2021 report

Health in Development Cooperation and Humanitarian Action

A critical analysis of an international, state and decentralised Official Development Assistance in the sphere of health care and humanitarian action with the aim of improving their quality, effectiveness and efficiency.

Highligths 2021 report browse the report
report 2021

data we worry about

1
COVID-19
2
Vaccine nationalism
3
SDG 3 on health and wellbeing
4
Restrictions in civic space and humanitarian access
5
Climate change
6
International
Cooperation
7
Spanish Official Development Assistance
8
Health in Spanish Cooperation
9
Humanitarian Action in Spanish Cooperation
monographs:

The inadequate European and global response to the pandemic

Neither health security nor vaccines against COVID-19 have been public assets.

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covid-19
cooperation
monographs:

Reforming the Spanish Cooperation system

The Spanish cooperation system must adapt to changes occurring in the international sphere and accommodate a more ambitious agenda, connected at once to the SDGs and climate change.

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monographs:

Humanitarian actors face daily the challenges of a shrinking of humanitarian space

Humanitarian space is a concept that symbolizes the environment in which we, as a non-governmental humanitarian organization, can work. It is framed by international humanitarian law (IHL).

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Presentation of the 2021 Report: Health in Development Cooperation and Humanitarian Action
15 December, 2021

Presentation of the 2021 Report: Health in Development Cooperation and Humanitarian Action

The event, promoted by medicusmundi and Médicos del Mundo Spain, took place at the Impact Hub Piamonte in Madrid, with a round table discussion on "Health in the world: beyond COVID-19".

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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.

data we worry about

1
In 2021, the COVID-19 pandemic constituted the greatest concern to world health

and was, for the second year running, the single-cause infectious disease to lead to the most deaths, as well as worsening the situation of other diseases. This pandemic is far from being under control globally.

COVID-19

2
Nationalism over vaccines against COVID-19 has hindered their equal distribution

with vaccines denoting a change in the evolution of the pandemic solely in those countries that have had access to them.

Vaccine nationalism

3
The targets set out for SDG 3, including universal health coverage, will not be met unless there is greater commitment

Advances in recent years in some indicators are not enough to avoid the growing inequality in relation to COVID-19, once again leaving behind poor and vulnerable groups in many countries.

SDG 3 on health and wellbeing

4
Administrative barriers, restrictive laws and other obstacles increasingly limit civic space and humanitarian access

negatively affecting organisations’ capacity to fulfil their mandate and, at the same time, violating international legal frameworks.

Restrictions in civic space and humanitarian access

5
Climate change is a key factor for the health of people anywhere on the planet

Some of the most important effects of climate change on health are the increased potential of transmitting infectious diseases, and food insecurity and migratory movement due to extreme phenomena.

Climate change

6
Only 6 of the 29 member countries of DAC fulfilled their objective in 2020 to allocate 0.7% of their Gross National Income to ODA

and the 21.3 billion dollars allocated in 2019 by DAC countries represented 12.09% of the ODA total, 5.4% less than in 2018. The health percentage is the lowest in the last ten years.

International Cooperation

7
In 2020, Spanish ODA represented 0.23% of the Gross National Income

far from the DAC average (0.32%), the European Union average (0.50%) and the commitment to 0.7%.

Spanish Official Development Assistance

8
The importance of health in Spanish Cooperation has increased and stands at 7.64% of its ODA

(202,139,530 euros), although the average of DAC countries is 12.09%.

Health in Spanish Cooperation

9
Humanitarian Aid in Spanish Cooperation remains some way from the goal of the Humanitarian Action Strategy to position it at 10% of the total ODA in 2022

despite undergoing an increase of almost 34 million euros, reaching 3% of its ODA total.

Humanitarian Action in Spanish Cooperation

Trend in Spanish Gross ODA and as percentage of GNI 2006-2020
Trend in Gross Health ODA
2004-2020
Trend in Spanish Gross ODA devoted to HA, 2006-2020

AOD por países
ODA by Countries
2010 - 2020

Data from OECD

AOD descentralizada en España
Decentralized. Health ODA in Spain
2020

 

Map of Humanitarian Crisis in 2020
Map of Humanitarian Crisis
2020

 

XX anniversary

In 2001, twenty years ago now, four non-governmental organisations with broad experience in health cooperation agreed over the need for a specific report on health, from both a development and humanitarian perspective..

Therefore, medicusmundi, Médicos del Mundo, Prosalus and Médicos sin Fronteras set in motion the “Health in Development Cooperation and Humanitarian Action” report. For different reasons, Médicos sin Fronteras and Prosalus left the project during this period.

The goal that led to this initiative taking shape 20 years ago is still pertinent: to influence Official Development Assistance (ODA) policies in the health sector and the Humanitarian Action (HA) sector, improving their quality, effectiveness and efficiency, as well as meeting their general objective, which is to support a critical analysis of international, state and decentralised ODA in the sphere of health and HA.

In one way or another, I've been linked to this report from the start and over the course of these past 20 years.

Looking at it with perspective, I believe it has contributed significantly to the development of health cooperation through sheer effort and limited resources. Many of the issues the report has highlighted over the years, from its analysis of ODA to the reality of health in the world, have been key reference points in the agenda of health cooperation policies.

Congratulations for the path travelled down and best of luck for the next stages!

José María Medina Rey
Enraíza Derechos

This rigorously drafted report contributes elements to Spanish Cooperation to defend and back health as a global public asset and is indisputable to continue on the path paved by the 2030 Agenda. This report is both brave and assertive. Congratulations and thank you!

Ramón Almansa López
Chief Executive - Entreculturas Foundation

Every year I laud the publication of the “Health in Development Cooperation and Humanitarian Action” report. In my view, the methodology and content of the report enables it to demonstrate the reality of Health Cooperation and Humanitarian Aid. I have used it as a resource for reports and courses as it sets out an analysis of the situation on a global scale and the gaps between the goals and resources used to meet them. I’m grateful to the authors and editors for the work they do, and I hope it continues to be a benchmark document.

However, I also believe its role to influence the distribution of ODA resources towards health and, within that, towards the different subsectors, has not had the desired effect and I can only make a plea so that between us all we can reach decisions based more on the evidence gathered by the document.

Miguel Casado Gómez
Head of Health Sector
General Directorate of Sustainable Development Policies
Ministry of Foreign Affairs, the European Union and Cooperation

Since its inception, Spanish Development Cooperation has suffered from a regrettable lack of analyses and studies oriented towards transforming policies. This report is clearly an exception. Since medicusmundi and Médicos del Mundo set it up, “Health in Development Cooperation and Humanitarian Action” has been a necessary reference point for anyone wanting to delve into this fascinating debate. I hope we can rely upon it for another 20 years.

Gonzalo Fanjul Suárez
Director of Policies and Analysis
IsGloba

Contributing analyses, reflections, self-criticism and criticism in the humanitarian and cooperation sectors is becoming increasingly relevant. The sector must bravely address the necessary reforms, and the more these are based on evidence, the better. Consequently, this report has contributed to the above over the past twenty years. From our Institute, which monitors international and Spanish humanitarian action, the report by our Médicos del Mundo and medicusmundi colleagues has become a reference point for a better understanding of the sphere of health, its priorities, and the availability of disaggregated data on this sector. Congratulations and keep moving forward, because now, more than ever, we need work like yours.

Francisco Rey Marcos
Coordinator
Institute of Studies on Conflicts and Humanitarian Action

I've read and used this annual report over the past decade. Its content is always of interest and uses solid and reliable data which the authors turn into valuable information for those of us who work in international cooperation and humanitarian aid.

I particularly remember Chapter 1 of a recent report that I’ve recommended to different groups of students in EASP programmes. Maintaining quality and increasingly pertinent documentation and analysis work over such a long period is not easy.

Thank you and congratulations. I hope your enthusiasm and resources to continue “informing” remain the same.

Natxo Oleaga
Researcher and Teacher

Development Cooperation in Navarra has been, and still is, shaped by a strong element of international solidarity in health and, from its origins at the end of the 1980s, has accompanied our local partners in strengthening public health systems in multiple countries. This characteristic has been reliably reflected in this report and has enabled us to grant visibility to and improve our commitment to health for all.

Andrés Carbonero
General Director of Social Protection and Development Cooperation
Government of Navarra

I would like to congratulate you for this report and the 20 years spent drafting it. The report enables data to be corroborated around the attainment of SDG 3 targets related to health and wellbeing and marks out the challenges we must face to ensure nobody is left behind. It demonstrates the impact of the pandemic on public health systems and the weaknesses shown in different geographical spaces; challenges which join already existing ones, showing how the increase in inequality impacts the wellbeing of global citizens.

Such reports help to reassess the role of decentralised cooperation in Andalusia as they show the added value of this cooperation in Spanish Cooperation as a whole and what is entailed in developing actions in closer proximity to citizens and with greater flexibility, creating alliances for health with people at the centre.

Furthermore, the report serves as guidance in cooperation policy as it positions health policies as elements for equality and to reduce inequality, thereby allowing us to search for more integral strategies which allow SDG 3 targets to be addressed in relation to the other SDGs, and with the clear aim of championing the wellbeing of an independent population.

Mª Luz Ortega Carpio
Director
Andalusian Agency for Development Cooperation

The 20th anniversary of the “Health in Development Cooperation and Humanitarian Action” report is a good opportunity to express my congratulations and appreciation to medicusmundi and Médicos del Mundo for having made it possible in this period and for its high quality. The report is a must for gaining insight into the history of and major issues in health cooperation over these years.

In the Department of International Health from the National School of Health, we have often used articles from the report as work and reference materials for students. A big thanks to medicusmundi and Médicos del Mundo and let’s hope the report continues for many more years to come.

Dr. José-Manuel Freire Campo
Professor Emeritus
Ex-Director of the Department of International Health from the National School of Health
Carlos III Health Institute

On this 20th anniversary, I’d like to congratulate Médicos del Mundo and medicusmundi for their annual report. An essential document for understanding the strategic importance of health in development cooperation, to analyse the impact of the fight against poverty and sustainable human development, to situate pending challenges and, most of all, to stress the need to invest in health as a global public asset.

Beatriz Coto Rodríguez
Director
Asturian Agency of Development

A report drafted with responsibility and commitment which places the stress on points which, for those of us who are part of development cooperation, are a source of concern and work.

In Aragón, Health holds a prominent position in the Management Plan of Aragón Development Cooperation 2020-2023; therefore, the report’s recommendations constitute an opportunity in designing and implementing public policies which enable a more just and equal world to exist and in which the right to life and health are increasingly a reality. Congratulations for 20 years of this report!

María Jesús Perich Sancho
Head of the Development Cooperation Service
Government of Aragón

First and foremost, I would like to congratulate Médicos del Mundo and medicusmundi and express my gratitude for and recognition of the excellent work carried out over these years in developing annual reports on Health in Development Cooperation and Humanitarian Action, reports which, in 2021, celebrate their 20th anniversary.

The excellent and meticulous work carried out periodically, incorporating and analysing data on ODA provided by the DGPOLDES Statistics team from the Spanish Secretary of State for International Cooperation, has been a source of information, enquiry and an incentive for reflection for many professionals working in health and cooperation, me included.

María Cruz Ciria Matilla
Head of the Health Sector in the Department of Sectoral Cooperation
Spanish Agency for International Development Cooperation
Ministry of Foreign Affairs, the European Union and Cooperation

Over these 20 years, the “Health in Development Cooperation and Humanitarian Action” report has evolved and become consolidated as a must-read for those of us with a commitment to global health.

A leading document which, through its meticulousness, grants us knowledge on the state and role of Health in Spanish Cooperation policies to, more importantly, analyse its development over time. A useful tool to which we often refer and use to support many of our analyses.

Leire Pajin Iraola
Director of Global Development
IsGlobal

This magnificent report, now with 20 years behind it, is an example of meticulous, detailed and relevant work. It is an essential read every year to gain an understanding of the challenges global health faces, the actions and tensions different actors face, and Spain’s contribution to such challenges. Over the past few years, it has been particularly important, with an international analysis section that is also highly valued beyond our shores.

At different professional stages, as a researcher and head of campaigns and content in different organisations, and now in a UN Agency specialised in global health challenges, this report is a gem.

Congratulations Médicos del Mundo and medicusmundi for these twenty years and all the best for the future!

Jaime Atienza Azcona
Chief, Health Financing
UNAIDS - Geneva

In conjunction with the twentieth edition of the annual report “Health in Development Cooperation and Humanitarian Action”, from AECID we would like to congratulate medicusmundi and Médicos del Mundo on this anniversary for the detailed and motivating work they have carried out over this period.

The global health crisis caused by the SARS-CoV-2/COVID-19 crisis has highlighted, to an even greater degree, the need to strengthen health systems around the world to attain Universal Health Coverage by 2030 (SDG 3.8). Health is a fundamental human right and has been, is, and will continue to be a priority for AECID and Spanish Cooperation.

The comprehensive annual reports are a key asset and a periodic reminder for Spanish organisations and actors working in health, with corroborated data and figures, of the development of ODA, and to integrate lessons learned and encourage us to act accordingly.

Antón Leis García
Spanish Agency for International Development Cooperation
Ministry of Foreign Affairs, the European Union and Cooperation

CooperaSalud

Is an online tool which interactively presents the data, analysis and recommendations included in the Annual Report: Health in Development Cooperation and Humanitarian Action.

These reports are a joint initiative between medicusmundi and Médicos del Mundo, which, since 2002, have provided a critical analysis of international, state and decentralised Official Development Assistance in the sphere of health care and humanitarian action with the aim of improving their quality, effectiveness and efficiency.