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public health

May 9, 2012

Budget cuts to foreign aid: what will they mean for global health?

The budget cuts to foreign aid are bad news for global health but sh

The budget cuts to foreign aid are bad news for global health but should be seen in the wider context of efforts to improve the effectiveness and scale of Australia’s aid program, says Joel Negin, Senior Lecturer in International Public Health at the University of Sydney.

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The cuts will have “an immediate and direct impact” 

Joel Negin writes:

There has already been a flurry of commentary about the 2012-13 budget’s cutback on Australia’s aid promises.  GetUp has asserted that this narrow surplus has been constructed “on the backs of the world’s poor.”

For those of us specifically interested in global health, what are the implications of these changes to the international development assistance program?

Tim Costello at World Vision has claimed that the $2.9 billion in savings over four years will lead to the deaths of up to 200,000 people.

While this is perhaps a dramatic extrapolation of some previous data, the point is valid.  Where Australia provides core funding for vaccination programs and malaria treatments, cutting back on those savings will have an immediate and direct impact on survival in communities that would not have access to those services without our support.

The news from the budget is not all gloomy however.  Following on from the Independent Review of Aid Effectiveness conducted in 2011, the aid program has made some important changes. 

Primary of these is the new focus on the poorest people in the world – signifying a new emphasis on people rather than countries.  The aid program is guided by five strategic goals – the first of which is Saving Lives.  Over 18% of the total official development assistance is allocated to this goal which represents approximately $850 million in 2012-13.

Saving Lives is based on a strong commitment to improving access to quality maternal and child health services and supporting large scale disease prevention, vaccination and treatment.  One of the other focus areas for AusAID is providing clean water and sanitation services to the poorest communities.  Improved sanitation and clean water makes a tremendous contribution to improved health but has largely been neglected by the public health community.  Toilets just aren’t that popular as a health message!

Australia’s water and sanitation efforts are particularly robust in sub-Saharan Africa – which saw a substantial increase in funding to over $350 million.  Programs will provide safe water to almost 200,000 people in Zambia, Malawi and Mozambique and will restore water services for more than a million in Zimbabwe.  Sanitation facilities will also be provided in the Solomon Islands and elsewhere.

Immunisation remains a pillar of Australian aid efforts with a $20 million contribution to the Global Alliance on Vaccines and Immunisations and specific programs in Fiji and elsewhere in the Pacific to immunise an additional 41,000 children.  Polio vaccination programs are also planned for Tanzania.

Though I am critical of the government’s budgetary decision, it is important to note that the aid budget has been increasing dramatically over the past decade.

In 2000-01, the aid budget was $2.4 billion (in current dollars) and in 2011-12, it was $4.8 billion.  This year it will be $5.1 billion rather than the $5.5 billion originally planned.  The aid budget is still forecast to reach almost $8 billion in 2015-16.  This represents an unprecedented scale-up in the aid program and an immense challenge for AusAID and all those involved in delivering this program.

Thankfully, with this budget has come a number of measures to improve the effectiveness of the aid program including the establishment of a clear Results Framework and an Independent Evaluation Committee.  Additionally, more of Australia’s aid will be delivered through multilateral partners such as the GAVI Alliance, UNICEF and the Global Fund for AIDS, Tuberculosis and Malaria.  This represents more efficient ways of spending taxpayer dollars to achieve measurable health outcomes.

The Australian government has made a real commitment to improving the effectiveness of its aid program and AusAID has delivered better results over the past two or three years.

It is a real pity that this progress has been hindered by politicians who used to assert that increasing aid was a bi-partisan article of faith.  Now that development assistance has been cut to expedite other political goals, what is preventing future governments from cutting further?

• Joel Negin is Senior Lecturer in International Public Health at the University of Sydney

 

 

 

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