United Kingdom - Global health

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The UK is the second-largest donor country to global health

The UK is the second-largest government donor to global health in absolute terms, after the US. ODA to health has risen in recent years. It increased from US$2.4 billion in 2015 to US$3.2 billion in 2020. ODA for health represented 15% of the UK’s total ODA in 2020. This puts the UK above the DAC average of 10% and makes it the fifth-largest donor to health in relative terms.

The UK provided US$1.6 billion (50% of ODA to health) as bilateral funding and US$475 million (15%) as earmarked funding through multilaterals (reported to the OECD as bilateral funding). The UK’s bilateral health efforts focused on medical research (23%), COVID-19 control (20%), infectious disease control (11%), family planning (10%), and health policy and administrative management (9%).

The UK is a strong supporter of multilateral health initiatives. In 2020, the UK contributed 35% or US$1.1 billion of its ODA for health through core contributions to multilaterals (DAC average: 44%). The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and Gavi, the Vaccine Alliance (Gavi) were the largest recipients of UK multilateral funding for health in 2020, receiving US$610 million and US$240 million, respectively. Based on recent pledges, the UK continues to be the third-largest public donor to the Global Fund (pledging £1.5 billion, or US$1.9 billion, for the 2020-2022 replenishment) and the largest donor to Gavi (pledging a total of US$2.9 billion for the 2021-2025 replenishment, according to official US$ conversion from Gavi). The UK hosted the Gavi Vaccine Summit in London in 2020 which likely influenced the UK’s sizeable pledge. In addition, the UK is among the largest funders to the Global Financing Facility (GFF).

The UK has played an active role in the global response to COVID-19 and that is expected to continue as addressing global health challenges and responding to the ongoing COVID-19 pandemic are core components of the new international development strategy. The UK made early contributions to all product pillars of the Access to COVID-19 Tools – Accelerator (ACT-A), including US$319 million to Coalition for Epidemic Preparedness Innovations (CEPI) and US$735 million to Gavi COVAX Advance Market Commitments (AMC) as of July 2022. The UK increased its funding to the WHO to support its role in coordinating the global response to COVID-19 and strengthening health systems in partner countries, providing a core contribution of £340 million (US$436 million) over the next four years. This represented a 30% increase to existing funding. For FY2021/22, the FCDO allocated £1.3 billion (US$1.7 billion) for global health and COVID-19 focused on continued support to multilaterals (including WHO, COVAX, and Gavi) and through bilateral spending in areas with the greatest needs. The UK will host the CEPI replenishment on March 7-8, 2022, in London. Its pledge to CEPI for 2022 - 2026 is US$205 million (£160 million) - 37% less than the previous commitment for 2017 - 2021. This decline is reflective of the UK’s overall ODA budget in 2021.

Despite global health remaining a priority moving forward, there are concerns that it will have a reduced budget, particularly UK multilateral global health ODA – as the UK’s overall ODA budget is reduced, other priorities could take center stage and the UK could reduce its multilateral ODA spend. The UK government prioritized global health during its 2021 G7 Presidency with a strong focus on pandemic preparedness. It established a new Pandemic Preparedness Partnership, a public-private partnership that sets out recommendations for cutting the time needed to develop and deploy vaccines for new diseases from 300 to 100 days. During the summit, the UK also galvanized international action to donate 870 million coronavirus vaccines to those who need them and close the vaccine gap. In addition, at the 2022 G7 Summit in June 2022, the UK announced £25 million (US$32 million) toward the new ‘Financial Intermediary Fund’ (FIF) for pandemic prevention, preparedness, and response, which is hosted by the World Bank. The fund will support countries whose healthcare systems are unprepared for the challenges caused by large outbreaks of infectious diseases and ensure that they can respond to and help contain major outbreaks.

In December 2021, the FCDO published two new policy papers on global health, setting out its agenda on health system strengthening and on ending preventable deaths which will remain core priorities for UK development assistance moving forward. The papers do not, however, set out any financial commitments or specific results targets, except contributing to meeting key UN Sustainable Development Goals (SDGs).

The FCDO is responsible for global health policy development

The Foreign, Commonwealth and Development Office (FCDO) has created a new global health directorate that pulls together all the teams working on global health within the organization. The directorate reports to the Director of Global Health Darren Welch, who is also responsible for the global health thematic in the FCDO. Global health comes under the responsibility of the Director General, Humanitarian and Development, Nick Dyer. The organizational structure of the FCDO is still unclear and there is no formal organizational chart published to explain how this directorate works with the Department of Health and Social Care (DHSC). From 2016, a global health oversight group with representatives from Department for International Development (DFID) and DHSC oversaw global health policy and programming of spending on areas of mutual interest between government departments, including the cross-government response to global health threats. It is unclear whether this group will be maintained in the future.