Australia - Global health

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

According to data from the Organisation for Economic Co-operation and Development (OECD), Australia’s total official development assistance (ODA) to health in 2019 was US$297 million, making Australia the 11th largest OECD Development Assistance Committee (DAC) donor to the sector. Health funding represented 10% of Australia’s total ODA in that year (DAC average of 8%) putting Australia seventh in a ranking of DAC donors’ funding to health relative to total ODA.

Aside from a slight bump in 2018, Australia’s ODA for health has fallen by a total of 20% since 2015 when it sat at US$370 million. Despite being one of Australia’s strategic development priorities, the emphasis on health in many bilateral programs has reduced in recent years, particularly for HIV/AIDS and reproductive health care. Funding for health will likely increase in 2020 and 2021 due to COVID-19.

In 2019, 72% (US$213 million) of Australia’s ODA for health was provided bilaterally (DAC average: 50%). The largest share of bilateral health investments went to basic health infrastructure (23%) with health policy and administrative management accounting for 17%. Infectious disease control made up 14% of bilateral funding to health in 2019: a marked decline compared to 2018, following a 243% spike in funding between 2017 and 2018 driven by Australia’s efforts to tackle outbreaks of tuberculosis and polio in the Indo-Pacific.

The other 28% (US$84 million) of Australia’s ODA to health was channeled to multilateral organizations. The largest sum was allocated to Gavi, the Vaccine Alliance (Gavi; US$62 million). Australia also disbursed US$163 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) between 2017 and 2019 (according to the Global Fund’s official US$ conversion). If paid out equally over the three years, this would amount to a contribution of around US$54 million in 2019. These funds were not, however, reported to the OECD.

In the years ahead, Australia will likely continue to support health multilaterals, which the government has recognized as key to the global COVID-19 response. For example, at the Global Vaccine Summit in June 2020, Australia pledged A$300 million (US$213 million, according to the official conversion from Gavi) to Gavi for 2021-2025. This is the largest contribution made by Australia in recent years and marks a return to funding levels seen under the previous center-left Labor Party government.

Australia’s latest development policy, ‘Partnerships for Recovery: Australia’s COVID-19 Development Response’, launched in May 2020, is oriented toward COVID-19 response and recovery efforts, and therefore includes health — in particular health security in the Indo-Pacific — as a key pillar. Australia’s funding to the health sector is set to increase because of its additional funding for COVID-19. ‘Partnerships for Recovery’ names emergency health and humanitarian assistance as the foremost immediate concern.

In the latest budget, funding for Australia’s ‘Humanitarian and COVID-19 Response Fund’ remained steady from the previous year while funding for ‘Global Humanitarian Partnerships’ increased 12% due to increased allocations to the International Red Cross and the World Food Programme. Longer-term health system strengthening is also a priority, specifically immunization, maternal healthcare, family planning, and efforts to prevent future pandemics. The latest budget suggests allocations of A$21 million (US$15 million) between 2021 and 2023 to support the ASEAN Centre for Public Health Emergencies and Emerging Diseases and commits to “supporting access to safe and effective COVID-19 vaccines” through funding for vaccine partnerships, the COVAX advanced market commitment (AMC), and the provision of Australian manufactured doses.

Australia’s policy also commits to investing in water, sanitation, and hygiene (WASH) projects and ensuring adequate provision of sexual and reproductive health services during the pandemic, including through United Nations Population Fund (UNFPA; to which it contributed US$7 million in core funding and US$11 million in non-core funding in 2019, according to official UNFPA figures). The FY2021/22 budget, however, records a slight decrease (7%) in funding for ‘Heath, Water and Sanitation’ projects in the Indo-Pacific. Australia will also fund global research and development (including multilateral initiatives) for COVID-19 vaccines, diagnostics, and therapeutics (see sector: ‘Global health R&D’).

The Department of Foreign Affairs and Trade’s Human Development and Governance Division leads on global health policy development

The Human Development and Governance Division (HGD) of the Department of Foreign Affairs and Trade (DFAT) 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 WASH. It works closely with the Indo-Pacific Centre for Health Security, other DFAT programs, and external other government partners (including the Health Department and Therapeutic Goods Administration), to plan and adjust pipeline investments.