Comparative Funding & Finances

Population assistance as defined at the International Conference on Population and Development (ICPD) which took place in Cairo in 1994, includes support for the following areas related to sexual and reproductive health:

• Family planning services
• Basic reproductive health services
• Sexually transmitted disease/HIV/AIDS prevention programs
• Basic research, data and population and development policy analysis

At the ICPD conference, it was estimated that it would cost US $18.5 billion annually by the year 2005 to meet the needs of developing countries. The international community pledged to share the costs, with donor nations pledging to provide one-third or $6.1 billion. However, funding still falls short. In 2004, population assistance levels stood at US $5.6 billion, up from $4.7 billion in 2003. While substantial gains were realized in population assistance in recent years, that term includes assistance related to HIV/AIDS prevention, which has claimed the bulk of new spending. Funding for family planning has actually fallen. In 2004, 45 percent of population assistance supported HIV/AIDS prevention, while only 9 percent was allocated to family planning.[1]

Moreover, actual resource needs are dramatically higher today than estimated need was projected to be when it was drafted in 1994— particularly when the figures are adjusted for inflation. This is largely due to increasing demand for family planning as more and more women seek choices in childbearing, the increase in the number of women of reproductive age as large populations of youth move into childbearing years and the growth of the HIV/AIDS epidemic (and some increase in the estimate of need is due to the expansion of the definition of population assistance).

Population assistance is dispersed either bilaterally (money given by wealthy countries to developing countries) or multilaterally (money from several sources is channeled through one institution before being given to developing countries). The largest bilateral population donor countries in 2004 were the United States, the United Kingdom, the Netherlands, Japan and France. Sweden, Norway, the European Union and Germany also give substantial support to population activities.[2] Although the U.S. may be the largest donor in terms of total funding given, it falls far behind many European countries in terms of funding per GNP, and ranks at the bottom of all donor countries in percentage of total official development assistance (ODA) allocated to reproductive health.

Multilateral funding institutions mobilizing resources on sexual and reproductive health include United Nations agencies-led by the United Nations Population Fund (UNFPA), the World Bank and other development banks, World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Private donors and foundations have been playing an increasingly significant role as well.  High profile individuals and foundations have had an enormous impact on funding for sexual and reproductive health.

Just as important as increasing and strengthening population assistance from donors is increasing the support given by recipient countries themselves. Developing country spending on reproductive health varies widely among countries and regions, and tracking progress is hampered by difficulties in obtaining accurate data. As a result of the African Summit on HIV/AIDS, Tuberculosis and other Related Infectious Diseases in 2001, the Heads of State of the Organization for African Unity signed onto the Abuja Declaration, committing to spend 15 percent of their countries’ annual budgets towards improving the health sector. No African country has yet met this commitment.  Raising more resources and commitment for family planning not only from African countries but from other developing country governments as well remains a great but challenging opportunity.

Development assistance is far more complex now than it was during the time of the ICPD. There are new terms, funding systems, institutions and international declarations guiding foreign assistance. Large amounts of money have been committed for disease-specific initiatives, but they have largely been reserved for high-profile diseases such as HIV/AIDS and malaria, leaving family planning programs often overshadowed. European donors and the World Bank have adopted development financing mechanisms that emphasize a holistic health systems development approach while incorporating aid effectiveness mandates such as country ownership and alignment with country development priorities. It is hoped that these mechanisms will better enable donors to follow aid effectiveness protocols such as those outlined in the 2005 Paris Declaration on Aid Effectiveness. In this ever-changing and increasingly complex environment, coordination, collaboration and communication among bilateral donors, multilateral organizations, private foundations, NGOs and developing country governments is key to long-term success in providing quality, integrated services to those who need them.
 

1 Source: UNFPA, 2005. Financial Resource Flows for Population Activities in 2003. New York: United Nations, and Netherlands Interdisciplinary Demographic Institute, 2006. Financial Resource Flows for Population Activities in 2004, preliminary draft.

2 Some donor countries channel much of their population assistance through multilateral institutions, but they are still referred to as “bilateral donors.”