Spain - Global health





ODA to global health dropped significantly between 2008 and 2020, but the sector is being reprioritized in response to the COVID-19 crisis.

According to Organisation for Economic Co-operation and Development (OECD) data, Spain spent US$199 million in ODA (both bilateral and multilateral) on health in 2020. This represented 7% of its total ODA (below the DAC average of 10%). This makes Spain the 15th-largest donor to health in absolute terms and the 21st-largest in relative terms. 
According to the ‘Master Plan for Spanish Cooperation 2018-2021’ (Master Plan), global health is a top priority of Spain’s development policy. Spain takes a rights-based and equity approach, focusing its health policy on strengthening universal health coverage (UHC) and promoting access to essential drugs and vaccines. Since the COVID-19 pandemic, global health and pandemic preparedness have been prioritized within the Spanish development cooperation agenda and the corresponding ‘Spanish Cooperation Strategy to Respond to COVID-19' initiative in 2020.
In line with Spain’s strategic priorities, Spain focused its bilateral health efforts on COVID-19 control (36% of bilateral health ODA), health policy and administrative management (11%), basic health care (10%), and reproductive health care (10%) in 2020.
In addition to channeling funding through bilateral channels, Spain also channeled 53% of its health ODA (US$106 million) as multilateral ODA (above the DAC average of 44%). The majority of this funding is channeled through the EU institutions (27% of total health ODA), followed by the World Bank’s International Development Association (IDA; 13%), and the Global Fund (6%). 
In response to the COVID-19 crisis, Spain announced that global health and epidemic preparedness will be reprioritized within its development cooperation policy. Between 2020 and 2021, Spain pledged €75 million (US$85 million) over the next 15 years to CEPI and €125 million (US$142 million) to Gavi COVAX AMC, along with additional disbursements amounting to €20 million (US$23 million) in ODA voluntary contributions to multilateral organizations. This new funding, which is in addition to Spain’s compulsory contributions to the multilateral system, will be channeled to the WHO, UN Women, the UN Program on HIV and AIDS (UNAIDS), and the World Food Programme (WFP). Moreover till 2021, Spain has donated more than 60 million COVID-19 vaccine doses to middle- and low-income partner countries, making it the seventh-largest donor worldwide and COVAX’s fifth-largest donor. 
ODA contributions to health are expected to continue to increase in 2022 in response to the COVID-19 crisis and the growing importance of global health narratives. In April 2021, the Spanish cabinet approved the new ‘Foreign Action Strategy 2021-2024,’ outlining Spain's foreign priorities and goals for the next four years. The new plan prioritizes strengthening global health as one of the 'vertical axes' of Spain's development cooperation strategy. In September 2021, the Spanish government announced plans to develop a new global health strategy focusing on individuals' 'right to health' and ensuring medical access for vulnerable populations. The new plan will include an action plan for international development cooperation and an appeal for global UHC in collaboration with the World Health Organization (WHO).

MAUC defines strategic orientations, AECID implements policy 

Within MAUC, the most relevant departments covering health issues are the General Directorate for Sustainable Development Policies and its health division. The Spanish development agency (the Spanish Agency for International Development Cooperation or AECID) implements health-related programs through its Directorate for Multilateral and Sectoral Cooperation and its regional departments (including the Directorates for Africa and Latin America), which manage bilateral programs on the ground. The Spanish Ministry of Health provides advice to MAUC and AECID on key issues and participates in global health forums such as the World Health Assembly.