The commitment made by economically advanced Northern countries to spend 0.7% of their gross national income on aid may no longer be a major factor in the progress of developing countries, according to this blog. Instead, the biggest sources of financing for development now available to Southern governments are domestic revenue and remittance flows from migrants to their home countries. So if the 0.7% target is irrelevant, how can development efforts be measured in a ‘post-0.7 world’? The writer argues that future assessments of overseas development assistance will need a much stronger focus on actions in policy areas beyond aid. For instance, a reporting system could be put in place to check how far external funders promoted development other than by giving development assistance. This requires monitoring national policies and international policy positions on issues such as visa facilitation, banking secrecy, arms export, agricultural subsidies, fisheries and renewable energy. Information on these and other areas could be compiled and quantified to compare countries' performance over time or with peers. This would provide good indications of how development friendly a external funder’s policies and international positions actually are. For this purpose, the writer recommends the 2003 Commitment to Development Index.
Resource allocation and health financing
To compound the apparent inadequacy of the G8, the meeting in Italy got off to an inauspicious start. The Italian hosts were not only under fire for not preparing a constructive agenda, preferring the US to take the lead, but were threatened with expulsion from the G8 for unabashedly reneging on aid pledges to double aid to Africa made at the Gleneagles summit in 2005. According to ActionAid, Italy is US$1.037bn behind in aid arrears, France is further in arrears with US$1.249bn, Germany US$497m, the United States US$263m, Canada US$186m and Japan US$138m. Only Britain is on course to hit its target. This lack of spending is having a devastating effect on Africa’s ability to reach its Millennium Development Goals’ (MDGs) targets. As the new UN MDGs 2009 report states ‘for many developing countries, lower levels of aid would not only impede further progress, but could reverse some of the gains already made.’ Indeed, the proportion of undernourished per population is rising again in sub-Saharan Africa after concrete advances had been made.
Thousands of ex-gold mineworkers in South Africa are suffering from silicosis and lack the medical screening, compensation, healthcare and support they need and deserve. Action for Southern Africa (ACTSA) led a campaign calling on gold companies to provide decent health and compensation in a campaign for justice for Southern African gold mineworkers with silicosis and tuberculosis. The campaign included: protesting outside the High Court; attending and speaking at many Anglo American AGMs; organising petitions; and producing campaign briefings. On 26 July 2019, the South Gauteng High Court approved a class action settlement worth at least R5 billion (approximately £268 million). The settlement establishes the Tshiamiso Trust, which will be responsible for paying compensation to eligible gold mineworkers and their dependents in Southern Africa.
The authors contend that the priorities of Northern donors dictate the aid agenda, implemented by the non-state and Southern ‘partners’ they fund. These priorities often clash with the needs and concerns of communities, governments and civil society in many countries around the world. The aid space is dominated by powerful interests, while the voices of those most affected by health inequity are regularly tokenised or excluded from the conversation. The authors argue that many actors within the sector – even among communities and civil society – do not question the underlying premise and structures of health aid. Their own ideas and world views have been shaped by, and for, aid and the industry that supports it. Questioning aid poses challenges to the professions, livelihoods and sources of power for those who work within the sector. Furthermore, whilst health aid is important in some situations, on its own aid can never lead to a world where all people can live healthy lives. Signatories of the declaration believe that collective social action in solidarity as one global community, working together to address the root causes of the struggle for health, can transform aid into an equitable means of ensuring health rights. Through the Kampala Initiative, the signatories commit to expose, explore, challenge and transform health aid through dialogue, advocacy, activism and action. They commit to build cooperation and solidarity for health, within and beyond the practice of aid, to build a future where health justice and equity are realised, and aid is no longer a necessity.
Kenya’s Central Organisation of Trade Unions (Cotu) has launched an appeal after it lost a High Court case seeking to block public health insurer, the national Health Insurance Fund (NHIF), from raising member contributions. NHIF plans to raise monthly contributions for high-income earners by more than 600% to help the government offer universal access to health services, as stipulated in the Constitution. It plans to raise monthly contributions for those earning a gross salary of Sh100,000 and above from Sh320 to Sh2,000, which represents 2% or less of total income. Lowest-paid formal sector workers earning a salary of less than Sh5,999 will contribute Sh150. Cotu’s main argument against the new charges is that the NHIF has in the past not managed the funds to the best interest of members and should not be entrusted with more money until it demonstrates that it has the capacity to improve the quality of services offered.
Price is one of the major barriers to reliable access to medicines while availability of medicines is also a major determinant of access. The Ministry of Health of Kenya and conducts surveys on a quarterly basis to monitor medicine prices in the countries. In these surveys information is collected on availability, affordability and price variation on a basket of medicines in the public private and mission sectors.
Civil society organisations have asked the Kenyan government to name the non-governmental organisations that have mismanaged funds meant to fight HIV/Aids, tuberculosis and malaria and, consequently, delayed the disbursement of further money from the Global Fund for HIV/Aids. ‘Civil society organisations have their own disciplinary measures against corruption through the various NGO-member consortiums,’ the CSOs said.
As part of government's initiatives to help manage the severe tuberculosis strains identified in KwaZulu-Natal, the provincial Health Department has set aside about R506 million writes Nozipho Dlamini. The extremely drug resistant tuberculosis (XDR-TB) strain resists all first level drugs (ordinary treatment given to TB patients) and two of the five major classes of the second-level drugs used to treat patients with multi-drug resistant TB (MDR TB). "For the MDR and XDR TB strains specifically, we are allocating R80 million, which forms part of our TB Crises management Plan," MEC Peggy Nkonyeni said, tabling her department's budget for this financial year.
We share the distress of our colleagues at the large numbers of children in South Africa who suffer and die from surgically correctable heart disease because there are insufficient human and other resources to provide them with the operations they need. But the plight of children with heart disease only gives us a small glimpse into children's health in South Africa generally and into the crisis affecting the public health sector. Our government and health service administrators must provide more explicit policies and frameworks that guide the allocation of health resources according to agreed priorities.
Fewer than one in five people at risk of HIV infection today have access to prevention programs, and annual global spending on prevention falls $3.8 billion short of what will be needed by 2005, according to a new report released by the Global HIV Prevention Working Group. The report, Access to HIV Prevention: Closing the Gap, is the first-ever analysis of the gap between HIV prevention needs and current efforts, and provides recommendations for expanding access to information and services that could help save lives and reverse the global epidemic.