Targeting health ODA to need: Spending by country and disease - Factsheet, July 2020

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Official development assistance (ODA) is an international resource provided largely by the Development Assistance Committee (DAC) donors and multilateral bodies. It is aimed explicitly at the economic development and welfare of developing countries. It is therefore well positioned to target places where need is greatest, and it is a key resource in the context of health.

Knowing where need is greatest and what form of investment is required (from emergency support to longer-term health systems strengthening) is key to ensuring support is well targeted.

This factsheet examines how health ODA is disbursed according to various measures of need. The analysis reviews the allocation of health ODA to country groups facing the greatest developmental challenges and with the lowest domestic resources available for health finance. The analysis also shows ODA funding towards specific diseases and how this compares to respective disease burdens.

A separate factsheet from Development Initiatives provides a general overview of aid spending on health, and examines key trends in ODA to health, using the latest data to assess who the major donors are and where health ODA expenditure is disbursed at the recipient and subsector level.

Key facts: Is health ODA targeted against resource need?

ODA accounts for a fifth of health financing in LDCs

ODA makes up a fifth of available health finance in least developed countries (LDCs) (Figure 1). This group of countries experiences severe structural impediments to sustainable development and are highly vulnerable to economic and environmental shocks.

Overall, ODA to groups of countries facing significant development challenges has increased in the last five years; however a decrease in health aid between 2017 and 2018 to all of these groups is a concerning trend

Over the last five years, ODA to health has increased by approximately 10% to various groupings of countries facing prominent development challenges. These include low-income countries, LDCs, fragile states and countries at most risk of being left behind. However, ODA to all of these country groupings fell between 2017 and 2018 (Figure 2).

Health ODA is targeted to where domestic resources are lowest

If relatively low levels of per capita government health expenditure are used as a basis of assessing need for health financing, donor funding to health is aligned relatively well to contexts facing the greatest constraints (Figure 3).

Health aid levels are notably varied among countries in most need

Despite the concentration of aid funding among countries most in need, there is considerable variation in the volume and per capita allocation of health ODA between countries with relatively low levels of government health expenditure (less than PPP$100 domestic government expenditure on health per capita). Some countries appear to receive relatively low levels of health ODA, in both volume and per capita terms, despite having the sparsest health finance availability.

Aid to pneumonia appears relatively low relative to its mortality burden

There are notable imbalances in funding to specific diseases according to relative disease burdens. For example, ODA to pneumonia is relatively low compared to the estimated levels of mortality caused by lower-respiratory infections (Figure 5).