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Aid for Health: Europe’s Biggest Economies Continue to Evade Commitments on Global Health

A new Action for Global Health report reveals that Europe’s biggest economies are shirking their aid commitments by failing to pay billions of Euros that should have been allocated to global health. The report finds that Europe’s wealthiest nations are still giving proportionally less than poorer European nations; on both general Official Development Assistance (ODA) and health ODA and the increasing use of loans by the EU as a means of delivering aid could plunge the poorest nations further into debt.

The report reveals that France, Germany, Italy and Spain alone account for a €5.2 billion ($7 billion) gap between health ODA and the target ODA of 0.1% Gross National Income (GNI) recommended by the World Health Organisation (WHO).

This huge funding gap is the equivalent to the resources required for treatment, care and support for 13 million people living with HIV, according to the UNAIDS investment, leaving many of the world’s most disadvantaged without access to even the most basic of health services.

AfGH, made up of 14 NGOs across Europe, launched the new report entitled “Who pays for Health” at the African Caribbean Pacific-EU joint Assembly in Addis Ababa (Ethiopia) on the 27th November.

The research by the Medical Mission Institute (MMI) compared actual health ODA from governments to their official ODA commitments to gain a more accurate picture of EU donor performance (France, Germany, Italy, The Netherlands, Spain and the UK). Many of these official figures include transfers that AfGH does not consider development such as debt relief, imputed costs for students from developing countries, costs for refugees in donor countries and administrative costs. 

The report details how most European donors are decreasing their contribution towards global health both in volume and in percentage on GNI. Even countries considered to be health champions (Sweden, Norway, Netherlands and Denmark) appear to be decreasing their contributions. The result is that most countries have failed to meet even half of the minimum requirement of 0.1% of GNI.

More shocking still is that countries with the biggest economic capacity, like Germany, France, Italy and Spain, are giving proportionally less aid than poorer European nations. Germany’s contribution to health ODA in 2011 is way below the recommended target at only 0.030% of GNI.

The UK stands apart as the only donor to achieve the recommended 0.1% of GNI contribution to global health in 2011. The Netherlands (although it still ranks second among the focus donor countries) and Spain has significantly cut Health ODA.  Italy remains one of the lowest contributors of health ODA overall.

Many donors, such as Germany, are now including loans as part of their official ODA.  Loans are a weaker and more controversial form of aid for social development, as developing countries ultimately need to repay these with interest. France is the worst performer with loans forming over a third of its ODA between 2011 and 2012.

Tim Roosen, Co-ordinator of the AfGH network, said: “In the last two decades, global health has advanced as never before but unacceptable differences remain between developed and developing countries. One billion people do not have access to essential medicines nor do they receive the healthcare that they need. Our research looks at how much money is actually going into global health investments and health development. The UK has shown us that it is possible to attain the 0.1 % GNI and it will become the first of the G8 countries to meet this long-standing commitment.

“EU policy makers are accountable for the commitments they have made to global health and this report articulates how well they have performed in delivering on those commitments. Donors need to address the financial cultural, political and trade barriers that prevent millions of people from accessing quality health services. 

“I think it’s important to note that in most developing countries, the health system is financed by national governments, donor funding and the patients themselves. Although states should be the main contributors, the reality is very different. Governments of such poor countries could possibly adopt effective taxation and budget allocation measures that would increase public revenue. But even so, without foreign aid, access to healthcare will continue to depend on the patient’s wealth and their geographic proximity to health facilities.”

For more information or to request quotes please contact: Dearbhla Crosse, Project and Communications Assistant with Action for Global Health, on +32 (0) 2 504 60 48 or email Dearbhla.Crosse [@]

Action for global Health (AfGH) is a broad European network of NGOs advocating for Europe to play a more proactive role in enabling developing countries to meet the Right to health for all and the Health Millennium Development Goals.


(AfGH) Action for Global Health uploaded a new Document 13 December 2013

A new Action for Global Health report reveals that Europe’s biggest economies are shirking their aid commitments by failing to pay billions of Euros that should have been allocated to global health.

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