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Understanding Growth and Poverty
Bilateral aid for health initiatives has fared better than aid as a whole.23 Bilateral commitments to official development assistance (ODA) for health increased from an average of $2.6 billion in 1997–99 to $2.9 billion in 2002. The largest increase in commitments came from the United States, which pledged $1.5 billion in 2003—up from $920 million three years previous (1997–99). In 2003, the United States committed a further $300 million to other multilateral agencies and the GFATM. The United Nations (UN) agencies increased funding from $1.6 billion to $2 billion over the study period—thanks largely to the extrabudgetary contributions of the WHO. Contributions from the World Bank, after increasing over the 1990s, now stand at $1 billion. The BMGF is the major nonprofit donor agency focusing on global health. The BMGF has focused its funding in two main areas: (a) improving the poor’s access to existing vaccines, drugs, and other tools to fight diseases common in developing countries; and (b) funding research projects to develop health solutions that are effective, affordable, and practical. Commitments from the BMGF amounted to $0.6 billion in 2002. Of the $6.5 billion provided by the above donors, the largest share went to support country and regional activities ($5.2 billion), with the remainder going to interregional and global activities (Michaud 2003). More than one-third of the funds went to Africa, and $1.25 billion was allocated to HIV/AIDS, malaria, and TB. The United States was the largest donor for HIV/AIDS, committing $790 million—more than double that of the next-largest donor in 2002. The GFATM allocated over half (56 percent) of total commitments to HIV/AIDS, with 27 percent going to malaria and 15 percent to TB (Michaud 2003). The largest increase in DAH was allocated toward fighting AIDS in Sub-Saharan Africa (table 12.6). Michaud (2003) reaches the following conclusions in his study on DAH: • DAH maintained a steady level during the 1990s even when total ODA was falling. • DAH allocation has responded to geographical needs, at least for HIV/AIDS, malaria, and TB. • The establishment of the GFATM (as suggested initially by the CMH) has generated increased commitment from the developed world to fight major health problems in developing countries. • Funds increased by $1.7 billion from 1997 to 2002 but continue to fall short of needs.