Skip to main content Accessibility help
×
×
Home

Development assistance for health: what criteria do multi- and bilateral funders use?

  • Trygve Ottersen (a1) (a2) (a3), Aparna Kamath (a4), Suerie Moon (a4), Lene Martinsen (a2) and John-Arne Røttingen (a4) (a5) (a6)...
Abstract

After years of unprecedented growth in development assistance for health (DAH), the system is challenged on several fronts: by the economic downturn and stagnation of DAH, by the epidemiological transition and increase in non-communicable diseases, and by the economic transition and rise of the middle-income countries. This raises questions about which countries should receive DAH and how much, and, fundamentally, what criteria that promote fair and effective allocation. Yet, no broad comparative assessment exists of the criteria used today. We reviewed the allocation criteria stated by five multilateral and nine bilateral funders of DAH. We found that several funders had only limited information about concrete criteria publicly available. Moreover, many funders not devoted to health lacked specific criteria for DAH or criteria directly related to health, and no funder had criteria directly related to inequality. National income per capita was emphasised by many funders, but the associated eligibility thresholds varied considerably. These findings and the broad overview of criteria can assist funders in critically examining and revising the criteria they use, and inform the wider debate about what the optimal criteria are.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Development assistance for health: what criteria do multi- and bilateral funders use?
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Development assistance for health: what criteria do multi- and bilateral funders use?
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Development assistance for health: what criteria do multi- and bilateral funders use?
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
*Correspondence to: Trygve Ottersen, Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway. Email: trygve.ottersen@medisin.uio.no
References
Hide All
Anderson, E. (2008), ‘Practices and implications of aid allocation’, Background Study for the 2008 Development Cooperation Forum, UN Economic and Social Council (ECOSOC).
Basu, S., Stuckler, D. and McKee, M. (2014), ‘An alternative mechanism for international health aid: evaluating a global social protection fund’, Health Policy and Planning, 29: 127136.
Berthelemy, J.-C. (2006), ‘‘Bilateral donors’ interest vs. recipients’ development motives in aid allocation: do all donors behave the same?’’, Review of Development Economics, 10(2): 179194.
BMZ (2013), ‘The German Government’s 14th Development Policy Report’, Federal Ministry for Economic Cooperation and Development Germany, http://www.bmz.de/en/publications/archiv/type_of_publication/information_flyer/information_brochures/Materialie223_Weissbuch_large.pdf [24 June 2016].
BMZ (2014), ‘German Development Cooperation Work’, Federal Ministry for Economic Cooperation and Development Germany, http://www.bmz.de/en/publications/topics/development_policy/Materialie239_ez.pdf [24 June 2016].
Brock, D. W. (2002), ‘Priority to the Worse Off in Health-Care Resource Prioritization’, in R. Rhodes, M. P. Battin and A. Silvers (eds), Medicine and Social Justice: Essays on the Distribution of Health Care, New York: Oxford University Press, 362372.
Burgett, A., Orzell, S. and Salvado, R. (2016), ‘Running from behind: global aid allocation and the new geography of poverty’, DPAF Working Paper Series, Bill & Melinda Gates Foundation.
Cagé, J. (2015), ‘Improving upon the World Bank’s country policy and institutional assessment: a new performance indicator based on aid effectiveness’, Journal of Globalization and Development, 5(2): 213233.
Ceriani, L. and Verme, P. (2013), The Income Lever and the Allocation of Aid Research Working Paper No. WPS 6367. Washington, DC: World Bank Group: Society for the Study of Economic Inequality.
CEWG (2012), Research and Development to Meet Health Needs in Developing Countries: Strengthening Global Financing and Coordination’. Consultative Expert Working Group on Research and Development: Financing and Coordination, Geneva: World Health Organization.
Cogneau, D. and Naudet, J.-D. (2007), ‘Who deserves aid? Equality of opportunity, international aid, and poverty reduction’, World Development, 35(1): 104120.
Daniels, N. and Sabin, J. E. (2008), Setting Limits Fairly: Learning to Share Resources for Health, 2nd edn, New York: Oxford University Press.
Department of State (2014), ‘Congressional budget justification. Department of state, foreign operations, and related programs. Fiscal year 2015’, http://www.usaid.gov/sites/default/files/documents/9276/222898.pdf [8 March 2015].
DFAT (2014), ‘Making performance count: enhancing the accountability and effectiveness of Australian aid’, Department of Foreign Affairs and Trade, http://www.dfat.gov.au/about-us/publications/Documents/framework-making-performance-count.pdf [8 March 2015].
DFAT (2015), ‘Health for Development Strategy 2015–2020’, Department of Foreign Affairs and Trade, http://dfat.gov.au/about-us/publications/Documents/health-for-development-strategy-2015-2020.PDF [16 June 2016].
DFAT (2016), ‘Australia’s aid program’, Department of Foreign Affairs and Trade, http://dfat.gov.au/aid/Pages/australias-aid-program.aspx [16 June 2016].
DFID (2011), Bilateral Aid Review: Technical Report, London: Department for International Development.
DFID (2015), ‘UK aid: tackling global challenges in the national interest’, UK Government, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/478834/ODA_strategy_final_web_0905.pdf [23 June 2016].
EAI (2015), ‘Updated – terms of reference for the Equitable Access Initiative’, The Global Fund, http://www.theglobalfund.org/documents/eai/EAI_EquitableAccessInitiative_ToRs_en/ [28 June 2015].
EAI (2016), ‘The Equitable Access Initiative’, Final report, http://www.theglobalfund.org/documents/eai/EAI_EquitableAccessInitiative_Report_en/ [14 January 2017].
Fan, V. Y., Glassman, A. and Silverman, R. L. (2014), ‘How a new funding model will shift allocations from the Global Fund to Fight AIDS, tuberculosis, and malaria’, Health Affairs, 33(12): 22382246.
Frenk, J., Gómez-Dantés, O. and Chacón, F. (2011), ‘Global health in transition’, in R. Parker and M. Sommer (eds), Routledge Handbook in Global Public Health, New York: Routledge, 1117.
Frenk, J. and Moon, S. (2013), ‘Governance challenges in global health’, New England Journal of Medicine, 368: 936942.
GAC (2016), ‘Where we work in International Development’, Global Affairs Canada, http://www.international.gc.ca/development-developpement/countries-pays/index.aspx?lang=eng [16 June 2016].
Gavi (2013), ‘Review of GAVI’s pilot prioritisation mechanism. Report to the GAVI Alliance Board, 11–12 June 2013’, Gavi, The Vaccine Alliance, http://www.gavi.org/Library/GAVI-documents/Policies/GAVI-Alliance-Prioritisation-Mechanism/ [18 February 2015].
Gavi (2015a), ‘Independent Review Committee review criteria for applications for all types of GAVI support 2016’, Gavi, The Vaccine Alliance, http://www.gavi.org/library/documents/gavi-documents/guidelines-and-forms/irc-review-criteria-for-2016/
Gavi (2015b), ‘General guidelines for expressions of interest and applications for all types of GAVI support in 2016’, Gavi, The Vaccine Alliance, http://www.gavi.org/library/gavi-documents/guidelines-and-forms/ [31 May 2016].
Gavi (2015c), ‘Country eligbility policy’, http://www.gavi.org/about/governance/programme-policies/country-eligibility/ [16 June 2015].
Gavi (2016a), ‘Countries eligible for support’, http://www.gavi.org/support/apply/countries-eligible-for-support/ [16 June 2016].
Gavi (2016b), ‘Prioritisation mechanism’, http://www.gavi.org/about/governance/programme-policies/prioritisation/ [31 May 2016].
GF (2013), ‘Terms of reference of the Technical Review Panel’, The Global Fund to Fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/trp/TRP_TechnicalReviewPanel_ToR_en/ [18 February 2015].
GF (2016b), ‘The Global Fund Eligibility Policy (GF/B35/06)’, The Global Fund to Fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/board/35/BM35_06-Eligibility_Policy_en/ [16 June 2016].
GF (2016c), ‘The Challenging Operating Environments Policy (GF/B35/03)’, The Global Fund to fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/board/35/BM35_03-ChallengingOperatingEnvironments_Policy_en/ [16 June 2016].
GF (2016d), ‘The Global Fund Sustainability, Transition and Co-financing Policy (GF/B35/04)’, The Global Fund to Fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/board/35/BM35_04-SustainabilityTransitionAndCoFinancing_Policy_en/. [16 June 2016].
GF (2016e), ‘What the Technical Review Panel Looks for in a Concept Note’, The Global Fund to Fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/trp/TRP_WhatTheTRPLooksForInAConceptNote_Paper_en/. [16 June 2016].
GF (2016f), ‘Allocation Methodology 2017–2019 (GF/B35/05)’, The Global Fund to Fight AIDS, Tuberculosis and Malaria, http://www.theglobalfund.org/documents/board/35/BM35_05-AllocationMethodology2017-2019_Report_en/ [16 June 2016].
Gibson, C. C., Andersson, K., Ostrom, E. and Shivakumar, S. (2005), The Samaritan’s Dilemma: The Political Economy of Development Aid, Oxford: Oxford University Press.
Gostin, L. O. (2014), Global Health Law, Cambridge, MA: Harvard University Press.
Guillaumont, P. (2008), ‘Adapting aid allocation criteria to development goals’, Essay for the 2008 Development Cooperation Forum.
IDA (2013), ‘Annex 2. IDA’s performance-based allocation system for IDA17’, International Development Association, http://www.worldbank.org/ida/papers/Annex_2_IDA17.pdf [28 Feburary 2015].
IHME (2014), Financing Global Health 2013: Transition in an Age of Austerity, Seattle, WA: IHME.
IHME (2016), Financing Global Health 2015: Development Assistance Steady on the Path to New Global Goals, Seattle, WA: IHME.
Institute of Medicine (2013), Evaluation of PEPFAR, Washington, DC: The National Academies Press.
Knack, S., Rogers, F. H. and Heckelman, J. C. (2012), ‘Crossing the threshold: a positive analysis of IBRD graduation policy’, Review of International Organizations, 7: 145176.
Koeberle, S., Bedoya, H., Silarszky, P. and Verheyen, G. (eds) (2005), Conditionality Revisited: Concepts, Experiences, and Lessons, Washington, DC: World Bank.
Leo, B. (2010), Inside the World Bank’s Black Box Allocation System: How Well Does IDA Allocate Resources to the Neediest and Most Vulnerable Countries?, Washington, DC: Center for Global Development.
Llavador, H. G. and Roemer, J. E. (2001), ‘An equal-opportunity approach to the allocation of international aid’, Journal of Development Economics, 64: 147171.
LuxDev (2013), ‘Vietnam’, Luxembourg Agency for Development Cooperation, http://dak.luxdev.lu/files/documents/VIE_light.pdf [7 March 2015].
LuxDev (2015a), ‘Annual Report 2014’, Luxembourg Agency for Development Cooperation, https://luxdev.lu/files/documents/RAPANN2014_web_UK.pdf [23 June 2016].
LuxDev (2015b), ‘Our activities’, Luxembourg Agency for Development Cooperation, http://luxdev.lu/en/activities#countries [23 June 2016].
MCC (2015a), ‘Candidate country report’, Millenium Challenge Corporation, https://www.mcc.gov/resources/doc/report-candidate-country-fy-2016 [23 June 2016].
MCC (2015b), ‘Selection criteria and methodology report’, https://www.mcc.gov/resources/doc/report-selection-criteria-and-methodology-fy16 [23 June 2016].
MCC (2015c), ‘About MCC’, Millennium Challenge Corporation, https://www.mcc.gov/pages/about [3 March 2015].
MCC (2016), ‘Who We Fund – the Country Selection Process’, Millenium Challenge Corporation, https://www.mcc.gov/who-we-fund [23 June 2016].
McGee, R. (2011), ‘Aid transparency and accountability: ‘build it and they’ll come’?’, Development Policy Review, 31(S1): s107s124.
McGillivray, M. (2011), ‘Aid allocation and fragile states’, in W. Naudé, A. U. Santos-Paulino and M. McGillivray (eds), Fragile States: Causes, Costs, and Responses, New York: Oxford University Press, 166185.
Ministry of Foreign Affairs Norway (2014a), ‘Reforming development assistance to improve results’, https://www.regjeringen.no/en/aktuelt/development_reform/id2005626/ [16 June 2016].
Ministry of Foreign Affairs Norway (2014b), ‘St. Prop. 1 (2014–2015) 10 Programområde 03 Internasjonal Bistand’: R. N. M. o. Finance, http://www.statsbudsjettet.no/Statsbudsjettet-2015/Dokumenter-NY/Fagdepartementenes-proposisjoner/Utenriksdepartementet-UD/Prop-1-S/Del-1-Innledende-del-/10-Programomrade-03-Internasjonal-bistand/ [22 June 2016].
Ministry of Foreign Affairs Norway (2016), ‘Utenrikspolitisk redegjørelse 1. mars 2016’, https://www.regjeringen.no/no/aktuelt/redegjoerelse_160301/id2477557/
Moon, S. and Omole, O. (2013), Development Assistance for Health: Critiques and Proposals for Change, London: Chatham House.
Moon, S. and Williamson, T. (2010), Greater Aid Transparency: Crucial for Aid Effectiveness, Project Briefing, London: Overseas Development Institute.
Norad (2014), ‘Instruks for Direktoratet for Utviklingssamarbeid (Norad)’, Ministry of Foreign Affairs, https://www.regjeringen.no/no/dokumenter/instruks_norad/id748340/ [22 June 2016].
Norad (2016), ‘About Norad’, https://www.norad.no/en/front/about-norad/ [22 June 2016].
Ooms, G., Derderian, K. and Melody, D. (2006), ‘Do we need a world health insurance to realise the right to health?’, PLoS Medicine, 3(12): e530.
Ottersen, T., Kamath, A., Moon, S. and Røttingen, J.-A. (2014), Development Assistance for Health: Quantitative Allocation Criteria and Contribution Norms, London: Chatham House.
Ottersen, T., Grépin, K., Henderson, K., Pinkstaff, C. B., Clift, C., Norheim, O. F. and Røttingen, J.-A. (2016), ‘Health and Development: An Explicit Approach to the Design and Assessment of Country Classification Frameworks Final Report for the Equitable Access Initiative Oslo: Norwegian Institute of Public Health.
OWG (2014), ‘Open Working Group proposal for Sustainable Development Goals’, Open Working Group, https://sustainabledevelopment.un.org/content/documents/1579SDGs%20Proposal.pdf [7 March 2015].
PEPFAR (2011), ‘Fiscal year 2011: PEPFAR operational plan’, The United States President’s Emergency Plan for AIDS Relief, http://www.pepfar.gov/documents/organization/183974.pdf [14 January 2017].
PEPFAR (2015), ‘PEPFAR Country/Regional Operational Plan (COP/ROP) 2016 Guidance’, US Department of State, http://www.pepfar.gov/documents/organization/250377.pdf [16 June 2016].
Pietschmann, E. (2013), Assist Those Most in Need, or Most of Those in Need? The Challenge of Allocative Efficiency for Aid Effectiveness, Bonn: German Development Institute.
Resch, S., Ryckman, T. and Hecht, R. (2015), ‘Funding AIDS programmes in the era of shared responsibility: an analysis of domestic spending in 12 low-income and middle-income countries’, Lancet Global Health, 3: e52e61.
Salvado, R. C. and Walz, J. (2013), Aid Eligibility and Income Per Capita: A Sudden Stop for MICs? DPAF Working Paper Series Seattle: Bill & Melinda Gates Foundation: Bill & Melinda Gates Foundation.
Sumner, A. (2012), ‘Where do the poor live?’, World Development, 40(5): 865877.
Temple, J. R. W. (2010), ‘Aid and conditionality’, in D. Rodrik and M. Rosenzweig (eds), Handbook of Development Economics Volume 5 Amsterdam: North-Holland, 44154523.
UK Parliament (2016), ‘UK aid: allocation of resources: interim report’, House of Commons, International Development Committee.
UNDP (2011), ‘Executive Board informal meeting. Information note on the 2008–2013 programming arrangements’, United Nations Development Programme.
UNDP (2012a), ‘Programming arrangements, 2014–2017’, United Nations Development Programme, http://www.undp.org/content/dam/undp/library/corporate/Executive%20Board/2012/second-regular-session/English/dp2012-25.doc [16 June 2016].
UNDP (2012b), ‘Second review of the programming arrangements, 2008–2013’, United Nations Development Programme, http://www.undp.org/content/dam/undp/library/corporate/Executive%20Board/2012/first-regular-session/english/dp2012-3e.pdf [16 June 2016].
UNDP (2013b), ‘Decisions adopted by the Executive Board in 2012’, United Nations Development Programme, http://www.undp.org/content/dam/undp/library/corporate/Executive%20Board/2013/English/dp2013-2e.pdf [22 June 2016].
UNICEF (1997), ‘Report on the allocation of general resources’, United Nations Children’s Fund.
UNICEF (2012), ‘Report on implementation of the modified system for allocation of regular resources for programmes’, Item 5 of the provisional agenda, Second regular session 2012, Executive Board, United Nations Children’s Fund.
US Congress (2003), ‘United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003’, H.R. 1298. 108th Congress.
US Congress (2008), ‘Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/ AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008’, P.L. 110–293. 110th Congress.
USAID (2006), ‘Policy framework for bilateral foreign aid: implementing transformational diplomacy through development’, United States Agency for International Development, http://pdf.usaid.gov/pdf_docs/PDACG244.pdf [16 June 2016].
USAID (2011), ‘The Nine Principles of Development’, United States Agency for International Development, https://www.usaid.gov/sites/default/files/documents/1872/200mbn.pdf [14 January 2017].
USAID (2014), ‘Ending preventable maternal mortality: USAID maternal health vision for action’, United States Agency for International Development, http://www.usaid.gov/sites/default/files/documents/1864/MCHVision.pdf [16 June 2016].
USAID (2015), ‘Family planning program overview’, United States Agency for International Development, https://www.usaid.gov/sites/default/files/documents/1864/FP-program-overview-508.pdf [23 June 2016].
Vázquez, S. T. (2015), ‘Geographical Allocation of Aid: Lessons from Political Economy’, in B. M. Arvin and B. Lew (eds), Handbook of the Economics Of Foreign Aid, Cheltenham: Edward Elgar Publishing, 90108.
World Bank (2016a), ‘World Bank GNI per capita operational guidelines & analytical classifications’, http://siteresources.worldbank.org/DATASTATISTICS/Resources/OGHIST.xls [1 July 2016].
World Bank (2016b), ‘How IDA resources are allocated’, World Bank, http://ida.worldbank.org/financing/resource-management [16 June 2016].
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed