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$2.2 billion in 2015 to US$2.9 billion) in 2019. ODA for health represented 15% of the UK’s total ODA in 2019. This puts the UK above the DAC average of 8% and makes it the third-largest donor to health in relative terms.

The UK provided US$1.2 billion (41% of ODA to health) as bilateral funding and USS$670 million (23%)  as earmarked funding through multilaterals (reported to the OECD as bilateral funding). Combined bilateral funding of (US$1.9 billion constituted 64% of health-related ODA (DAC average: 50%). The UK’s bilateral health efforts focused on medical research (25%), family planning (17%), infectious disease control (12%), health policy and administrative management (10%), and reproductive healthcare (10%). UK funding to health has increased by 8% on average between 2014-2016 and 2017-2019, driven by increases in funding for family planning, HIV/AIDS, R&D, and nutrition.

The UK is a strong supporter of multilateral health initiatives. In 2019, the UK contributed (USS$1.0 billion or 36% of its ODA to health through core contributions to multilaterals, albeit below the DAC average of 50%. 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, receiving US$472 million and US$237 million respectively. Based on recent pledges, the UK continues to be the third-largest public donor to the Global Fund (pledging US$1.7 billion for the 2020 to 2023 funding period) and the largest donor to Gavi (pledging a total of US$2.1 billion for the replenishment period 2021 and 2025 (including US$1.7 billion in new pledges and US$0.3 billion in pre-existing pledges).

The UK is playing an active role in the multilateral and global response to COVID-19. The 2021 Integrated Review of UK Security, Defence, Foreign Policy and Development positions global health as a priority issue and affirms the UK Prime Minister’s five-point global pandemic preparedness plan set out at the 75th United Nations (UN) General Assembly in September 2020. The government is promoting this plan through its G7 Presidency in 2021. The Integrated Reviews states that the government will increase core funding to the World Health Organisation (WHO) by 30% to £340 million ($434 million) over four years from 2021 to 2025, and seek to reform the institution. Health systems support in low-income and new health technology access will be prioritized.

The UK has also made contributions to all product pillars of the Access to COVID-19 Tools (ACT) Accelerator, including US$332 million to the Coalition for Epidemic Preparedness Innovations (CEPI) and US$735 million to Gavi COVAX Advance Market Commitment (AMC) as of April 2021.

However, the UK will cut other areas of global health, such as sexual reproductive health. Advocates claim that the UK’s funding to the United Nations Programme on HIV and AIDS (UNAIDS) has been cut by 83% from £15 million ($21 million) to £2.5 million (US$3.2 million). The UK will also cut funding to the United Nations Population Fund (UNFPA) Supplies program, the flagship program for family planning, by 85% from £154 million (US$ million) to around £23 million (US$29 million) in 2021. 

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 organizational structure of the FCDO is still unclear and there is no formal organigram 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.

The Global Funds Department within former DFID used to manage the UK’s contribution to multilateral health, but this Department no longer exists and management for global funds in health are split now across thematic teams within FCDO.