing
The UK contributed US$2.5 billion to global health or 13% of total ODA in 2016 (the latest year for which multilateral and bilateral data is available) making the UK the second-largest government donor in absolute terms and the fourth-largest in relative terms. In 2016, the UK contributed 41% of its ODA for health through core contributions to multilaterals, below the DAC average of 56%.
Between 2016 and 2018, the UK’s bilateral ODA to health rose by 24%, from US$1.5 billion to USS$1.8 billion. Health accounted for 14% of the UK’s total bilateral ODA in 2018, an increase from 2016 when it represented just 12%. US$615 million of the UK’s bilateral contributions were channeled as earmarked funding to multilaterals.
Strengthening global health security is a priority for the UK and they seek to leverage their national expertise in public health and medical research to promote this. At the 75th United Nations (UN) General Assembly in September 2020, the UK Prime Minister set out a five-point global health security plan which the government intends to promote through its G7 Presidency in 2021. The plan calls for:
- Global network of zoonotic research hubs to identify dangerous animal pathogens that may cross the species barrier and infect human beings;
- Development of global manufacturing capacity for treatments and vaccines for future pandemics that all countries can access;
- Global pandemic early warning system to share data across countries and alert the world to transmission;
- Crisis response system with agreed protocols to enable a coordinated emergency response across all countries; and
- End to export controls on essential goods for fighting pandemics (and an agreement to not revive the controls).
Reproductive health care and family planning accounted for 25% of the UK’s bilateral health spending in 2018. At the 2017 London Summit on Family Planning, the UK pledged £225 million (US$300 million) a year for women’s and girls’ access to modern family planning methods between 2017 and 2022. They also provided £30 million (US$40 million) to the Global Financing Facility (GFF) to pilot new ways to leverage donor money to incentivize domestic investment. The UK government signed a new agreement with United Nations Population Fund (UNFPA) Supplies in October 2020, pledging £425 million (US$567 million) to ensure that 20 million girls and women will have access to family planning every year up to 2025.
Health policy and administrative management accounted for 13% of bilateral spending, reflecting the importance the UK places on health system strengthening in recipient countries. Basic nutrition and infectious disease control both account for 9% respectively, consistent with the UK’s policy of focusing spending on the world’s most vulnerable.
The UK is a strong supporter of multilateral health initiatives. It is the largest donor to Gavi, the Vaccine Alliance (Gavi; utilizing all Gavi’s funding channels to pledge a total of US$2.1 billion between 2016 and 2020). The UK hosted the third Gavi replenishment virtually in June 2020 where it committed an additional US$1.7 million for the 2021-25 period. It is the third-largest public donor to The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund; pledging $1.7 billion for the 2020 to 2023 funding period), and among the largest funders to the Global Financing Facility (GFF) and the Global Polio Eradication Initiative (GPEI). The UK has increased its funding to the World Health Organization (WHO) to support it in its role coordinating the global response to COVID-19 and strengthening health systems in partner countries, providing a core contribution of £340 million ($ 454 million) over the next four years. This represents a 30% increase to existing funding and makes the UK the second-largest member state contributor.
The UK is playing an active role in the global response to COVID-19, making early contributions to all product pillars of the Access to COVID-19 Tools (ACT) Accelerator. It is the largest funder to the Coalition for Epidemic Preparedness Innovations (CEPI), contributing US$297 million to the international effort to develop a vaccine against COVID-19 and US$706 million to Gavi to support vaccine delivery and distribution to low- and middle-income countries. It has contributed US$50 million to the Therapeutics Accelerator and $28 million) to the Foundation for Innovative New Diagnostics (FIND).
DFID was responsible for global health policy development
The Department for International Development (DFID), in collaboration with the Department of Health and Social Care (DHSC) used to lead the UK’s global health policy and strategy and had overall responsibility for the UK’s health ODA spending. It is unclear at present what the permanent management structure will look like under the new Foreign, Commonwealth and Development Office (FCDO). In 2016, a global health oversight group with representatives from DFID and DHSC oversaw global health policy and programming of spending on areas of mutual interest between government departments, including the cross-government response to global health threats. Again, it is unclear whether this group will be maintained under the new department.
The UK’s bilateral health programming was highly decentralized under DFID, with country offices leading on designing and managing global health programs within partner countries. Within DFID headquarters, there were two units responsible for global health policy and funding decisions: The Global Funds Department and the Policy Division. The Global Funds Department managed the UK’s contribution to multilateral health funds and its partnerships with these funds. The Policy Division supported new policy development and provided technical support to country programs. It is not yet clear how the UK’s health spending will be organized in the new FCDO.