Health is a priority of French development policy; France will host 2019 Global Fund replenishment
In 2016 (latest year for which full data is available), France was the fourth-largest donor country to health. Its total official development assistance (ODA) to the sector stood at US$971 million, a 16% increase from 2015, and accounted for 8% of its total ODA (on par with the Organisation for Economic Co-operation and Development (OECD) Development Assistance Committee (DAC) average).
Health is a strategic priority of French development policy, as reiterated in the conclusions of the Interministerial Committee for International Development Cooperation (CICID) in February 2018. It is a key area of its multilateral engagement, and France will host the sixth replenishment conference of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund) for the 2020-2022 period, in October 2019, in Lyon.
France’s health strategy has traditionally included the fight against AIDS, tuberculosis and on UHC. The strategy for global health for 2017 to 2021 emphasizes four additional priorities for health interventions:
- Health systems strengthening (HSS);
- Global health security;
- Promotion of health for the most vulnerable; and
- Development of expertise, innovation and research in global health.
The bilateral chapter of France’s health ODA policy is mainly carried out by the French Development Agency (AFD). AFD defines the main objectives of its policy in the sectoral intervention framework for 2015 to 2019. The focus is on the intersection of social protection and global health, particularly with regard to maternal and newborn health, and sexual and reproductive health and rights (SRHR). In 2016, the Ministry of Foreign Affairs (MAE) published its 2016-2020 strategy on SRHR. Within this sector, French ODA focuses on three areas: HSS, family planning and access to contraception, and facilitating youth access to SRHR.
Global health is also a key sector within France’s multilateral engagement. In 2016, France channeled 70% of its health ODA multilaterally (US$676 million), which is a much higher share than the average among DAC countries (56%). In 2016, France delivered 45% of its total health ODA to the Global Fund, and France remains the second-largest donor to the Global Fund after the US. France pledged €1.1 billion (US$1.3 billion) to the Global Fund for the 2017-2019 period. Other key multilateral recipients are the EU institutions, the World Bank’s International Development Association (IDA), and the International Finance Facility for Immunization (IFFIm).
France is a pioneer in supporting innovative financing mechanisms for health. It is the second-largest donor to IFFIm, a financing entity that makes immediate funding available to Gavi, the Vaccine Alliance (Gavi) for immunization programs by issuing ‘vaccine bonds’ in the capital market. In 2006, France also introduced an airline ticket tax to fund UNITAID, a global health initiative that aims to make prevention, diagnostics, and treatment of HIV/AIDS, tuberculosis, and malaria affordable and widely available. France is the largest contributor to UNITAID. France plans to allocate €85 million (US$ 96 million) annually to the organization, drawn from innovative finance mechanisms such as its financial transaction tax (FTT) and air ticket levy. The Global Fund, UNITAID, and IFFIm are all quoted in the 2017-2021 ‘Strategy for multilateral aid’ as key partners of France’s multilateral engagement.
In 2017, France’s bilateral ODA to health amounted to US$172 million according to OECD data, a decrease of 42% compared to 2016 (US$295 million). Bilateral health ODA reached a peak in 2016 due to a US$113 million project to the sub-Saharan region focused on infectious disease control. In 2017, the largest share of the funding was allocated for medical services (18%), health policy and administrative management (13%), and infectious disease control (12%). This strongly aligns with strategic priorities of global health.
The MAE’s sub-directorate for human development leads on global health
The MAE drives the development of strategies for French development policy, including around global health. Within the MAE, global health is covered by the ‘Sub-directorate for Human Development’ (HUMA), within the Directorate-General for Globalization, Culture, Education and International Development (DGM). When it comes to the design of specific AFD programs related to global health, AFD’s ‘Health and Social Protection’ department, a sub-section of the ‘Human Development Department’, plays the lead role.