Health in Development Cooperation and Humanitarian Action

2021 report

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2021 is particularly relevant as it marks the 20th anniversary of the Health in Development Cooperation and Humanitarian Action Report. Unfortunately, this year has continued to be marked by the COVID-19 pandemic, which is the number one global health concern and has exacerbated the situation for all other diseases.

Moreover, the figures contained therein are not encouraging. The document shows that Spanish Official Development Assistance (ODA) represents 0.23% of Gross National Income, far from the average of the Development Assistance Committee (DAC, 0.32%), the European Union (0.50%) and the commitment of 0.7%.

With regard to health, Spain allocates 7.64% of its ODA (202,139,530 euros) to this sector, while the average for DAC countries is 12.09%.

For its part, Spanish Development Cooperation's humanitarian aid as a whole has experienced a notable increase of almost 34 million euros, reaching 3% of its total ODA. However, this is still far from Spanish Development Cooperation's own target of at least 10% by 2022.

COVID-19

The crisis stemming from the COVID-19 has exacerbated other health problems.

Estimations point to child mortality potentially increasing by 42% in the first six months of 2020,

and the same could occur with other diseases that chiefly affect the most vulnerable populations.

 

Recommendations

We won't know the real impact of interruptions to health care due to the COVID-19 pandemic for some time. In the meantime, countries must apply a health focus to all policies, continue their efforts to control the pandemic and strengthen public health systems.

Vaccine nationalism

The unequal distribution of vaccines against COVID-19 and vaccine hoarding by the richest countries exposes the failure of the international community in its reaction to the pandemic and reflects how far we remain from adequate world health governance.

Vaccine hoarding could lead to 241 million doses having to be thrown away if they are not used by the end of 2021.

In the meantime, the COVAX initiative, the tool created to be able to distribute 2 billion doses in 92 low-income countries by the end of 2021, had only circulated 330 million vaccines by October.

 

recommendations

There is an urgent need to deliver vaccines to impoverished countries to limit the risks of the Delta variant of coronavirus and others that may surface such as the Omicron variant, as well as maintaining public health measures.

Sustainable Development Goal 3

The advances that have materialised in the past 20 years in certain health indicators do not avoid increased inequality, as shown by the fact that the majority of the 5.2 million deaths of children under five could have been avoided, as could 80% of the maternal deaths or premature deaths through non-communicable diseases.

 

recommendations

We must back a strengthening of health systems, particularly in medium- and low-income countries, if we want to drive forward SDG 3, in addition to working on social and commercial determinants of health on a global scale.

Restrictions to civic space and humanitarian access

Administration barriers, restrictive laws and other obstacles seriously limit the humanitarian space, negatively affecting humanitarian organisations' capacities to fulfil their mandate.

This is in addition to a growing trend by States to control international humanitarian work inside their frontiers, infringing international legal frameworks, particularly International Humanitarian Law (IHL).

 

recommendations

Bearing in mind the specific nature of humanitarian action, States must assimilate and respect humanitarian exemptions in their national legislation and respect IHL.

Climate Change

Health is clearly affected by climate change and the situation could get worse in the coming years. The heatwave-associated mortality for the over-65s has increased 80% since the year 2000.

Moreover, changes in the distribution of vectors which transmit diseases such as malaria, dengue and the Zika virus will make these diseases increase and 216 million people could suffer forced displacement in their countries for climate reasons by 2050.

efectos cambio climatico

 

recommendations

The climate crisis is a health crisis and climate change is a shared threat, with all countries sharing the responsibility to act now and invest in saving lives by strengthening public health.

International cooperation


Only six of the 29 Development Assistance Committee member countries fulfilled the goal of allocating 0.7% of their Gross National Income (GNI) to Official Development Assistance.

They are Denmark, Luxemburg, Norway, the UK, Germany and Sweden.

The total Aid from member countries as a whole represents 0.32% of their GNI, a long way from that 0.7%

The ODA total of DAC members was 161.2 billion dollars, denoting an increase of 3.5% with respect to 2019

Spain scores the position 19, out of 29, in absolute figures.

The 21.3 billion donors allocated in 2019 by DAC countries represented 12.09% of the ODA total, 5.4% less than in 2018

recommendations

The set of DAC donors must fulfil the inescapable commitment of allocating 0.7% of their national income to ODA and the health sector must be kept a priority via adequate budgets that place it at around 15% of the ODA total.

Official Spanish Development Aid

In 2020, Spanish ODA reached 2.64 billion euros, representing a slight decrease of 15 million euros.

Despite increasing in importance, reaching 0.23% of the GNI, this amount is still some way away from the 0.32% average of the set of DAC donors and the commitment to 0.7%.


Trend in Spanish Gross ODA and as percentage of GNI, 2006-2020

recommendations

Spanish ODA has spent over a decade in a prolonged crisis and was among those donor countries with the lowest percentage of GNI allocated to ODA. The steps taken to establish a working framework and priorities for the years ahead must be accompanied by certain credible and adequate budget estimates to face the global challenges of the future.

Health in Spanish Cooperation

In 2020, Spanish Cooperation allocated 201.9 million euros to health, representing 7.5% of their total ODA.

a percentage that triples the allocated assistance in 2019 and the greatest percentage designated to health by Spanish Cooperation since 2010.

Nevertheless, it remains below the average of the set of DAC donor countries.


Trend in Spanish Gross health ODA, 2006-2020

recommendations

Spanish Cooperation must increase its investment in health to reach percentages that are similar to the set of DAC donors, committing to strengthening public health systems and to ensuring quality and equal universal health coverage.

Humanitarian Action in Spanish Cooperation

Although Spanish Cooperation’s Humanitarian Action underwent a notable rise in 2020 of close to 34 million euros, moving from the 62 million in 2019 to 96 million and representing 3% of the total of its ODA,

this percentage once again stands some distance from the 11% average of the DAC and that established by the Humanitarian Action Strategy of Spanish Cooperation.


Trend in Spanish Gross ODA devoted to HA, 2005-2020

 

recommendations

Spanish Cooperation must substantially increase funds allocated to Humanitarian Action to effectively move closer to its commitment to allocate at least 10% of its ODA to Humanitarian Aid in 2022, as stipulated in its Humanitarian Action Strategy.