Health is not a priority sector; however, support to the Global Fund is substantial
EU institutions spent US$1 billion on global health in 2016, according to data from the Organisation for Economic Co-operation and Development (OECD) . This corresponds to 5% of the EU’s total ODA. The European Commission (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 for a multi-year period, 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 European Consensus on Development, agreed to in 2017, commits the EU to spending at least 20% of its ODA on health and social inclusion. While it has made strides in this direction, the EU has yet to meet this target during the current MFF.
73% or US$732 million of the EU’s ODA to health was provided as bilateral ODA in 2016. This accounts for 4% of total bilateral ODA. Funding increased by 25%, or US$149 million, compared to 2015. The increase is largely due to spending on basic nutrition, which more than doubled (US$53 million in 2015 and US$119 million in 2016) and now makes up 16% of all bilateral health ODA. Basic health infrastructure also saw significant increases (from US$9 million in 2015 to US$74 million in 2016), now making up 10% of bilateral health ODA. Basic health care remains the top sector (34% of bilateral health ODA), remaining stable from 2015 levels.
43%, or US$315 million, of bilateral ODA to health is earmarked for multilateral organizations, including first and foremost the UN Children’s Fund (UNICEF), which received US$122 million in 2016. The EU channels substantial funding from its bilateral health ODA as budget support (in 2016, US$106 million, or 7% of all budget support, went to the health sector). Apart from the funding that is reported as health ODA, the EU provides partner countries with general budget support that also indirectly benefits the health sector. In 2016, benefits for health are estimated at around US$207 million (based on the Muskoka methodology, approximately 10% of general budget supports the health sector). This brings total bilateral ODA benefiting the health sector in 2016 to US$993 million and total health ODA – including multilateral support – to US$1.2 billion.
Core contributions to multilateral organizations within the health sector amounted to 27% or US$268 million of total health ODA in 2016, focusing on the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund), according to OECD data. The commitment saw a sharp rise compared to 2015 (US$113 million), due to delays in disbursements. Since the Global Fund’s creation in 2002, the Commission has contributed a total of US$2.1 billion (as of September 2017). For the 2017-2019 funding period the EU increased its previous pledge by 16% to €475 million (US$593 million; it had pledged €370 million, or US$410 million, for the 2014-2016 funding period).
The Commission also provides earmarked bilateral funding to Gavi, the Vaccine Alliance. According to Gavi, the EU provided US$14 million in 2016. The EU pledged US$240 million for Gavi’s 2016-2020 funding period and provided US$7.8 million as direct contributions in 2017, according to Gavi.
The EU has also supported the Global Polio Eradication Initiative (GPEI) since 2006. In 2017, it contributed US$16 million; given that no funding was disbursed in 2016, the funds in 2017 were higher than in the years before. Funding to GPEI 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.
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 international Cooperation and Development (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).