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What?

Because the European Union (EU) institutions are an important donor of ODA, we’ve decided to analyse its aid to health as an independent funding body from the Member States. To avoid any double reporting of the Member States contributions to the development funds managed by the EU, we won’t be comparing the volumes but rather the modalities.

The European Union institutions have granted €827 million and €961 million of DAH (Development Assistance for Health) in 2015 and 2016 respectively. As indicated in our methodology, we are not including general budget support in our calculations as the share of health is difficult to determine accurately. It is important to mention however that given the amount invested by the EU institutions as assistance through general budget support, the inclusion of budget support would impact final conclusions.

How?

The EU institutions are singular in the development aid scene since they are both a recipient and a donor.

The EU never reported any equity investment nor loans as ODA for health, meaning that 100% of its financing is composed of grants.

Because the European Union does not have a GNI per say, but rather uses a compilation of its Member States’ GNIs, we have chosen to look at the share of health in EU ODA rather than how much of its GNI EU allocates to DAH.

This graph shows a slight decrease in the share of ODA allocated to health between 2015 (8.7%) and 2016 (8,2%), which is interesting to note knowing the fact that in terms of volume, DAH actually increased between 2015 and 2016.

This means that the increase in volume of DAH was not as ambitious as the increase of ODA and actually represents a decrease in terms of how much ODA is targeted towards health. 

In 2016, the EU contributed to multilateral organizations for health up to 25% of total DAH, although the only contribution was towards the Global Fund to Fight AIDS, Tuberculosis and Malaria. 

 The EU used to report Gavi as a bilateral project in the CRS, which we consider as inaccurate. Moreover the 2015 contribution to Gavi was reported under a wrong channel and code, which makes the tracking of those outflows difficult.

 

 

 

In 2014, only 46.6% of its DAH was untied and 77.6 in 2015.

To Whom?

Since the CRS database does not allow providing multiple recipients for one activity, all the multi-countries or multi-regions projects are reported as “unspecified”.

Therefore we could not allocate 8% of the amount in 2016 to a specific country or income group.

In terms of income groups, the EU institutions are targeting the poorest countries. It provided 85% of its bilateral DAH to low-income and lower-middle-income countries on average for 2014-2016 (respectively 49% and 36% in 2016).

As a consequence, upper-middle-income countries received 7% of DAH on average for 2014-2016.

The implementers of the EU bilateral DAH are mainly civil society, the UN organisations and the public sector.

It should be underlined that the EU institutions are financing public-private partnerships up to €9 million in 2016, even if it represented a small share of the total DAH (less than 1%). Those PPPs are nearly all being implemented in Sub-Saharan Africa.

What for?

Our methodology is proposing an alternative classification to the CRS purpose codes. We’ve tried to classify the health projects according to the SDGs as an attempt to suggest different codes than those proposed by the Working Party on Development Finance Statistics and to produce more detailed information. As mentioned in the methodology, this report is made for food for thought and to trigger the discussions on improving the accuracy of ODA for health.

The EU institutions are mainly financing support to health systems. Since the Global Fund is the main multilateral organisation financed by the EU institutions, the fight against epidemics is logically the sector that is the most financed with multilateral outflows.

Although the EU is also providing substantial bilateral funding to the fight against the three pandemics which complements global health initiatives, the majority was specifically allocated to the fight against other communicable diseases and to the fight against HIV/AIDS in 2016.

The EU institutions are also considerably financing nutrition, which was the second main recipient sub-category in 2014, 2015 and 2016 on average.  

It’s worth noting that specific issues such as non-communicable diseases, neglected tropical diseases or family planning are basically under-funded, each receiving less than to €2 million per year.

Transparency

In this project, we have tried to assess to what extent each donor is contributing to Universal Health Coverage (UHC) taking into account the difficulty to formulate an extensive procedure to determine what is UHC and what is not.
So far, we could only claim that 16% of the projects of the EU institutions on average for 2014-2016 are contributing to UHC as a principle objective, mainly due to a lack of detailed information provided through the CRS.