Health is one of Italy’s development priorities; strong support to multilateral health organizations
Following years of budget cuts, Italy’s official development assistance (ODA) to global health currently remains relatively low. In 2015, it contributed US$241 million to health ODA (latest year for which complete data is available), remaining stable from 2014 contributions. As Italy’s total ODA rose, the proportion going to global health went down from 7% to 6% in the same time period. This is lower than the average health ODA spend (9%) of other members of the Organisation for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC). Health has been a priority for Italy’s development policy in the past and has been reaffirmed as a strategic priority in the Programming Guidelines and Directions for Italian Development Cooperation 2017-2019. Within health, the Guidelines place a focus on health system strengthening (HSS); maternal, newborn and child health (MNCH); non-communicable chronic diseases; communicable diseases; and mental health.
As with the rest of its ODA, Italy delivers most of its health ODA multilaterally (68% in 2015, or US$164 million), despite seeing a sharp decline since 2014 (when multilateral health ODA stood at 76%). Health is a key sector of its multilateral engagement. After years of cuts, Italy has stepped up its funding to multilateral organizations working on health. The largest share of multilateral funding went as binding contributions to the European Union. Italy resumed funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) in 2014 (to which it had stopped contributing since 2009 because of the economic crisis), leading to a significant increase in health ODA between 2013 and 2014. At the Fifth Global Fund Replenishment Conference in Montreal (September 2016) Italy announced that it will contribute €140 million (US$175 million) for the 2017-2019 funding period; in 2017, Italy contributed US$44 million. This is a strong increase compared to the €100 million (US$111 million) pledged by Italy for 2014 to 2016. In 2017, Italy introduced the “5% initiative”, which provides that Italy retains a 5% share of its contribution to the Global Fund for the period 2017 to 2019 (€7 million in total) for the direct financing of synergistic initiatives implemented by Italian research institutes. The activities will be identified and agreed on together with the Global Fund.
Italy is also a major funder of Gavi, the Vaccine Alliance (Gavi). It supports Gavi mostly through innovative finance mechanisms: It is the largest donor to Gavi’s Advance Market Commitment (AMC), a mechanism that provides market incentives for vaccine makers to develop and produce sustainable and affordable products for neglected diseases. According to the Programming Guidelines, Italy will contribute US$126 million (€114 million) to AMC between 2017 and 2019. In 2017, Italy contributed US$55 million, 51% of total contributions by all donors to the AMC, according to Gavi. Italy is also the third-largest contributor to the International Financing Facility for Immunization (IFFIm), a financing entity that makes immediate funding available to Gavi. According to the Guidelines, Italy will contribute US$91 million (€83 million) to IFFIm between 2017 and 2019. In 2017, it contributed US$35 million to IFFIm (9% of total from all donors), according to Gavi. In addition, in 2015, Italy committed €100 million (US$111 million) in direct funding to Gavi for 2016 to 2020, its first-ever direct contribution. Taking together all funding mechanisms (AMC, IFFIm, direct funding), Italy has committed US$437 million for Gavi’s 2016-2020 funding period.
Italy’s bilateral ODA to health amounted to US$66 million in 2016, corresponding to 3% of Italy’s total bilateral ODA. Within health, funding focused on medical services (41%), health policy (12%), and basic nutrition (9%). This is partly in line with the priorities spelled out in the Guidelines for Development Cooperation 2016-2018, which include a focus on universal health care (UHC) and HSS. Global health research and development (R&D) is a new focus area of Italian development cooperation (for more details, see section ‘Deep Dive: Global Health Research and Development’).
DGCS defines priorities within global health
Within the Ministry of Foreign Affairs and Development Cooperation (MAECI), the Directorate General for Development Cooperation (DGCS) defines Italy’s priorities around global health. Relevant departments include the Deputy Minister’s cabinet, geographic departments, and the unit on multilateral development cooperation, which is in charge of relations with multilateral organizations working on global health, such as the Global Fund. Within the development agency AICS, the office in charge of programs in the health sector is the ‘Human Development’ office. It is headed by Enrico Materia.
Italy’s priority countries for bilateral cooperation on health:
- South Africa
- Burkina Faso