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Funding for Sexual and Reproductive Rights and Health

Funding for Sexual and Reproductive Rights and Health. Adrienne Germain Alexandra Garita Repoliticizing Sexual and Reproductive Health and Rights Langkawi , Malaysia August 5, 2010 Plenary 5. Donor Funding for Health (1). Overseas Development Assistance (ODA)

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Funding for Sexual and Reproductive Rights and Health

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  1. Funding for Sexual and Reproductive Rights and Health Adrienne Germain Alexandra Garita Repoliticizing Sexual and Reproductive Health and Rights Langkawi, Malaysia August 5, 2010 Plenary 5

  2. Donor Funding for Health (1) Overseas Development Assistance (ODA) Fragmented and not enough (WB, 2010) 1995- $2.9 billion 2007- $14.1 billion Focus: vertical programs HIV/AIDS largest share RH decline as proportion but not in absolute amount

  3. Donor Funding for Health (2) • Bilateral • Multilateral (UNFPA, UNICEF, WB) • Special funding mechanisms • Global Fund to fight AIDS, TB, Malaria • UNITAID • GAVI and other public-private partnerships

  4. Large Foundations • Gates: New 5 year pledge $1.5 billion ($900m MNH; $400m FP; $200m Nutrition)- not new money • MacArthur: Focus on maternal mortality and adolescent sexual and reproductive health • Ford: SRHR per se not priority; fractured program • Hewlett, Packard: Emphasis on FP/ Population

  5. Health System Strengthening: An emerging focus Ideally: • Harmonization of health sector investments • Country by country- based on local epidemiology and demographics • Principles: pro-poor, pro-women, based on human rights • Prioritize comprehensive SRHR

  6. Comprehensive SRHR • Contraception • Maternity care (ante and post-natal care, skilled attendance, emergency obstetric care) • Safe abortion services • STI/HIV prevention and treatment • Protection of human rights − Sexual and Reproductive Rights • Comprehensive sexuality education

  7. Health Systems Strengthening Initiatives • International Health Partnership (IHP) • 13 donors (Austria, Belgium, Canada, Finland, France, Germany, Italy, Norway, Portugal, Spain, Sweden, the Netherlands, UK) • 47 countries • Principles: country-led; one national health policy; pro-poor; RH and communicable diseases • Emphasizes health systems strengthening • Focus: harmonization of funding (Paris, Accra) • United States Global Health Initiative • $63 billion, 6 years • Harmonize AIDS investments (PEPFAR), malaria, TB, maternal and child health, FP/RH

  8. Funding Health Systems Strengthening • Create mechanism or use existing? • GAVI • WB • GFATM • World Bank: expected to triple to $4.1 billion (40% increase over FY 09) health system financing • Global Fund- experimenting with proposals based on National Strategic Plans for health system that include not only AIDS, TB, Malaria but also RH/MNH; RH window for regular proposals

  9. Estimates of funding needed for SRRH • Estimated cost of RMNH range from $15.2 billion to $23.7 billion annually (PAI 2010) Includes: • FP; MNCH; STI prevention; drugs; supplies and other materials; personnel Excludes: • Safe abortion services • HIV/AIDS resource requirements ($19 billion to $35 billion needed annually) • Task Force on Innovative Financing for Health Systems: $251b required for HSS by 2015 from all sources including governments ($10b per year on SRH)

  10. Where are we against need? • European donors: comprehensive SRRH policies (Netherlands, Norway, Denmark, Sweden, UK) but separate funding streams and staffing; HIV > RH • US Government: never adopted SRRH but GHI can come close • Few Southern Governments have SRH policies/programs or SRR strategies FALLING SHORT • SG’s Joint Plan of Action: $14 −24 billion in 49 countries • G8 Muskoka Initiative: pledge $7.3 − 8.3 billion

  11. Challenges for Advocacy (1) Who is our target audience? • Donors: who drives funding decisions? Individuals? • Governments: Ministries of Finance? (Abuja) • Content/Positions • SRRH encompasses HIV − or not? • Vertical and horizontal approaches • Human Right to health and pro-poor, pro-women, pro-marginalized groups • Country ownership?

  12. Challenges for Advocacy (2) • Need bigger pie for health but new money not likely • European government budgets contracting • US funding goes to US NGO contractors; no abortion • Governments not meeting current commitments (Gleneagles- 0.7% GNP to ODA- 5 exceeding target ) (Abuja- 15% of GNP to health- 6 meeting targets) • While promoting funding increase, do more on using existing funds better

  13. Challenges for Advocacy (3) • Building our Movement • Donors question value of funding political movements • Difficulties with measuring results of advocacy • Need for new blood, training, mobilizing • Perceived and actual competition for limited resources among our several constituencies

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