There is no doubt that the UK’s Department for International Development (DFID) is a world leader in development issues and has been at the forefront of tackling HIV and AIDS and other health issues, as well as globally championing the Millennium Development Goals (MDGs).
But good health is critical to improving people's lives, as are human rights and concretely addressing inequalities or marginalisation. A White Paper that doesn’t clearly acknowledge the role of health, human rights and inequality puts the UK government’s commitment to these issues into question and casts doubts on their commitment to taking an evidence-based approach to development.
The lack of a mention of health or the MDGs is we’re told because the UK government’s current commitment to improving health still stands. But health is clearly not at the centre of its approach to supporting developing countries to survive the economic crisis.
This is an issue that is clearly of concern to Alliance linking organisations around the world, many of them recipients of DFID funding. All highlight the concern that health and HIV/AIDS are not mentioned.
From Alliance Zambia Lillian Byers, Acting Executive Director said, “As [DFID is] the current coordinating donor agency for health in our country it concerns us that health is not explicitly cited as a critical area for continuing focus.”
“It is impossible to tackle economic growth and fight global poverty, especially in an economic crisis context without explicit and prominent focus on investing in public health, focusing on equality, supporting civil society and improving the effectiveness and transparency of multi-lateral institutions,” adds Paola Pavlenko from Alliance Ukraine.
A child born in a developing country is over thirteen times more likely to die within their first five years. An additional 200,000-400,000 infants are now likely to die due to the effects of the economic crisis.
HIV prevention programmes are in jeopardy. Thirty-four countries representing 75% of people living with HIV already see an impact on prevention programmes that target their high-risk groups. It is imperative that the UK government keeps health high on its development agenda.
Among the recommendations the Alliance is making to the UK government is that commitments to HIV and health require faster action because of the financial crisis, not despite it.
Developing countries need the UK’s support to identify, prevent, react and mitigate against the particular effects of the economic crisis on health.
Aid needs to be channelled more effectively by supporting civil society in its role in service delivery, advocacy and accountability. Avoiding the use of short-term financing and using long-term, predictable funding for civil society organisations can avoid disruption of life-saving services in particular for fragile states.
Reviewing the impact on health in developing countries of the institutions that receive support from the UK government and providing money based on the difference they make on the ground would ensure value for money.
We would want to see the UK leading the reform of international financial institutions like the World Bank and IMF to make them more accountable and relevant by giving developing countries more say in decision-making.
Countries are already experiencing adverse impacts from the economic crisis on their HIV treatment programmes. This is only expected to get worse in regions where countries already face shortages of anti-retroviral therapy or other disruptions to AIDS treatment.
Caroline Halmshaw, Head of Policy
Download the Alliance’s full submission in response to the government’s White Paper or read the letters submitted by Alliance linking organisations in India, Ukraine, Zambia and Cambodia.